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MOC Watch: ABIM Says 'We Got It Wrong'

— The ABIM pumps the brakes on several controversial parts of its MOC program.

MedpageToday

"ABIM clearly got it wrong. We launched programs that weren't ready ... We want to change that," the .

Five key changes, including enrollment fees, program language, the internal medicine exam, a 2-year suspension of part IV practice performance projects, and self assessments, will be implemented immediately with ongoing updates.

"There were parts of the program about which we've received a lot of negative feedback that our directors themselves agreed with. Therefore, we made the decision to commit to changing them, and we pulled back the ones we could not stand behind operationally," Richard J. Baron, MD, president and CEO of the ABIM, told ֱ in a phone interview.

Baron, who authored the ABIM's statement, said the ABIM is starting a conversation with the internal medicine community, and will be making regular announcements on changes to the program, every 4 to 6 weeks, based on what they're hearing.

"We are doing it because we think it's the right thing to do. We had the right values, but didn't fully actualize them through the program. We're hoping that people will work with us to add value to the program," Baron added.

This re-calibration comes on the heels of several physician debates sparked by recent publications.

In January 2015, physicians from the Mayo Clinic published a study in based on physician feedback that severely criticized MOC with an emphasis on part IV.

During the same month, Paul S. Teirstein, MD, the man who , took a bite out of MOC in a Perspective piece.

On the same day, however, in another , Mira B. Irons, MD, and Lois M. Nora, MD, JD, MBA, suggested that MOC is a work in progress and that the 2015 standards have to be adjusted to empower the medical community.

Internists who've spoken out about MOC in the past voiced satisfaction with the ABIM statement.

"This remarkable change in ABIM policies is a response to the thoughtful feedback from the physician community," , of Yale School of Medicine, wrote in an email to ֱ. "The ABIM needed to balance the concerns of the physician community, the responsibility to serve the public, and the recognition of the need for more evidence about the validity of the evaluation programs."

, of NorthShore University HealthSystem in Northbrook, Ill., agreed. "It was with great relief that I read this morning that ABIM has decided to listen to the unified voice of practicing physicians and reconsider it's current MOC requirements," he wrote in an email to ֱ.

"The ABIM took a bold step today," , of UAB School of Medicine, wrote in an email to ֱ. "Their steps are appropriately drastic and welcomed throughout internal medicine."

All of the physicians confirmed that the ABIM's decision was a solid start to changing the MOC program.

"I am hopeful that this public dialogue and recent actions will be a catalyst to efforts to strengthen the current system and find ways to make it less burdensome, less costly, more relevant, more useful, and more fun for those who go through it," Krumholz said.

"While there is still much work to be done, this is a good beginning," Grumet said. "Internal medicine physicians feel under fire from all directions including Medicare and healthcare reform. This is the first step to righting one of the many wrongs that are having profound impact on the care our patients are receiving."

"They recognized that they had developed an MOC process that internists found inconsistent with the intent of the process," Centor said. "They listened to the internal medicine community and have made an important commitment to improve the MOC process."

"The ABIM, at its essence, is the profession setting standards and evaluating itself, but there is no question that it needs to evolve and improve its approach over time," said Krumholz.

"Kudos to the ABIM staff and board for working to make MOC what it can become," Centor said.