MOC’s Conflicts of Interest

How much do you know about the American Board of Medical Specialties’ Maintenance of Certification and the American Board of Internal Medicine’s recent 25% fee increase in a single year for their new MOC alternative, “Longitudinal Assessment?”

We’re trying to find out, so our elective representatives, state medical societies, and the IRS can know, too.

If you haven’t done so already, please take our anonymous survey and share it with your physicians colleagues by email or social media. (It takes just three minutes to complete).

Thank you all.

A Radiologist Reviews the Siva v ABR Oral Arguments

Ben White, MD (a practicing radiologist) gives a cogent (albeit limited) review from a doctor’s perspective of the Siva v American Board of Radiology oral arguments presented 16 February 2022 to the three judges of the 7th Circuit Court of Appeals on his blog:

In response to the ABR’s it’s-my-party-and-I’ll-cry-if-I-want-to stance, the judge is flabbergasted:

“There’s no possible way…You can’t take the position that ‘we are the ones that certify and therefore we can define the content of the certification requirement without regard to the limitations of section 1 [of the Sherman Antitrust Act].’ That cannot possibly be your position”.

The ABR lawyer says no, but she’d just said that very thing and then literally reiterates it again in almost the same words.

This was presumably met with a long blank stare during the very pregnant pause in the audio.

So, she meant yes.

And the ABR is not entirely wrong, because MOC isn’t really a CPD product. The CPD part of MOC (OLA) is merely the veneer of credibility for the program. MOC isn’t really about CME.

It’s a tithe.

Read the whole thing.

ABIM Raises Annual MOC Fees 25% for 2022

The American Board of Internal Medicine (ABIM), in the midst of a global pandemic and record levels of physician burnout, medical education debt, and retirements, added insult to injury to the dwindling internal medicine physician workforce by raising their annual Maintenance of Certification (MOC) fees 25% from $165 in 2021 to $220 in 2022. Physicians with more than one certification can add another $120 per year for each additional certification the want to “maintain.”

Physicians receive nothing new to explain this massive single-year increase in fees for their “MOC points.” It is just the same old every-10-year high-stakes test (or if a doctor prefers, answering hundreds of proprietary timed “longitudinal assessment” questions pushed to their cell phone as they try to do their jobs).

Because the ABIM’s MOC product is now indelibly tied to the validity of a doctor’s initial ABIM specialty board certification, physicians that work at hospitals that require board certification from an American Board of Medical Specialties’ member board like ABIM, they will be left with little choice but to pay the fees and participate in this product’s requirements if they want to maintain privileges at those hospitals.

But that is not how it always was. And while the Court of Appeals of the Third Circuit sided with ABIM in the antitrust suit against them, in oral arguments (1:57:00 in the transcript) before the judges of Court of Appeals of the 7th Circuit in a similar lawsuit against the American Board of Radiology (ABR), the judges seemed to take notice of the importance of the HISTORY of how that tie was established. While we cannot predict how the Appellate judges will rule in the ABR antitrust case, there might be a glimmer of hope for working physicians employed at hospitals to end the gaslighting and forced participation in ABMS Maintenance of Certification for credentialing if the court remands the ABR case back to the District Court level.

Physicians interested in help in the forced participation in the unproven MOC program are encouraged to join PPA (its free and allows us to know who our supporters are) and consider a donation to the legal effort via our GoFundMe page or directly to PPA and (earmarking your donation “Legal” in comments).

122 Million Reasons Why Psychiatrists and Neurologists Should Help End MOC

From the first amended complaint in the class action antitrust lawsuit filed against the American Board of Psychiatry and Neurology (pictured here):

MOC is not about maintaining standards as ABPN contends. It is a revenue-driven commercial endeavor, motivated by tens of millions of dollars in new MOC fees.  As indicated by the failure of its earlier voluntary (continuous professional development) CPD product, MOC is financially successful only because it is mandatory and tied to certifications. ABPN’s financial results amply document this. After the launch of MOC, from 2004 through 2018, ABPN’s “Program service revenue” exceeded its total expenses by a yearly average of $4,448,338, as reported in its Forms 990 filed with the Internal Revenue Service (“IRS”). But for its reporting status as a supposed not-for profit organization, this translates into almost $4,500,000 in average annual profits before investment and other income is taken into account.

During the same time, ABPN “Net assets or fund balances” skyrocketed over 971%, from $12,610,227 at the beginning of 2004 to $122,470,594 in 2018. In other words, while it took ABPN almost seventy years to accumulate net assets (assets less liabilities) of $12,610,227 from selling certifications, ABPN net assets increased almost ten-fold to $122,470,594 as a result of selling MOC, including $97,169,079 in cash, savings, and securities on hand at year-end 2018.

Learn more about our fight to end Maintenance of Certification and what you can do,