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ACP offers a number of resources to help members make sense of the MOC requirements and earn points.
Understanding MOC Requirements
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April 11-13, 2019
Internal Medicine Meeting 2019
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Lifelong learning. We love it. And I suspect that is the reason
that many of us are internists; we have always been the ones who
want to know "why?". Learning and discussing new things
with my peers at the chapter meeting recently motivated me. More
than one of my patients has benefited from my newfound knowledge
that I can use losartan to help manage gout and blood pressure. I
also learned from and had conversations with several of you at the
chapter meeting about the ABIM's new
maintenance of certification (MOC) requirements, and I want to
take this opportunity to share some resources. Please link to the
current ACP's information about MOC. I will be sharing your
concerns and learning more about ACP's conversations with the ABIM
about the process at the national meeting upcoming in April.
In addition the ABIM is seeking to improve the MOC process and
is asking for input. Please link to their website to productively share
your concerns and suggestions.
In this newsletter you can also learn from Dr.
Unrein about how Colorado is addressing maintenance of
According to the ACP, "Internal medicine physicians are
specialists who apply scientific knowledge and clinical expertise
to the diagnosis, treatment, and compassionate care of adults
across the spectrum from health to complex illness." Implied
in that definition is that we will continue to change our practice
patterns as evidence is presented to us. In addition to gaining new
knowledge at the chapter meeting, I also got to recently watch over
100 highly energized internist-fans learn some IM trivia at the
Doctor's Dilemma competition between the Denver residency programs.
Regardless of where we are in our career pathway, we internists
strive to learn to do what is best for our patients. And it's
The Colorado ACP Council for Early Career Physicians, or CECP,
has had a busy year fulfilling its charge to "enhance professional
development, provide educational opportunities, promote networking,
and maintain a home for Colorado's early career internists."
Members of CECP dawned their Rockies' purple for a meet and
greet with Internal Medicine residents as the Rockies hosted the
San Diego Padres in August. Several early career physicians were
able to welcome a continent of brand new interns and a handful of
returning residents to the state of Colorado on a great, warm,
blue-sky afternoon. Next, a number of early career physicians were
able to extoll the benefits of a career in Internal Medicine for a
group of interested medical students from Front Range medical
schools. The students were very engaged and had many insightful
questions about their next steps and even a few about ACP. Then,
the CECP welcomed a large crowd to St. Joseph's hospital in Denver
for the fall ECP educational meetings. After socializing over
dinner, the group of early career physicians, residents, and
medical students, experienced a very informative talk about medical
information and practices to know to be useful on a wilderness
trip. Finally, during the Chapter meeting at the Broadmoor in
February, physicians gathered for an interactive ECP breakfast
seminar about being an employed physician in the current era.
We hope Colorado's early career physicians, within 16 years of
medical school graduation, can join the Council for a spring
service event and summer networking gathering. Stay tuned to the
Colorado ACP website for more information on upcoming ECP events,
or to contact the leadership of Council for Early Career
Chad R. Stickrath, MD
Chair, Colorado ACP Council for Early Career Physicians
What are MOC and MOL and what are the differences between them?
By now I take it all of ACP physicians know and have heard of MOC
(called OCC for Osteopathic-certified internists). If you haven't,
this article is beyond your present comprehension and I direct you
to the ABIM or the AOBIM website for ongoing certification
requirements/education. Suffice it to say that MOC (OCC) is a
specialty-specific ongoing board certification process, while MOL
is the future of maintaining a medical license in Colorado (and
MOL is a confusing term and concept. First and foremost, it
sounds too much like MOC. My hope in this article is to clarify the
similarities and the differences, but I will continue to use the
abbreviations, so pay close attention.
In the 1980s, for various reasons, the Colorado legislature
removed any minimum requirement for CME in order for a physician to
renew his or her medical license (and the licenses of many other
health care professionals). Colorado is one of only four medical
licensing jurisdictions that still allow license renewal without
any CME. This, coupled with the pressures associated with the
Skolnik Act to increase physician accountability, have made
Colorado the testing ground and leader for MOL.*
Many other states and medical societies have reviewed the
concept of MOL and have rejected it, in part or outright. But a
unique climate exists in Colorado, so we are at the forefront of
this movement and we are moving forward. I am neither for nor
against the concept of MOL, but I serve on the Colorado Medical
Society's MOL sub-committee and have done so for several years as a
voice of caution, looking out for redundancy and trying to protect
physicians from becoming over-burdened. In that role, I have
advocated for a paced, sensible approach to MOL.
My message to Colorado ACP members is to give a glimpse into
what may be coming our way.
The momentum of MOL implementation in Colorado has slowed down
some, at least in part as a byproduct the backlash from the
increased requirements of MOC. The attitudes of the CMS MOL
subcommittee and the Colorado Medical Board (CMB) have tempered.
But one thing is clear: the opportunity to reject MOL in Colorado
has passed. There was a resolution I put forth at the CMS House of
Delegates to have to MOL sub-committee look at the issue more
carefully and report back to the CMS House of Delegates this
upcoming September. As a result of that vote, there will probably
be no MOL legislation during the 2014 legislative session. 2015
will probably see some sort of legislative action.
We all know that we renew our licenses every two years, on odd
years of the calendar, in springtime. The Colorado legislature
meets in the winter and spring for 120 days every year to pass
legislation. Legislation is usually and appropriately written
vaguely to grant the administrative branch of government the
authority and time to conduct hearings and promulgate rules and
regulations. This takes time.
As the CMS MOL sub-committee foresees it, MOL in Colorado will
look something like this:
It is too far into the future to know what the self-assessment
and practice improvement pieces will look like. One last word of
caution for all of the lifetime-certified internists wanting to use
MOC requirements as a means of qualifying for MOL requirements (I
am specifically taking about ABIM here), after 2023, in order to
continue having yourself designated as meeting MOC requirements
under ABIM's rules, you will have to pass a secured
These are the nuts and bolts of MOL, MOC, OCC and any other
alphabet soup you would like to place on the ongoing lives of
physicians. Good luck!
*If you do not know the implications of the Skolnik Act, you
should. I refer you to the Colorado Medical Board [BME]
A series of free online cases and questions addressing
high-value care is available to help clinicians weigh the benefits,
harms, and costs of tests and treatment options for common
conditions in order to improve health and eliminate waste.
Each topic can be completed in 30 to 60 minutes on a desktop,
laptop, tablet or smartphone. These interactive cases offer
clinicians the opportunity to earn free CME credits and ABIM
Medical Knowledge (MOC) points.
The five topics are:
To learn more about ACP's High Value Care initiative and access
other helpful and free materials, visit the
In October 2013, ACP launched the ACP Leadership Academy to
provide internists with training and resources specific to
leadership in a healthcare setting. The Academy mainly focuses on
preparing early career internists for leadership roles, however it
also offers opportunities for existing leaders to enhance their
skills or refresh their knowledge.
The primary component of the ACP Leadership Academy is formal
education offered in partnership with the American College of
Physician Executives (ACPE). Steep discounts are provided to ACP
members on select courses, including strategic thinking, financial
decision-making, managing physician performance, and more. Offered
in a variety of formats, these courses offer opportunities to build
your CV, earn CME, and even roll coursework into either a
certificate program or a master's degree. To learn more or to register.
An additional component of the Academy is the ACP pre-course
offered during Internal Medicine 2014, "The Art of
Leadership". Focusing specifically on leadership within
internal medicine, pre-course topics include management skills,
building effective work teams, and more. To
Moreover, ACP is working on additional programs and resources,
including live local workshops and online modules.
Don't forget - you can always hone your leadership skills
further by participating in and leading local chapter
Contact us if you are interested:
Christina M Reimer, MD,
Governor, ACP Colorado Chapter
Chapter Staff:Christine Westbrook
Ph: (720) 301-3184
details about the ACP Leadership Academy, including updates to
For members who were unable to attend the annual chapter meeting
at the Broadmoor (we missed you!), I will summarize the health and
public policy update that I delivered on behalf of our chapter
Health and Public Policy Committee (HPPC).
While 2013 was a very active legislative year with some
controversial bills being passed, there was not a lot of new
health-related legislation. Rather, most of the energy expended on
health issues had to do with issues related to the continued
rollout of the Patient Protection and Affordable Care Act (PPACA).
Colorado did go ahead with the Medicaid expansion consistent with
Being an election year, 2014 is not likely to be a very active
year for legislation but who knows? The "mid-term"
election that will take place will be interesting with the
possibility of a swing in the control of the state Senate as well
as gubernatorial and US senatorial elections. The 6th Congressional
district promises to be a contested race this year as well.
Despite problems with the federal website, our Colorado health
exchange has been doing quite well. Over 60,000 people had signed
up for private insurance through the exchange by the end of January
and over 86,000 were new to Medicaid by the end of 2013. People
have until 3/31 to sign up for insurance.
The chapter HPPC participated in the 2013 ACP Leadership Day in
Washington, DC and met with most of the Colorado Congressional
delegation or their staff. Priority issues were the SGR fix and GME
funding. Some of our committee members also followed up with visits
in their district offices as well. Mark Matthews
and Dipesh Amin continue to represent us at the
CMS' Council on Legislation and Mark attended the first meeting of
the Colorado Primary Care Coalition on our behalf. Dave
Downs helped arrange a meeting of members of our HPPC with
Sen. Irene Aguilar to discuss her health care cooperative proposal
and we hope to continue to engage the Senator as this plan further
On a national level the ACP has been very active in pushing for
an SGR fix and we probably have the best chance in a long time
(perhaps ever) to see a permanent solution. The national HPPC also
published statements or position papers on team-based care,
prescription drug misuse and firearm-related violence.
Lastly, our chapter Governor and HPPC has been examining the
issue of whether or not to secure the services of a lobbyist to
help us be more effective at monitoring and impacting state
legislation and regulatory affairs. In a recent poll, just over 50%
of respondents supported this concept. Over the next several months
we will further evaluate this and seek proposals from selected
- Al Steinmann