Blog | Tuesday, February 4, 2014

Maintenance of Certification, or extortion?


I trained in internal medicine and cardiology at the tail end of the era of lifetime board certification by the American Board of Internal Medicine. In fact, my timing was perfect; I was “boarded” in medicine in 1987, and in cardiovascular disease in 1989, which (I am pretty sure) were, respectively, the last years that the ABIM offered certificates without an expiration date in those disciplines.

Late last year, I received a ABIM letter about my “enrollment status” in the ABIM’s maintenance of certification (MOC) program, which stated, among other things, that:
• I was not enrolled in the MOC program;
• My ABIM certifications were “valid indefinitely;” and
• I could enroll in the MOC program in January, and by so doing, would hence forth be listed as “Certified, Meeting MOC Requirements”

I thought this all a bit strange. After all, how could there be MOC requirements if the certificate was “valid indefinitely?” I didn’t give it much thought until last week, when I tried to enroll. After a tedious registration process and a very long and somewhat annoying mandatory survey, followed by several more verification steps (medical school, NPI number and state license) I finally got to the enrollment page, where I was asked to provide credit card information to cover the annual $353 charge (including “applicable discounts”). Now I was really confused, so I called the ABIM.

After a bit of back and forth, here is what I learned:
• Yes, my board certification is valid indefinitely;
• If I don’t “enroll” in the MOC program, I will be listed as “certified, not meeting MOC;” and
• I don’t have to actually do anything except pay the registration fee to be listed as “meeting MOC”

Does this make sense? I have no requirements, but if I don’t pay $353 a year, I will be listed as not meeting requirements? What requirements? I thought I had a certificate that was valid indefinitely!

The only conclusion I could come to is that I was being shaken down by the ABIM, which was saying, in essence, that they would officially downgrade my status if I didn’t play ball and pay up. Whatever you think of MOC, this seems like nothing more than extortion to me.

What do you think?

Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital. He then held a number of senior positions at Mount Sinai Medical Center prior to joining North Shore-LIJ. He is married with two daughters and enjoys cars, reading biographies and histories, and following his favorite baseball team, the New York Yankees, when not practicing medicine. This post originally appeared at his blog, Ausculation.