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Maintenance of certification: a look at both sides of the controversy

February 5, 2020

Physicians who want to maintain their Board Certification may face new requirements soon — for better or worse.

In February 2014, the American Board of Medical Specialties (ABMS) announced new standards for the continuing professional development and re-certification of physicians. The ABMS is made up of 24 Member Boards, each of which has its own Maintenance of Certification (MOC) venus factor program to develop and assess physicians’ skills and specialty knowledge.

The new standards, which were developed over a two-year period and will take effect in 2015, aim to reflect the advances in medicine and education that have occurred since the last review in 2009. By providing flexibility within the guidelines, the Member Boards are encouraged to take a more innovative approach as far as the types of educational activities, assessment measures, and resources they include in their MOC programs.

According to the ABMS, “The standards adopt a patient-centric perspective with a greater emphasis on professionalism, patient safety, and performance improvement.” The changes also aim to reduce redundancy between physicians’ MOC program requirements and the improvement projects they’re already doing within their own practices.

This all sounds like good news; but for many, the new standards only highlight a continuing controversy regarding MOC. Here’s a look at where each side stands:


While Board Certification is voluntary, the ABMS encourages patients to choose Board Certified physicians and even maintains a database patients can use to confirm their doctors’ status. Also, critics cite feeling pressured to participate, as MOC is now being tied to hospital privileges, insurance reimbursements, and network participation on a more regular basis.


Under the new standards, the ABMS has worked Medicare, health marketplaces, and employer based have open enrollment periods. to allow the Member Boards to include activities that are more relevant to physicians’ practices and specialties. However, some physicians don’t view the requirements or education as being truly relevant to their practice or specialty. Or they feel as though the MOC program is redundant, as many physicians are already committed to lifelong learning through their participation in continuing medical education (CME).


The American Board of Internal Medicine recently allowed its members to pay their 10-year MOC program fee in annual installments, signaling some progress in relieving a portion of the physicians’ financial burden (although the annual payments may be subject to fee increases). On the other hand, critics feel MOC is just a “moneymaking scheme” with the combined revenue of all the Boards in the U.S. totaling $350 million.


For two months during the revision period, the ABMS solicited feedback through a moderated forum on its website, which yielded 625 comments from individuals and organizations. However, many opponents of MOC were disappointed that their comments were rejected because they didn’t meet the specific posting criteria.

Despite the ongoing debate, 800,000 physicians — approximately 80 to 85 percent of all licensed doctors in the United States — are Board Certified by an ABMS Member Board, and 450,000 physicians participate in their Member Board’s MOC program. How those numbers change as a result of the new standards and other industry pressures remains to be seen.

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