“Instead of piecemeal evaluations, the entire MOC program should be compared head-to-head with other policy interventions or health systems interventions that improve healthcare quality, thus providing an empirical basis for choosing MOC over alternative strategies for quality improvement,” Dr. Kazi said.
“We hope that the high costs of MOC catalyze future studies examining the impact of MOC on the quality and economics of care delivered by board-certified physicians in the United States,” Dr. Kazi added.
Dr. Richard B. Baron from the American Board of Internal Medicine told Reuters Health by email, “Their analysis is less about time and cost of doing MOC than it is about the time physicians take staying up-to-date. They estimate that it is about an hour a month, and about 40 hours to prepare for the exam every decade. While the researchers attribute that time to MOC, I suspect most physicians would be spending this time staying abreast of the latest developments in their field, with or without MOC. What MOC offers them is a structured framework to keep up and a marker for the public that they are.”
“Our MOC program already recognizes so much of what physicians are doing in practice to stay up to date,” said Dr. Baron. “We can and should do more in that area. We are getting a lot of feedback from physicians about how we can improve MOC, and this feedback will help us shape what we know will be an evolving program.”
“In conversations we have already had with the community, one thing physicians have shared loud and clear is that they deeply value staying current in their field,” he added. “They believe they should spend time staying abreast of the latest updates in their discipline. We are talking with the community to assure that MOC gives them a structured way to stay current, and we all agree it is an important marker for patients that they have done so.”
“The researchers make some claims about overall costs to the health care system,” Dr. Baron said. “If you accept their methodology, which is a stretch, other research that appeared in JAMA in December showed greater overall savings – 30 times as much as the costs reported here – just in Medicare costs for physicians who participated in MOC. So maybe all those hours spent keeping up are worth it, not just for the physicians and the patients we take care of but for our entire health care system.”
