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ACC Member Perceptions of MOC New York Chapter

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Title: ACC Member Perceptions of MOC New York Chapter


1
ACC Member Perceptions of MOC New York Chapter
  • May 2014

2
Methodology
  • 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
  • n4,406 ACC members completed the survey
  • n304 New York ACC Chapter members completed the
    survey

3
Respondent Composition
TENURE Total New York ACC U.S. MD Membership
In training 11 11 10
1 - 7 years 16 14 21
8 - 14 years 13 12 13
15 - 21 years 15 13 15
22 - 28 years 20 22 13
29 or more years 23 26 28
Not in practice 1 3 --
No response lt1 -- --
Total 4,406 304 32,001
4
Key Findings
  • Overall, ACC New York 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.

5
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?
6
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 ABIMs 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 Secured
reexamination required every 10 years (Part 3)
7
2014 MOC Familiarity
Total New York Very
Familiar 56 47 Not Familiar
19 22
Q. How familiar are you with all of the changes
that the ABIM has made to its certification /
recertification process?
8
2014 MOC Favorability
Total New York Total
Favor 4 4 Total Oppose
87 87
Q. Do you favor or oppose the new ABIM MOC
requirements?
9
Perceptions of Cost
Q. Do you think that the cost associated with the
MOC and recertification programs is
10
MOC Effect on Future Plans
Total New York Total Yes
32 27 Total No 37
35
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
11
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.
12
Recommended ACC Support
Remove MOC requirements Assume certification
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.
13
CardioSource.org Helpfulness
Total New York Very
Helpful 35 25 Not
Helpful 13 12
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?
14
MOC
Strongly oppose
Time aware from patient care
Disappointed in ACC
Eliminate MOC
Ridiculous
Evidence?
Too Expensive
ABIM Out of Control
Practice Relevance
Burdensome
Onerous
ABIM is a Monopoly
ABIM Money Grab
ACC Should Certify
Eliminate PIM
Waste of Time
Stand Up for ACC Members
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.
15
From the Mouths of Members
  • 1-all or none ( no grandfathering) 2- no formal
    exam (lots of expense and time wasted) 3-abim can
    run internet based programs for mandated cme to
    maintain certification! More cost time effective
    and achieves mandated learning goals
  • 1. PIMs and surveys are an insult to practicing
    physicians and cardiologists. Remove them with
    immediate effect. 2. It is the grandfathered
    physicians/cardiologists who need to take the MOC
    exam most, as they are the ones most outdated in
    terms of knowledge. What a strange logic the
    most outdated are the ones exempt from taking the
    exam. The MOC industry needs to be dismantled
    root and branch, as they are imposing their own
    agenda to earn millions, at great cost to
    physicians whose lives, en masse, have already
    been destroyed due to the pressures being imposed
    on the profession from all sides and on so many
    fronts.
  • ABIM is a profit making organization which needs
    a reality check. It is expensive and costs a lot
    both in terms of money and time. I learn lot more
    attending a review course like the one MGH offers
    than ABIM mandates. If they are so concerned
    about our knowledge let them give modules free.
  • ABIM is a self serving enterprise that has a
    conflict with revenue generation for themselves
    and the consulting physicians.
  • ABIM is an out of control organization which has
    no basis in reality.
  • ABIM is the certification body and ACC leadership
    should work with them! I personally have retired
    but MOC Is merely a natter of pride.
  • ABIM is unreasonable in terms of its expectations
    and cost. Expectations for MOC are completely
    unreasonable. This is extortion on many levels.
  • ABIM is using their monopoly to their financial
    advantage.
  • ABIM needs to stop It is very obvious that all
    these new requirements are just an excuse to make
    more money for them selves. I really did not
    become a physician just to take and retake tests
    and convince people to do the PIM just to keep a
    board certification. They must remember we have
    lives to live not just to satisfy their other
    issues.
  • Abusive
  • acc must take full responsibility
  • ACC PIMS are more burdensome than the ABIM
    ones-simplify it!!
  • ACC should ask ABIM not to self impose more
    burden on working cardiologists.
  • ACC should be more in tune with membership
    opinion on this topic PRIOR to any major changes
    such as these are enacted. ABIM should be more
    interested in our opinions on ways to improve
    CME, not simply make an edict.
  • ACC should take this over.
  • All these requirements are compromising patient
    care, they do nothing to enhance pt care. Its a
    money and power grab by the ABIM
  • Another bureaucracy , paper work ,useless/

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.
16
From the Mouths of Members
  • as expected, physicians are again being unfairly
    asked both from a time and financial perspective
    to be taxed unfairly given the already growing
    constraints against us. We NEED more
    representation for doctors to the powers that
    matter for change
  • As usual, the ACC is powerless to deal with the
    issues that practicing physicians feel are
    important. I don't know why i bother paying dues.
    AT some point, perhaps soon, the old adage will
    finally apply to the ACC "Lead, follow, or get
    out of the way!"
  • Board Certifications, CMEs , MOC , Hospital
    meetings ,Daily ACC Newsletter reading , office
    meetings etc. Is one allowed to have a family
    life ? Hobbies ? WOW Just getting to be too Much
  • Board certified cardiologists do not need this
    kind of financial and intellectual harassment.
    There is no evidence that any of the MOC
    activities make any difference in patient care.
    If board certified physicians cannot be trusted
    to take responsibility for keeping up to date,
    then they can't be trusted to care for patients.
    Stop treating physicians like kindergarteners
  • Cardiologist are frustrated and weary of
    increasing demands that preclude them from any
    semblance of home life years after they proved
    their capacity to meet requirements of the
    boards. Our profession has been divided into
    multiple parts for which we are required to
    maintain separate boards rather than one board
    exam for what we do. In addition to a humiliating
    and daunting board exam every ten years we now
    have the added burden of keeping tract of our
    learning and proving we are keeping up with
    medical knowledge in cook book MOC requirements.
    At the same time our pay is steadily declining
    and other parties are demanding we spend time to
    prove our quality for payment. We spend much more
    time than ever before completing electronic
    records. We have courses and exams for
    malpractice insurance, State license, hospital
    privileges and it never seems to end.
    Cardiologist are taking boards that qualify them
    for "consultations" but our society could not
    prevent the elimination of the consultation codes
    for CMS. We now have separate CME requirements
    and costs of certifying our echocardiogram and
    nuclear medicine facilities. I would like to see
    MOC replace the secure exam or allow a choice
    between MOC or the secure exam.
  • CME credits required for medical license renewals
    might be used as a basis of meeting MOC
    requirements. Or if MOC requirements are to be
    continued then CME credits requirement for
    license renewals should be abolished.
  • CME requirements re credentialing for Hospitals,
    malpractice insurance etc. PLUS transition to EMR
    with ever expanding meaningful use mandates/
    documentation requirements PLUS q 10 year
    recertification exams (for CV disease, for Echo,
    for Nuc, etc...), plus competitive business
    environment, decreasing reimbursements,
    increasing audits and precertification, economic
    mandates to form networks, committees to
    restructure practices and document efficacy/
    patient satisfaction, etc... AND ON TOP OF IT
    ALL, I NOW HAVE TO JUMP THROUGH q2 YEAR MOC HOOPS
    TO SATISFY ABIM DEMANDS? (pt survey/chart
    review/etc a total WASTE OF TIME, EFFORT,
    MONEY)!!!!!! Is there any time left for patient
    interaction/care (let alone addressing business
    issues)? PLEASE HELP US !!!!!(AND ADVOCATE FOR
    COMMON SENSE SIMPLE SOLUTIONS) At some point,
    (multiple) well meaning actions lead to
    disaster....the enemy of good is perfect, etc....

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.
17
From the Mouths of Members
  • Current Medicine and Cardiology practice requires
    knowledge integrated and interfaced with EMR.
    Access to information is immediate and online.
    Exams and modules are obsolete because are not
    keeping with current changes
  • current status is confusing
  • Currently retired from active practice. Though I
    maintain my own quota of CME credits, I have no
    intention of pursuing MOC requirements. My
    certification has been grandfathered and I will
    be reported as "Certified, Not Meeting MOC
    Requirements." As a retiree this has no impact. I
    regret that the younger people still active in
    practice have to deal with this onerous process.
    What impact is this requirement having on the
    quality of patient care, teaching and research?
    Also, the mandates from the RRC on training
    programs is equally out of control.
  • Do we really deserve to be treated like
    adolescents? We have had to put up with a lot of
    interference recently. I find that the
    cardiologists that I work with are professionals
    in the true sense of the word. This implies
    keeping up to date, practicing responsibly and
    ethically. I sometimes wonder where all this
    external interference comes from. I'm sure there
    are a very small number of cardiologists who are
    not practicing according to these high standards
    but there must be other ways to deal with this.
  • drop the whole thing
  • Either MOC or the exam but not both.
  • Fight against these ridiculous requirements
    demanded from professionals- we are practicing
    cardiologists not kids at kindergarten
  • For those in practice a long time, this is a
    terrible burden. If there is insistence on
    something along these lines, there should be some
    period of grandfathering so that doctors in
    practice 25 years do not need to do this.
  • GET RID OF ANOTHER ROAD BLOCK AND UNNESESSARY
    BURDEN ON ALREADY STRAINED FINANCIAL SITUATATION
    OF PHYSICIANS . LOOK WHAT HAS HAPPENED TO US
    AKLRADY WITH aco AND OBEMA CARE
  • Good luck to ABIM. I am opting out.
  • H.L. Mencken.. "Simplify. simplify, simplify".
  • How many bureaucratic things we need . I will not
    practice find cardiologists for patient,
    disgusting .
  • I am a pediatric cardiologist
  • I am a pediatric cardiologist and dealing with
    the same issue with ABP. My wife is an internist
    and she has started loosing motivation t practice
    medicine because of the time she spends in non
    patient care (EMR, various courses to keep
    hospital privileges, dealing with insurance and
    now MOC. I appreciate this advocacy with ABIM. I
    also wish ACC to provide advocacy for the
    pediatric cardiologist members too. I see very
    little effort in this regard from ACC and we
    pediatric cardiologist feel like step children. I
    am considering not renewing my membership with
    ACC and rather join a more dedicated organization
  • I am a pediatric cardiologist- So none of this is
    applicable

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.
18
From the Mouths of Members
  • I am in favor of continuing education and I help
    plan CMEs. The MOC is draining any interest from
    CME activity and participation, since clinicians
    must spend more on MOC.
  • I am not sure what the impetus for this kind of
    program was.
  • I am refusing to pay the ABIM any more money.
    They already charge way too much for their
    certification examinations. It is nothing but
    extortion.
  • I believe it is not unreasonable to provide some
    evidence that a professional is keeping up with
    new knowledge in his/her field. However, the
    costs and time requirements of the MOC, as it is
    now structured, are prohibitive in an economic
    environment that is hostile to practicing
    physicians.
  • I believe that the moc requirements are not
    needed. no professional has such requirements to
    practice. this does not make us better doctors,
    it is a waist of precious time. it takes doctor
    away from their patients and families. will not
    support the acc if nothing is done
  • I believe that these changes to MOC were
    capricious and not well thought out. The
    motivation is unclear. If board certification and
    recertification does not sufficiently demonstrate
    that a physician has the knowledge base to
    practice as a cardiologist on its own merits than
    why is is necessary. The MOC requirement added to
    the board certification seems overbearing.
  • I believe that we need to take a stand against
    the unilateral ability of the ABIM to redefine
    maintenance of certification for physicians who
    have established their certification under
    pre-existing rules. It is one thing to change the
    process for physicians who are becoming newly
    certified, but this process is establishing
    something retroactively for people who certified
    in good faith under previous rules.
  • I did not feel the ACCF board review course
    covered topics adequately for my interventional
    boards. This needs to be improved.
  • I find it extremely onerous financially and it is
    clearly a money-making scheme
  • I have been in practice for greater than thirty
    years, F.A.C.P., F.A.C.C., F.A.C.P, provide about
    100 c.m.e. credits per year including ten in
    vascular and echocardiography. I work from 8 to 5
    or 6 pm. daily and come in on Sunday to do paper
    work to catch up from the week. The hospitals
    mandate that I come in and do 12 hours to comply
    with their electronic records. ICAEL now wants me
    to take the test for echos and stress echos that
    only someone that just came out of their
    fellowship could pass, even though I submit all
    my studies and have passed their standards, even
    before it became mandatory. I don't mind taking
    courses and I have attended the A.C.C. at the
    Hilton in NY every year for greater than thirty
    years. However, you say I'm grandfathered and
    then change it all. I disagree.

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.
19
From the Mouths of Members
  • I have no problem with physicians having to stay
    up to date or mandating CME's. The MOC is OK as
    far as continuing ed is concerned. The practice
    improvement modules are a waste of time. The
    charges (for the MOC and all the other things we
    have to do are exorbitant ) and the time required
    burdensome. It is unclear to me whether at this
    stage in my career I will retake the boards
    within 10 years (especially when I have Echo and
    Nuclear boards to take as well)
  • I have not received the MOC requirements yet
  • I have tried to do a phase IV PIM and found it to
    be a hopelessly complex and time consuming
    process.
  • I hope ACC advocates for solutions where problems
    exist, not where education theorists speculate
    they may exist. MOC revision is not a response to
    an actual problem but to a theoretical problem. I
    hope ACC listens to its membership, aligns itself
    with us and advocates for our interests.
  • I prefer low cost online materials to maintain
    certification that I can access whenever I have
    free time so I don't have to take time away from
    my private practice
  • I should be able to do whatever CME I'd like, not
    have to pay the ABIM for theirs. This is a self
    serving ABIM arrangement. Practicing cardiologist
    are upset about this!!
  • I strongly believe that 50 CME credits a year
    should be adequate
  • I strongly oppose MOC. We live in an incredibly
    regulated world and the previous system was
    adequate to ensure ongoing learning and staying
    up to date. This is just more busy work and
    expense in a world of vanishing physician
    reimbursement. I feel as though the ABIM is doing
    this to milk more money out of their
    co-physicians who have no recourse.
  • I think it's unnecessary requirement for sub
    specialties . Doctors with sub specialty should
    take their specialty certifications
  • I think that ACC should develop its own "MOC"
    exam for certification in cardiology to achieve a
    status of Fellowship. Also I believe that I,
    having been denied Certification by ABIM, the MOC
    exam to maintain certification is meaningless to
    me. Herein lies the importance of ACC Grand
    fathering those practicing Cardiology physicians
    using their knowledge and experience treating
    patients and caring in their prevention of CV
    disease, maybe considered for Grand Father
    clause.
  • I think that the MOC requirements is purely
    another way to make money from physicians in
    practice. Prior to MOC (when I took my boards)
    physicians electively did CME courses which I
    have done for the last 29 years. I think the
    advantage was that physicians could focus on
    training and learning relevant to their practice
    as opposed to taking a standardized exam and
    answering irrelevant course booklets. No other
    profession (law, accounting, etc) have such
    stringent requirements with regard to taking
    recurring exams. We should be channeling our
    energy and learning practices to helping patients
    and not finding new ways to get money from
    physicians.
  • I trust the ACC leadership to do what is best to
    improve C V care.

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.
20
From the Mouths of Members
  • I understand fully that the changes to MOC
    process have been promulgated by ABIM and not
    ACC. However, that this could occur with
    strenuous objections and threats of serious
    action by ACC is extraordinarily disappointing.
    It is another example of ACC's lack of leadership
    and effective advocacy. No one cares how many
    guidelines ACC authors. What cardiologists care
    about is their day to day responsibilities and
    their work environment. The new ABIM MOC
    regulations worsen those tremendously, even
    ignoring the high cost. This is a test case for
    ACC Either these requirements are rolled back,
    or ACC will have been proved to be essentially
    irrelevant. The organization will follow the path
    blazed by the AMA, which went from having near
    universal membership in the 1960's to
    representing less than one in five physicians
    today. WAKE UP!
  • I was grandfathered in, but elected to re-take
    the exam even before the new requirements. The
    most onerous by far is the practice based
    requirements which are horrible and seem like
    kindergarten busy work
  • I will not decertify when my current credentials
    expire
  • I would cancel my membership from ACC, if they do
    not listen to us.
  • I would like a quarterly update of what I have to
    do by when...
  • I'm glad that I'm retired!
  • In my opinion, ABIM's oversight of the certifying
    exams results was not adequate. Some manipulation
    of results occurred so that resident program
    directors made sure that their candidates did
    well on the exam
  • In this changing environment in medicine
    generally with new electronic medical records
    requirements, and all of the other pressures
    placed on physicians to see more patients and do
    more with less, it is absurd that the American
    Board of internal medicine place this kind of
    pressure on physicians who were promised that
    they would not be placed in this position
    previously.
  • It is monopoly by ABIM because they are the only
    one in the business of certification . They are
    doing whatever they want and we are to oblige
    with the requirement . There is no evidence that
    it improves quality of care in anyway. It's a
    sham to fill their pocket and pay the hefty
    salaries of the CEO . And they want show they are
    doing something to justify the salaries .
  • It is unacceptable ABIM claiming monopoly on
    content approval for MOC. Why can't we use some
    CME credits for MOC ?
  • It seems that it is a money grab, with no
    evidence that it helps patient care
  • It would be more helpful to set up MOC as
    questions to answer after a topic review.
  • MOC is a money making scheme of ABIM and serves
    no useful purpose
  • MOC not needed!
  • Money making scheme for abim and acc

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.
21
From the Mouths of Members
  • Most cardiologists are very conscientious about
    keeping current. I feel that the MOC requirements
    onerous, and somewhat parental.
  • Much too onerous and expensive esp. for those who
    have been in practice for many years. After
    taking recert 2 times and passing, maybe that
    should be it, and you should only have to do CME
    to maintain certification. Do we really need 65
    yr olds taking exam??
  • New MOC issues involving those "grandfathered""
    for 30 or more years is a new exercise to raise
    more money and does not speak well of those
    asking for it. Hope good and mature sense would
    still prevail to undo those shenanigans.
  • Not happy.
  • Onerous, too costly and more over regulation.
  • Onerous, not in touch with the realities of
    current practice, way too time consuming and
    expensive. What credit do we get for multiple
    board certifications. Simply put, outrageous.
  • oppose vigorously
  • Our lives are very busy trying to keep up will
    the new advances and regulations that have become
    part of cardiovascular medicine. We don't need
    more bureaucracy. Where is the ACC? Why are you
    trying to undo this when it should have been
    opposed from the beginning.
  • Personally, I would want to have better
    information as to what the new requirements are.
    Also, I would like the requirements not to lose
    an additional financial burden on the members
  • Physician in general are very dissatisfied with
    entire recertification process devised by ABIM,
    Its popularity and acceptance is low, may be time
    is ripe to start a rival to ABIM, It seems ABIM
    does not realize that physician age also they get
    married, they have their children and then grand
    children, we also face ups and down in our life,
    for physicians to continue a long and drawn out
    process is unintelligent see this entire process
    is another tool in hand of malpractice lawyers to
    demoralize the practicing physicians not full
    time salaried physicians sitting in medical
    institutions who rarely see patients or involved
    in direct patients care. I would like to know how
    many professors or full salaried have gone
    through this process I believe ACC and ACP etc
    should get a good survey of physicians before
    dissatisfaction is extreme.
  • physicians are concerned about the costs of these
    MOC young faculty view it is a financial burden
    medical divisions or departments do not assume
    the cost older physicians who have been away from
    the classroom and test taking may pose a
    challenge for proper evaluation. cme and its
    validation, maintenance and documentation may be
    part of the solution
  • PIMs are a huge waste of time and are not useful
    in any way to assess or improve knowledge
  • Please don't make our life more complex which is
    already overwhelmed with too many responsibility,
    long duty hours and too many board exams.

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.
22
From the Mouths of Members
  • Please include our other CME approved activities
    in MOC. NY State requires 50 hrs/ yr, and this
    should be counted in MOC.
  • please join with other professional organizations
    so that we can exercise a stronger voice to have
    these new requirements changed. Increased
    regulation is humiliating.
  • Please support the major opposition from medical
    fraternity regarding NEW MOC requirements from
    ABIM
  • Putting aside the issue of whether or not MOC
    achieves the desired objective, I spent 3 of my
    gross annual income as a cardiology fellow to
    certify in internal medicine. For someone at my
    stage in life, it's a considerable investment. At
    the time, the product offered was certification
    for 10 years. They didn't say there would be a
    caveat or an asterisk attached to my
    certification. You can tell me what the cost of a
    product is ahead of the sale. As an informed
    consumer, I can judge its relative value. But
    what legal right does ABIM have threatening to
    taint that certification after the fact with a
    public statement that I am not meeting
    requirements if I don't pay newly assessed fees?
    That's not what I paid for. It's called
    blackmail.
  • Question 5 Do you favor or oppose the new ABIM
    MOC requirements? ..is really two questions.
    Cannot answer as above. ACC should work to
    succeed the "requirements" to a version of MOC
    specific for cardiologists and our collective
    voices. thanks
  • Resent the cardiology establishment milking the
    members for more money at every turn. All on line
    courses are too expensive, they should be made
    free, this is what universities should d be all
    about, and proving participation in those
    activities should suffice.
  • Shame on you ACC
  • should be discontinued or take the place of the
    exam. both should not be in place.
  • Someone has got to be the focal point of reigning
    ABIM in- they create cost and excess time demands
    that are burdensome and unfair. Continued
    education and some form of MOC are fine, but they
    are out of control and are clearly very self
    serving. The exam in particular is a waste if you
    do regular knowledge and pIM work, they are
    double dipping.
  • STAND UP TO ABIM and support your members! We are
    facing enormous pressures from government,
    insurers, hospitals and the legal system. Why are
    we adding self inflicted wounds? If ACC cannot do
    more to help defend the private practitioner I
    don't see the value of membership. I have signed
    the petition to stop MOC so far there are 13,000
    signatures. This represents significant
    discontent-I hope ACC is listening.
  • Stating the obvious. Enough is enough for a
    million reasons....
  • suggest that a unilateral decision that appears
    to largely be a money grab should be resisted.
  • Tell them that those of us who are already Board
    Certified should be Grandfathered.
  • The ABIM is acting in the capacity of an
    organized crime syndicate. They should be brought
    up on racketeering charges

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.
23
From the Mouths of Members
  • The ABIM should not be permitted to enjoy the
    monopoly it currently has on certifying and
    recertifying physicians, making us jump through
    hoops so that they can continue to enrich
    themselves at our expense - both in dollars and
    hours - with no proven benefit to anyone but
    themselves - especially the CEO who reportedly
    rakes in 800k per annum. As cardiologists, we're
    encouraged to practice evidence-based medicine
    how about a little evidence demonstrating there
    is any virtue to this onerous certification
    process. I did one of these ludicrous PIMs the
    last time I recertified and it was an utter waste
    of time.
  • The ACC should advocate for us. MOC should be
    abolished. Keep CME requirements (any reasonable
    level is OK)
  • The ACC should formally oppose the ABIM's over
    reaching and expensive intrusions into the
    practice of medicine in general and cardiology in
    particular.
  • The concept of CME is good and needed . However,
    I feel that the "industry" that has grown around
    this recertification process appears to be more
    interested about making money rather making good
    doctors. Avoid these stress producing tests and
    assume doctors who remain active in practice and
    keep themselves intellectually up to date with
    conferences, teaching, reading journals, etc. are
    really what this country needs. K
  • The cost associated with MOC is unacceptable and
    borderline scam.
  • The cost in time and money must be reduced
  • The field of cardiology is ever evolving - new
    innovations, new techniques, new insights are
    made everyday. The certification/recertification
    exams themselves are dated (usually lag 1-2 years
    behind current data). The MOC will absolutely not
    change my practice strategies, and will not
    enhance my knowledge base but in fact force me to
    'know' dated material.
  • The manner in which the ABIM has addressed this
    issue is unethical. Their primary intent is self
    gain. The threat to designate nonparticipating
    physicians as failing to meet MOC requirements
    unless they pay a fee (in the thousands of
    dollars) to sign up is extortion, which is a
    felony.
  • The MOC is 100 unreasonable and not indicated.
    The MOC is a financially beneficial endeavor for
    the ABIM. The ABIM claims that the MOC will
    resolve a self-declared problem when NO problem
    actually exists. The ABIM president's response
    statement regarding the MOC is a disgrace and an
    insult to the intelligence of the members. The
    statement could have been written by any
    politician or attorney.
  • THE MOC IS TOTALLY COUNTER-PRODUCTIVE AND NOT
    NECESSARY
  • The MOC process in general has become a money
    making scam. I am an interventional cardiologist
    in private practice (20 years) and a huge part of
    my interventional boards had to do with PCI of
    renals/carotids/peripheral, as well as mitral
    valvuloplasty and TAVR. What happened to coronary
    angioplasty as the mainstay of the CORONARY
    INTERVENTIONALIST????? I have become very
    disillusioned with the MOC system.

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.
24
From the Mouths of Members
  • The MOC process is a joke. The exam is not a true
    test of competency. Overly expensive and an
    incredible waste of time
  • The new ABIM MOC rules are a burden to practicing
    physicians, especially those with umpteen years
    of experience and continue CME activities. AMA
    PRA is more than sufficient to maintain current
    CME. This new MOC will also wind up replacing the
    current CME activities and cause physicians to do
    modules instead of attending live conferences.
  • The new MOC requirements are intrusive, costly
    and do not serve to improve the practice of
    medicine/cardiology. I am sick of the costs of
    practicing medicine being over-regulated.
  • The newly revised requirements are extremely
    burdensome on an actively practicing
    cardiologist. They need to be streamlined and
    made less expensive. Recertifying for multiple
    boards will become a full time job and not allow
    physicians to practice medicine.
  • The PIMs are bullshit and a waste is time. I
    passed the test as I am not grandfathered in. I
    have not finished the PIMs and likely won't have
    time. They are ridiculous and not pertinent and
    disrespectful to our time and it is all a money
    generating scheme
  • The process is burdensome, inappropriate (patient
    survey portions) and excessively expensive
  • The program is cumbersome The process confusing
    ACC should work with the AIBM to develop the
    trues objectives for this program and a
    reasonable program for practicing cardiologists
    Right now this looks like a scheme for the ABIM
    to raise revenue
  • The RCPSC in Canada requires its members to do
    CME activities every year. You log on their site
    and record your activities. There is a dashboard
    where you keep your MOC needle in the green zone
    for the year and for the 10-year MOC cycle. No
    need for repeat exam. A lot less stressful.
  • The secure exam is superfluous. The important
    thing is whether people are keeping up to date
    with knowledge. That is tested with the modules.
    The way the test is administered is degrading
    with our being fingerprinted, photographed, and
    videotaped. It lacks professionalism and treats
    physicians like criminals. It would be good to
    add a Journal Club component where we read key
    papers and have to answer questions. That would
    help with knowledge too.
  • These new requirements are awful, expensive,
    time-consuming and do not add value to life-long
    learning. This is where we need the ACC to stand
    up and represent us and cardiology
  • They are expensive and extremely time consuming
    and of dubious value. I work over ten hours a
    day, not including night call and weekend call.
  • They are overly burdensome, expensive and time
    consuming.
  • This is a betrayal after I was grandfathered. It
    seems that it may be an attempt to generate
    revenue.

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.
25
From the Mouths of Members
  • This is ALL about making money!!!!
  • This is in my opinion a ridiculous, bureaucratic
    scam that is meant to enrich the AIBM at the
    expense of physicians. It should be resisted at
    every level.
  • This is part of a sad and relentless march
    towards socialism without anyone saying so in so
    many words and with collusion from so called
    thought leaders and experts.
  • This is simply a money making new program for
    ABIM ABIM has become a monopoly and abusing its
    power without any input from the people
    supporting it financially. It is undemocratic
    and abusive.
  • This MOC garbage is an additional burden to what
    is already becoming an overwhelming one-- given
    changes in medicine occurring with the ACA, ICD
    10, PQRS, etc. A board exam q ten years is more
    than enough. Our own medical overweight
    institutions need to stop nickeling and diming
    practitioners (CME and MOC being perfect
    examples)and focusing on helping us.
  • this whole idea is a sham and acc should have
    nothing to do with this money making scheme have
    personally accumulated hundreds of cme credit
    hours. Does this amount to nothing
  • Too busy to go through MOC Need to scrap it and
    ACC should take the lead in this
  • Too many requirements bi hold 3 certificates and
    IBHRE status for ppm and icd's and then there are
    separate hospital and state requirements with in
    servicing. Its too much and not necessary
  • Too many requirements for practicing medicine
    that actually take out time from clinical
    medicine and ultimately bad for patient.
  • too much for a practicing physician board cert
    test takes 3 months to get results and they fail
    25-33 of doctors who have already passed
    it--gtridiculous
  • Undue burden on practicing physicians and adds no
    value whatsoever in improving patient care.
  • Used SCAI-ACC Board Review for recent 10 year
    recert in IC, and found that the actual test was
    way off the mark from the review in terms of the
    weight given various aspects.
  • Very expensive - Feels like doctor tax. Large
    time commitment with little data showing
    association with competency.
  • We already have too many hoops to jump through.
    The format of MOC is excessively time consuming,
    expensive and has no relationship to day to day
    practice. I will not participate in this charade
  • We are too busy to fulfill so many different
    requirements especially with multiple
    certificates. Too costly as well. Finally we have
    to factor this nuisance in with other
    requirements states and hospitals require. There
    isn't time left for anything less. Develop
    modules that are open book and eliminate the
    exams. Allow the modules to count toward more
    than 1 certificate
  • We need help on how to actually go about doing
    what we need to do to comply with MOC

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.
26
From the Mouths of Members
  • WE NEED TO BE LEFT THE HELL ALONE THE ACC NEEDS
    TO LOSE THE ABIM WE SHOULD COMPLETE CMES AND BE
    DONE NO MORE TESTS
  • We should all refuse to comply with there onerous
    time wasting and costly requirements.
  • What exactly is the rationale for these changes.
    Sorry for my cynicism but it seems to me that
    part of the motivation is financial. The fees
    will keep the coffers of ABIM brimming. Otherwise
    what exactly was broken that needed fixing? What
    motivated these unilateral changes. Was the
    quality of care worsening? Cardiologists are not
    grade scholars and should be trusted to know to
    continue the habit of life-long learning without
    the compulsion imposed from above. Most hospitals
    require a certain minimum number of CME credits
    to maintain privileges. That should be enough.
    Lastly, when people are grandfathered, this
    status should not be changed on a whim as is
    being done here by ABIM. What evidence is there
    that people who were grandfathered provide lower
    quality care?
  • While I like to be as academic as possible I
    believe both the ACC and ABIM are using this as a
    money making opportunity. The charge for MOC
    should be zero dollars
  • While I understand the rationale for the MOC
    requirements and certainly could not argue with
    the need for physicians to be well-informed and
    current, the cost in time and money is just
    another burden for those of us in active
    practice. Another 5-20 hours per year does not
    seem like much to the ABIM, but its going to be
    hard to find when you're on the front line all
    day. The repetitious litany on the FAQs of the
    ABIM website is also offensive. We know you don't
    care much, ABIM, but don't make it so obvious.
  • With the new almost mandatory installment of EHRs
    I know cardiologists that have been practicing
    for gt15 years and have seen their productivity or
    lifestyle drop tremendously. The almost
    simultaneous addition of these requirements seems
    so untimely that it almost appears to be an
    attempt to 'kick a guy while he's down'. I can
    ultimately understand the more frequent question
    modules but the practice improvement parts are
    unproven and likely unnecessary. The latter seem
    like the typical 'solutions' we see
    administrators trying to prove their abilities
    and relevance throw at the people actually out in
    the field. Imagine asking a soldier to go back
    into the field every 6 months and collect data
    about number of shots fired, accuracy and
    temperature of the atmosphere at the time of the
    shot. Would it add data that would allow you to
    spit out a report? Yes. Does it sound ridiculous?
    No more than your measures sound to those of us
    who are actually stretched out thin enough as it
    is, sirs.
  • You can tell them that not only do I have no
    intention of taking the MOC but about 15 other
    cardiologists I spoke to recently feel the same
    way. We already spend enough on CME and other
    related requirements of the state and hospitals
    we work for. I wonder if the ABIM is just losing
    dues paying members and trying to use MOC as a
    way to recoup some money
  • Your website has been poor for many years. There
    are no teaching videos. You overcharge for all
    subscriptions such as ACCEL You should get in the
    business of fostering education in a low-cost way
    free of charge for all paying members such as by
    posting maintenance of certification lectures on
    your website and making your website functional
    like the ESC
  • website

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.
27
Questions Chapter Exec Nancy Weiner, MPH
(nweiner_at_nycms.org) (212)686-0228 Amy Dearborn
(adearborn_at_acc.org) 202.375.6257 Greg Brouse
(gbrouse_at_acc.org) 202.375.6531
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