On Sep 21, 2023 to much fanfare and carefully produced press release, the American College of Cardiology and its subsidiary, less political, organizations including the Heart Failure Society of America (HFSA), the Heart Rhythm Society (HRS) , and the Society of Cardiovascular Angiography and Interventions (SCAI) announced their plans to create a new cardiovascular board to compete with the American Board of Internal Medicine (ABIM)’s initial and career-long continuous certification programs (known as Maintenance of Certification or “MOC”).
“Together, the consortium will submit an application to the American Board of Medical Specialties (ABMS), requesting an independent medical Board for cardiovascular medicine to pursue a new competency-based approach to continuous certification—one that harnesses the knowledge, skills and attitudes required to sustain professional excellence and care for cardiovascular patients effectively. ABMS remains the only authority widely recognized by the public, regulators and payers for initial and ongoing physician certification in the U.S. The new Board will replace the “Maintenance of Certification” approach with a pathway to continuous certification and competency, offering diplomates convenience, support, choice and credit for the learning that physicians currently do to keep their knowledge and skills at the highest level.”
While few details are evident in their announcement, a fairly balanced preliminary review of the announcement from physicians was covered by Michael O’Riordan at TCTMD. Practicing Physicians of America remains skeptical of the ability to the new Cardiovascular Board to effect the ability to end the unproven and discriminatory MOC program, in large part because this new “board” must pass muster with the ABMS, a member organization of the Accreditation Council for Graduate Medical Education (ACGME). In our view, this makes it unlikely that the regulatory capture of physicians by ABMS MOC program and its flawed “continuous certification” will end. Instead, the new “cardiovascular board” may just redirect working physicians’ CME funds to their organizations rather than sharing a portion of those funds with the ABIM. It is quite likely that the ABMS won’t care if the new cardiovascular board usurps the ABIM’s funds as long as money (and data) generated by some form of lifelong exercises/assessments keeps flowing to ABMS Solutions LLC and continues to grow their monopoly over Maintenance of (state) Licensure (MOL) relative to physician self-directed continuing medical education (CME).
Recall that the ABIM (the largest member board of ABMS) was unilaterally changed the once fully voluntary lifelong board certification credential to a time-limited one that demanded career-long fees from physicians without any credible evidence of its value to patient care and safety. They even managed the have MOC included as a “quality registry” in the Affordable Care Act through extensive lobbying in Washington DC. This regulatory capture of physicians greatly benefits insurers, hospitals, pharmacy benefit managers, group purchase organizations and many others health care intermediaries at the expense of working physicians and their patients. The new cardiovascular board will likely have to play in this ABMS/ACGME sandbox if it stands a chance of widespread acceptance with the insurance and hospital industries.
So tread likely, cardiovascular specialists, and be careful what you ask for and create. Despite how powerful your cardiovascular organizations might think they are, they are are no match for the much more powerful organizations playing the Big Money games with health care in Washington DC.