The world of medicine is undergoing tremendous change. Concern is increasing about the rising costs of medical care, patient safety and medical errors, and transparency of information about physicians. Demands are being made by patient advocates, politicians, payers, and credentialers for more objective evidence that physicians are competent to provide high-quality care and that they are practicing in a competent manner. All physicians can expect to see new rules and regulations designed to address these concerns, and they will need specific strategies to help them fulfill the new realities of professional practice.
The American Board of Psychiatry and Neurology (ABPN) Maintenance of Certification (MOC) Program outlined on the board’s website has been recognized by the Centers for Medicare and Medicaid Services, the Federation of State Medical Boards, and many private insurers and credentialing organizations. Diplomates who participate may discover that the ABPN MOC Program can aid in their lifelong learning requirements and, in the process, fulfill their competency documentation requirements as well.
The main goal of the ABPN MOC Program is to help ensure that diplomates of the ABPN serve the best interests of the public, their profession, and themselves by maintaining their competence through their lifelong learning efforts. Competent physicians have always demonstrated certain hallmark characteristics, including their professionalism, a desire to assess and improve their medical knowledge, a willingness to demonstrate their cognitive expertise, and an intent to improve their performance in practice with their patients. The four-part MOC Program of the ABPN seeks to reinforce each of these hallmark characteristics in its diplomates and to document that those diplomates maintain the competence required to provide quality patient care.
Busy physicians are understandably frustrated by any new rules and regulations, but many diplomates have found the ABPN MOC Program to be less onerous than they first thought. Part I (Professional Standing through Medical Licensure) has always been an ABPN requirement for certification. Part II (Self-Assessment and CME) is documented with products that are readily available from professional organizations. Part III (Cognitive Expertise through MOC Examination) is a clinically oriented examination with an expected high pass rate. Part IV (Performance in Practice) consists of clinical modules that are being developed by professional organizations and feedback modules with survey forms available at no charge on the ABPN website.
ABPN policies have been designed to facilitate diplomate participation in MOC. One set of MOC activities (that is, Self-Assessment, CME, Performance in Practice) suffices for all ABPN certificates that a diplomate might possess. The ABPN will give diplomates MOC credit for activities that meet its requirements and that they already perform as part of their professional activities within an institutional quality-improvement program. Beginning in 2012, the ABPN began to waive three years of MOC requirements for diplomates who complete an ACGME-accredited fellowship and pass the ABPN subspecialty examination. ABPN diplomates can take a combined MOC examination that covers multiple certificates at the same time and for a reduced fee. ABPN diplomates with “lifetime” certificates may now enter the Continuous MOC Program by either passing the MOC examination or registering for the Continuous MOC Program, completing three years of MOC activities, and passing the MOC examination within three years. The fee to participate in the Continuous MOC Program is $175 a year, which is considerably less than the average specialty board MOC fee.
To assist diplomates in their efforts to pursue MOC, the ABPN has created a password-secure folio system on its website. Using the folio, diplomates may record their MOC activities, identify specific MOC requirements and timelines, monitor their progress in MOC, receive regular MOC updates and reminders, and register for MOC examinations.
These are indeed trying times for all physicians, and we might expect to see even more calls for objective evidence of ongoing physician competence. Through its recognized MOC Program, the ABPN can be a significant ally to busy diplomates as they pursue lifelong learning and respond to the challenges of the new health care era. ■