ACC Member
Perceptions of MOC
Washington Chapter
• Online survey distributed by U.S. ACC Chapters to chapter members.
• Survey live April 23 – May 26, 2014. At least one reminder emails sent.
• Completes:
• n=4,406 ACC members completed the survey
• n=95 Washington ACC Chapter members completed the survey
Methodology
TENURE
Total
Washington
ACC U.S.
MD Membership
In training
11%
6%
10%
1 - 7 years
16%
21%
21%
8 - 14 years
13%
15%
13%
15 - 21 years
15%
14%
15%
22 - 28 years
20%
21%
13%
29 or more years
23%
20%
28%
Not in practice
1%
3%
--
No response
<1%
--
--
Total
4,406
95
32,001
Respondent Composition
Key Findings
•Overall, ACC Washington Chapter Members mirror those in the rest of the U.S.
with respect to attitudes toward MOC.
•While most members who responded to the survey are aware of the recent
MOC changes, they are not as familiar with all of the particulars.
•There is strong opposition to the changes and opposition is universal, cutting
across generation. Much of this opposition is driven by the high financial and
time costs associated with the new requirements and lack of perceived value.
•Members want the ACC to work with ABIM to revise the MOC requirements – to
remove the MOC requirement, assume certification responsibilities, revert to
pre-2014 requirements and/or remove practice improvement modules from the
process.
Awareness of 2014 MOC Requirements
Q. Are you aware of the changes that American Board of Internal Medicine (ABIM) made to its Maintenance of Certification (MOC) program as of January 2014?
Description of MOC
On January 1, 2014, the American Board of Internal Medicine (ABIM) implemented changes
to its Maintenance of Certification (MOC) program. The changes to the new MOC
requirements are extensive and will apply to all certified physicians, including those
originally grandfathered.
Changes to ABIM’s MOC program requirements are designed to engage all ABIM diplomates
in MOC activities on a more frequent, or continuous, basis to demonstrate that physicians
are maintaining their certification and “Meeting MOC Requirements.”
Meeting MOC Requirements will be defined as passing a secure examination after training
and maintaining a 10-year certification contingent upon completing MOC activities as
follows:
• Some MOC Part 2 or Part 4 activities are required every 2 years
• 100 MOC points are required every 5 years (20 points minimum in both Part 2 and Part 4)
• Completing patient safety and patient survey modules required every 5 years
2014 MOC Familiarity
Q. How familiar are you with all of the changes that the ABIM has made to its certification / recertification process?
Total Washington
Very Familiar
56%
53%
2014 MOC Favorability
Q. Do you favor or oppose the new ABIM MOC requirements?
Total Washington
Total Favor
4%
4%
Total Oppose
87
%
87%
Perceptions of Cost
MOC Effect on Future Plans
Q. Have these recent MOC requirements affected your planning for the future, specifically thoughts of retirement, part-time practice or transitioning out of the practice
Total Washington
Total Yes
32%
34%
Total No
37%
41%
Recommended MOC Process Revisions
Q. If you were tasked with revising the MOC process for cardiologists, which of the following would you recommend? Please select all that apply.
Recommended ACC Support
Q. Recognizing that the ABIM is a completely separate and independent entity from the ACC, how could the ACC best serve its members regarding the MOC requirement changes from ABIM? Please select all that apply.
Remove MOC requirements
Assume certification
CardioSource.org Helpfulness
Q. The ACC currently provides resources on CardioSource.org to assist members in meeting the ABIM MOC requirements. Using the following scale, how helpful are these CardioSource.org resources?]
Total Washington
Very Helpful
35%
36%
Not Helpful
13%
11%
*ALL Q. And lastly, please provide any final comments that you would like ACC leadership to know concerning
RESPONSES the 2014 ABIM revised requirements concerning Maintenance of Certification.
From the Mouths of Members …
Q. And lastly, please provide any final comments that you would like ACC leadership to know concerning the 2014 ABIM revised requirements concerning Maintenance of Certification.
• ABIM certification has little to do with competency or actually improve care. It is time for ACC in conjunction with ABIM to revisit post graduate education into a more supported and functionally process that reduces care variability. A legislatively required ongoing educational program, funded by health care (insurance companies and Hospitals) to support ongoing training and testing (similar to commercial airline pilots) would be optimal
• ACC should advise ABIM to keep current with CV trends. They need to lower the PCI annual procedural requirements- 75/yr is not
consistent with the current ACC/SCAI 50 per year requirements. The days when 75/yr are over. Cases are not easy to come by nowadays.
• As a person doing further fellowship training I am being overwhelmed with the continued regulation at very large expense to me. I just
took the boards for >$2000, echo boards for >$1500, now just signed for the heart failure board for >$2800 and may sign up for the nuclear boards. None of this was necessary for the generations that proceeded me. Further given how old we are coming out of fellowship, I have three children and given how poor public education is in metropolitan areas, they are in private schools. Lastly, ABIM does not allow us to moonlight like prior generations did so I am persistently cash strapped. To add insult to injury, within hours of paying large amounts of money to boards, I suddenly get barraged with expensive review course adds, so see ABIM making money from several angles. The boards are enough, the MOC is redundant and unnecessary (and expensive). This is all becoming one great self-perpetuating bureaucracy.
• Each year there seems like there is a new way to regulate, charge and complicate a physician's ability to practice. In a very busy
environment adding new complexity onto of all the other complexity of running a program is counter productive.
• Essentially revoking "grandfather" status after decades of honoring it, is a breach of an agreement made between physician's and the ABIM. They need to reconsider unilaterally changing the rules.
• Essentially, ABIM is charging $300/year to not say bad things about practicing cardiologists.
• Every 10 year exams are OK. Rest of the MOC is useless.
• I am not sure what the ABIMs goals are. They say quality but that is a farce, nothing about the changes will monitor for quality. If they just want more money, just say so, But don't take more money and make life more difficult. I am a good physician and strive to do well for my patients. Just feels like no one is on the doctors side anymore. We take board exams, go to meetings. That should be sufficient. I was very discouraged by the ABIM.
• I am now retired but still involved with QA at my hospital.
• I am so glad (and surprised) you are getting involved. I have felt intimidated and frustrated for the last six months ever since I first heard of this MOC process and then tried, under duress, to comply. My hospital has already been inquiring about why I am no longer certified, and what my plans are to remedy the situation.
From the Mouths of Members …
Q. And lastly, please provide any final comments that you would like ACC leadership to know concerning the 2014 ABIM revised requirements concerning Maintenance of Certification.
• I have been in practice for 19 years as a Cardiologist, and Electrophysiologist. I have taken the Cardiology Boards in 1993, 2003,
2013 and EP in 1994,2004, and will take the EP Boards in three weeks. The time and expense in taking and preparing for Boards along with CME needed for our Echo lab accreditation is becoming increasingly more difficult to manage along with the need for CME, maintaining meaningful use with EHRs. I enjoy the practice and art of medicine. I enjoy continued learning and the benefits it provides to my patients. However I am spending more time away from my patients and family in order to meet these increased demands from all sides. I would appreciate some more balance in my professional career and would wish that for all physicians.
• I have been very disappointed in the ABIM ---- after multiple phone calls trying to get someone to evaluate a project I have been
involved in RE: appropriateness criteria for percutaneous coronary intervention --- and whether it would satisfy the PIMS --- no response. I would like an answer before I put in a lot of time and then learn it is not acceptable.
• I have used the abim site for tracking all of my moc activity. The cost of recertification is enormous. I have 4 certifications- 3 w/ abim and 1 w/ cbnc. In the future I will keep one and the travel/hotels/time away from work/ exams, etc. is not work the value engendered by the recert's.
• I think that the MOC requirements are intrusive, expensive, take time away from patient care and have not been shown to improve
patient care. At a time when more and more tasks and responsibilities are being pushed onto physicians and taking us away from patient care, I expect organizations like ACC and ABIM to help improve this environment rather than create more regulations and hurdles for practicing physicians.
• I took all the MOC requirements and completed them. I took the examination that we take every 10 years twice and did not pass. I am
going to take it a third time. It seems that the examination has changed. More like Cardiology trivial pursuit. My patients still seem to like me.
• In my opinion, a full time practicing specialist in cardiovascular medicine is exposed to real-world scenarios that constitute
'maintenance of certification' with far greater relevance than the exercises devised by the ABIM. I've engaged in one such MOC activity thus far and it was truly a waste of my time. Further, the fees the ABIM is charging for this 'service' are exorbitant and borderline extortionist. This process is broken, irrelevant and overpriced. It should be revamped. It won't cause me to quit medicine earlier, but it will further sour my mood while trudging through the increasingly demoralizing experience of 'doctoring' in this country.
• It is unclear to me what the benefit of the MOC is. I am fully supportive of the need for ongoing education, but this appears to be misdirected with uncertain motivation, and a significant added expense.
• It is very confusing. I just re-certified in Internal Medicine and still don't completely understand the process. I'm really not looking forward to the Cardiovascular Medicine re-cert in a couple years. This process needs to be simplified and as a cardiologist, I would be very reassured to have more ACC involvement. It is very clear that the ABIM seems to be overstepping in their role and while board certification is important and should be meaningful, it can't be this confusing. Hopefully the ACC can help us with cardiology-specific tracks and assistance in the entire MOC process.
From the Mouths of Members …
Q. And lastly, please provide any final comments that you would like ACC leadership to know concerning the 2014 ABIM revised requirements concerning Maintenance of Certification.
• MOC is an extra burden for physicians. We already go thru certification process with the Cardiology boards, Echo Boards, Nuclear
Boards and in my case next year ACHD boards. MOC appears just a strategy for ABIM to make more money... Stop this nonsense economical driven requirement!!
• MOC should not require a secure exam. The cost and inconvenience are unnecessary. Exams can be given as modules to be
performed online.
• No other profession requires a expensive exams and stringent recertification criteria that physicians and cardiologists are faced with.
That too now with rapid decline in reimbursement, increase in workload with aging population. Yearly CME requirements should be sufficient and would allow physicians to devote time to patient care.
• Not required at all. Has it ever been showed that even board certification leads to better patient care or clinical outcomes , then why to
implement more of the same in the form of MOC.
• Oppose ABIM from expensive, non productive, and totally useless MOC requirements.
• Physicians are being bombarded by "performance improvement" requirements from insurances, hospitals, ACOs. We need a unified
process. For example, as an interventional cardiologist and nuclear board certified cardiologist, I am already required to maintain CMEs for several boards, participate in "door to balloon" initiatives, etc. I also have a family to raise and support. I would like the ACC to be sensitive to physicians practicing in the community and make recertification less burdensome!
• Practice improvement modules (PIM's) are mostly a waste of time for me and my staff
• See above. I recently did a portion of ECHO-SAP and this should be eligible for MOC certification.
• since ABIM is not going to eliminate MOC (it's too lucrative for them, and it will make the leadership feel like they are improving quality whether that ultimately proves to be true or not, and it looks good in the public eye) it would be best for ACC to figure out how
members can best satisfy requirements both for those who wish to spend as little time as possible in these activities, as well as those who wish to get the most return from the time that is invested.
• The ABIM is using its monopoly in order to effect a simple money grab without real data to support any significant benefit derived from
these changes.
• The ABIM website is very user unfriendly; points to lack of respect given to providers by that organization.
• They are at best tone deaf. Physicians are under siege and they are making it worse. I'm not interested in yet another agency telling
me what to do, how to spend my time or how to educate myself. They have also committed a contractural breach by changing requirements of Grandfathered physicians. They are participating in the degradation of the practice of medicine. Your costs are too high.
From the Mouths of Members …
Q. And lastly, please provide any final comments that you would like ACC leadership to know concerning the 2014 ABIM revised requirements concerning Maintenance of Certification.
• This is an outrageous imposition requiring incessant "product" from ABIM. The current modules for "Practice Improvement" are nothing less than idiotic.
• This is just a big money making scam by ABIM. To be recertified in Internal Medicine, Cardiology, and Electrophysiology is hundreds
of dollars a year, or I can 'prepay' the thousands of dollars every 10 years. I don't have a big problem with the actual requirements, it's the extreme cost.
• This moc revision is yet another hurdle for cardiologists to jump through.
• Those changes are horrible, and some of us are considering about quitting recertification by ABIM. ABIM is the only party benefiting
tremendously financially from those changes, patients and providers benefit nothing from those changes.
• TOO MANY RECERTS ; Intervent Cardio, Nuc Cardio, Echo Cardio for me and now this . WHEN will it end ?? Too many bureaucrats
wanting income / livelihood from tests / recert . This is crazy and is driving young people away from cardiology and older ones to retire early
• We all have a lot of work to do. Stop adding more and more requirements.
• We should demand a change
• What do you recommend for retired volunteers?
• What the hell are they doing? And why? Are they after more money, and why do they believe that at my age of 71 I should not be
practicing Cardiology without Internal Medicine boards?
• WHEN YOU CAN NOT GET PAID TO WORK YOU DEVELOP CRITERIA SO YOU GET PAID BY OTHERS!
• Yet another way of keeping our minds away from patient care and increase our practicing costs. Now, as a fellow, thinking about this
