The ABIM won't revoke an internist's board certification if they don't complete the program's suspended aspects, according to the announcement. Those who have met all requirements except for the self-assessment portion (which was suspended for at least two years) will get a new certificate this year. It also stated that the ABIM will have “new and more flexible ways for internists to demonstrate self-assessment of medical knowledge” by the year-end and that the exam will be revised by this fall to be “more reflective of what physicians in practice are doing.”
Physicians have pushed back against the new requirements, and the program has been harshly criticized at recent meetings of the American Medical Association House of Delegates. The ABIM has certified the competency of some 200,000 physicians in internal medicine and 20 other subspecialties. As the largest medical board, the ABIM has faced the loudest criticism of its MOC program.
Doctors have characterized it as a revenue generator rather than a meaningful exercise. An online petition posted last March has drawn more than 22,000 “signatures” calling for the program to end.
The AMA said in a statement that it was “delighted” that the board was listening to physician concerns and that the ABIM would align the MOC program with principles the House of Delegates called for at its November 2014 interim meeting in Dallas.
But the board's course correction didn't satisfy Dr. Westby Fisher, an internist and cardiologist with the NorthShore University HealthSystem in Evanston, Ill., who has been one of the most pointed critics.
“The American Board of Internal Medicine deployed some chaff in an attempt to ward off a flurry of incoming Exocet missiles aimed squarely at its yearslong history of corrupt and coercive financial dealings, gross mismanagement and entirely unproven Maintenance of Certification program by saying simply, 'We got it wrong and sincerely apologize,' ” Fisher wrote in a blog post.
Fisher instead praised the efforts of Dr. Paul Tierstein, who has developed an ABIM alternative organization known as the National Board of Physicians and Surgeons.
Teirstein, meanwhile, characterized the ABIM moves as “clearly a step in the right direction,” but also said in statement that the board needs to do more.
“It must be stressed that the changes disclosed today are only a very partial, initial fix,” wrote Teirstein, who is chief of cardiology and director of interventional cardiology for the Scripps Clinic in San Diego. “The current MOC requirements are still onerous, not clinically relevant and too expensive.”
Dr. Patrick O'Gara, president of the American College of Cardiology, called the ABIM decision “welcome news.”
“Last year's significant changes to the program generated legitimate criticism and sparked heated discussions—including among members of the cardiovascular community,” O'Gara said in a news release. “The changes announced today are encouraging and the ABIM should be recognized for listening to the physicians and specialty societies—including the ACC.”
Hospitalist and patient-safety advocate Dr. Robert Wachter tweeted that the ABIM made the “right call.”
Even while apologizing and promising an improved version of the MOC program, the internal medicine board emphasized that it's important for physicians to have “publicly recognizable ways” to demonstrate their knowledge. “The goal is to co-create an MOC program that reflects the medical communities' shared values about the practice of medicine today and provides a professionally created and publicly recognizable framework for keeping up in our discipline,” Baron wrote in his letter on the ABIM website.
The American Board of Medical Specialties has maintained that patients want to know if their doctors are board-certified, noting that it receives 1 million annual visitors to its Certification Matters website, where patients can check their physician's status.
Follow Andis Robeznieks on Twitter: @MHARobeznieks