condition of licensure, payment, employment, or hospital privileges becomes law on Nov. 1. In an April letter urging Gov. Mary Fallin to sign Senate
Bill 1148, OSMA officials cite instances of physicians who could not get hospital credentials because the Oklahoma Board of Medical Licensure does not officially recognize their non-ABMS specialty board for certification purposes. “Oklahoma physicians want to be continually improving themselves to demonstrate a commitment to lifelong learn- ing. For many physicians, MOC is a way to do that. But it is not a one-size-fits-all solution and should not be used as the sole deciding factor in a physician’s ability to practice and treat patients,” OSMA officials wrote. OSMA Executive Vice President Ken King says it’s too
early to determine the law’s impact. The legislation drew pushback from patient safety groups, and OSMA continues to monitor hospitals’ reaction because nothing in the law expressly prohibits the facilities from making MOC a cri- terion of hospital privileges. But OSMA maintains such actions would interfere with
the practice of medicine because SB 1148 bans forced MOC by amending the state medical practice act. “We think it’s a solid law,” Mr. King said. “At the end of
the day, doctors felt it was time to step up and say, ‘Look, there’s no evidence MOC does anything to improve the quality of care doctors provide to patients. We pride our- selves on being evidence-based, and there’s just no evi- dence for this.’” TMA’s Council on Legislation is tracking similar laws
brewing in other states: A narrower Kentucky law prohibits MOC as a condition of licensure; a pair of Missouri bills build on the Oklahoma law saying CME suffices to dem- onstrate professional competency; and several Michigan measures go further to expressly prohibit hospitals and insurers from denying privileges or network credentials based solely on MOC. “Maintenance of certification red tape and insurance company policies far too often stand in between physi- cians and their patients. That’s not just a hassle — that’s dangerous,” Michigan State Medical Society President Rose M. Ramirez, MD, states in a press release promoting the or- ganization’s MOC reform campaign (
www.Right2Care.org). Lawmakers in those states also have gotten behind the
bills in part to discourage physicians from leaving practice at a time when many states face shortages. Oklahoma’s law was carried by physician legislator, state Rep. Mike Ritze, DO (R-Broken Arrow). As TMA similarly courts Texas physician legislators to
carry the torch in the Lone Star State, Dr. Callas empha- sizes TMA’s legislative advocacy will ensure a pathway for those physicians who want to pursue MOC, but that path- way should be voluntary and meaningful. “Do we believe MOC is important? Heck, yeah. But it should be state-driven, specialty-driven, and medical as-
AMA HOUSE TAKES ACTION ON MOC
Physicians’ growing discontent with mainte- nance of certification (MOC) programs bubbled over at the 2016 Annual Meeting of the Ameri- can Medical Association House of Delegates. A group of state medical associations, sup-
ported by Texas, pushed the house to endorse tough language. The house directed AMA to “call for the immediate end of any manda- tory, secured recertifying examination by the American Board of Medical Specialties (ABMS) or other certifying organizations as part of the recertification process for all those specialties that still require a secure, high-stakes recertifica- tion examination.” Delegates also adopted a new report from the AMA Council on Medical Education that examined the cost and relevance of MOC activities. Delegates approved new policy statements in the report, including directives to AMA to:
• Examine the activities that medical specialty organizations have under way to review alternative pathways for board recertification;
• Determine whether there is a need to establish criteria and construct a tool to evaluate whether alternative methods for board recertification are equivalent to established pathways; and
• Ask ABMS to encourage its member boards to review their MOC policies regarding the requirements for maintain- ing underlying primary or initial specialty board certification in addition to subspe- cialty board certification to allow physi- cians the option to focus on MOC activi- ties most relevant to their practices.
September 2016 TEXAS MEDICINE 31
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