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im Monday, MD, worked hard to attain board certification in three different specialties: neurology, clinical neurological physiol- ogy, and sleep medicine. She knows it sets her apart, and with- out it, for instance, she could not have an accredited sleep lab or see certain Medicare patients. She also knows it’s important for patient care that she keep up her skills and knowledge, and she doesn’t mind taking a test or completing continuing medical


education (CME) to stay fresh. Dr. Monday does mind that the exhausting recertification exams she spends months preparing for are largely filled with multiple-choice questions that entail regurgitating facts often irrelevant to what she sees in daily practice. That’s in addition to expensive test and material fees, ongoing peer review activities, and quality improvement projects that duplicate her existing efforts in the office or at the hospital. Multiply some of those requirements by three because she’s triple-boarded.


If Dr. Monday opted out of maintenance of certification (MOC), she wouldn’t lose her medical license. But she likely would lose access to hospital privileges and health insurance networks, which often require up-to-date board certification. “The last thing doctors want to do is become less educat- ed. We’re already fighting off scope-of-practice intrusions,”


28 TEXAS MEDICINE September 2016


the member of the Texas Medical Association Council on Socioeconomics said. “We’re willing to do what’s reason- ably necessary. But there comes a point at which we have to push back and say: This is not making us better doctors. Doctors have had enough of mandates like MOC and PQRS that don’t result in quality patient care. Period.” MOC — not to be confused with maintenance of medical


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