Page 10 - Delaware Medical Journal - May 2017
P. 10
PRESIDENT’S PAGE
were randomly selected at four types of settings in Washington, DC, (coffee shops, metro stops, senior centers, and community centers) revealed that when it comes to having a good experience with a doctor, the following matters:
• Having a doctor who listens to them (85%).
• Having a doctor who is caring and
compassionate (71%).
• Having a doctor who explains well (69%).
• Having convenient and quick access to
health care (47%).3
• Participating in ABMS MOC has done
nothing to gauge one’s abilities in these areas.
obtain staff privileges at many hospitals in the state and is also required by many insurers. While MOC is not required for licensure in the State of Delaware, the Federation of State Medical Boards has long been in discussions about instituting a maintenance of licensure program (MOL) similar to MOC and based on principles of lifelong learning. The major components of what is known about effective lifelong learning in medicine:
improvements can I make?)
• Assessment of Knowledge and Skills (What do I need to know and be able
to do?)
• Performance in Practice (How am I
4
To pose these questions to ourselves is quite reasonable. However, this process relies heavily, but not exclusively, on ABMS MOC. As a medical society,
we need to make sure that our options for demonstration remain open and are not exclusively tied to an organization which has betrayed the trust of many physicians.
So where do we go from here?
MSD has started to engage with others, including the hospital systems, in this process. We do not enter into these discussions blind to the fact that MOC is strongly supported by many hospitals and insurance companies and that hospitals
have invested heavily in creating options
for physicians to participate in MOC. And while the ABMS member boards continue
to make changes to their process, they fail Shorter exams taken on personal devices without the need to attend a secure testing yet we hear nothing of a reduction in MOC fees from ABMS. If you are not already aware, physicians are spending almost 10 times the cost of the board exam just to participate in this process. A cost analysis
of the American Board of Internal Medicine MOC process showed the following:
• $23,607 spent per internist every 10 years (95% CI, $5380 to $66,383) 2015
• Cumulatively MOC costs $5.7 Billion/ 10 years
• 32.7 million physician-hours spent on MOC.5
MSD seeks a better way for physicians to have satisfaction in their careers, decrease burnout, and demonstrate that they can provide excellent patient care to Delaware’s patients. We propose that hospitals allow physicians to participate in alternative MOC pathways for the purposes of maintaining staff privileges. A CME-based pathway with additional credit hour requirements acceptable. Allowing MOC through the National Board of Physicians and Surgeons would unburden doctors greatly and still require more participation in CME than is required by the Board of Medical Licensure and Discipline. Some administrators and physicians will argue that CME is just not
good enough to demonstrate that a physician is committed to patient safety. To this, I and patient safety data comparing MOC physicians with non-MOC physicians is lacking. Furthermore, many physicians
are participating in quality and safety measures every day. MSD would propose that if you are a medical director or a training program director, then you should be afforded credit for these activities in terms of demonstrating quality and safety. Lastly, we invite hospitals and insurers to work with us to create an alternative third pathway which would provide direct local impact on the quality and safety of our patients here in Delaware, relieve the burden on our already high percentage of burned out physicians, and restore the focus of health care to the patient!
Prayus Tailor, M.D.
President, Medical Society of Delaware
REFERENCES
1. Cook DA, Blachman MJ, West CP, Wittich CM. Physician attitudes about Maintenance of Certification. Mayo Clin Proc. 2016;91:1336- 1345.
2. Medical Society of Delaware (2016, July 27). MSD eNews and Views. Retrieved and accessed March 31, 2017.
3. Wen LS, Tucker S. What do people want from their health care? A qualitative study.
J Participat Med. 2015; 7:e10.
4 Federation of State Medical Boards. FSML Maintenance of Licensure (MOL) Task Force on Continuous Professional Developmental (CPD) Activities. March 11, 2014. Available at: www.fsmb.org. Accessed April 7, 2017.
5 Sandhu AT, Dudley RA, Kazi DS. The cost analysis of American Board of Internal Medicine’s Maintenance of Certification Program. Ann intern Med 2015; 163: 401- 408.
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