Friday, May 15, 2015

MAINTENANCE OF CERTIFICATION (MOC): a rising business opportunity!


Continuation of our Money and Medicine Series

Maintenance of Certification (MOC) has become the latest repository of profitability for physicians and others with an ear to current business practices in America. The idea put forth is that MOC is useful for making sure that physicians keep up to date -- never mind that all 50 states have already imposed mandatory Continuing Medical Education (CME) that requires physicians to take post-graduate courses to maintain licensure. These courses are expensive and often require travel. These programs have generated money for the entrepreneurs who run them. Now the specialty boards want in on the loot. The American Board of Internal Medicine (ABIM) is an example of the extravagance to which these programs may go.

If we study the IRS Form 990 for ABIM for Tax Year 2012, we see that the ABIM president and CEO received base pay of $465,687 to which was added $44,742 in "bonus and incentive compensation ." One may ask with reasonable curiosity why a base pay of nearly one-half million dollars would need another forty-four grand for "incentive compensation." We'll have to put that question to the ABIM board. We may presume with reasonable medical probability that it was not to avoid a "consolation" stipend.

However, that's not all. In addition to the $465,687 for base pay and the $44,742 for "bonus and incentive compensation," the president and CEO was also awarded $83,654 in retirement and other deferred compensation, plus "non-taxable benefits" of $34,869.

The total for this compensation package was $628,952. not bad for not even having to lift a scalpel or a stethoscope! And, yes, we have similar information for other boards, more on the other boards in future issues. In the meantime, know that there were 15 or more persons at ABIM who were compensated $190,000 or more. Impatient scanners of this information may on their own look up Form 990 for each of the specialty boards and for the ABMS itself (American Board of Medical Specialties). In short, ABIM has itself become a rising business prospect.

As for the purported usefulness of MOC, one respondent to this unproved assertion wrote  (viz., blog of Dr. Wes, 5/14/15) that "there is no evidence MOC improves performance ... this is just poor marketing and another ABIM/ABMS fabrication."  The Florida Medical Association (FMA) voted that MOC should not be used as part of the criteria that hospitals use to designate medical staff. More  state medical associations should follow this example. In the meantime, MOC appears overrated as an educational tool and underrated as a money-making machine.

References

"Maintenance of Certification Controversy," Dr. Wes, drwes.blogspot.com, 05/14/15

"Do We Really Need Physician Re-Certification Testing? There has to be a  better way," Manisha Juthani-Mehta, MD, www.psmag.com/health-and-behavior, 4/24/15 (this doctor describes having had to spend $1,720 in 2010 for MOC and $775 for the infectious disease exam, a total of $2,495. She states that the current internal medicine exam costs $1,940. This testing is clearly beyond what is necessary and reasonable; however, it makes doctors jump through hoops while enriching the board and its paid personnel including officers, trustees, and directors). 

"When does a $681,000 salary require additional incentive compensation," The Weinmann Report, www.politicsofhealthcare.com, 04/17/15

"Florida Doctors Fight Back," The Weinmann Report, www.politicsofhealthcare.com, 09/18/14

"Do Doctors Expire in 10 years?" The Weinmannn Report, www.politicsofhealthcare.com, 05/12/14

"Maintenance of Certification," JAPS, V. 18, # 3, Fall 2013, by Christman, K.

"Board certification - a malignant growth," JAPS, V. 16, # 2, by Dubravic, M.

"Disillusionment invades medical practice," The Weinmann Report, www.politicsofhealthcare.com, 02/22/14

"How physicians eat their young," The Weinmann Report, www.politicsofhealthcare.com, 02/12/14

"Money and Medicine," The Weinmann Report, www.politicsofhealthcare.com, 07/21/12












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