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From the Governor
Phillip F. Bressoud, MD, FACP, ACP Governor


Curbside----Maintenance of Certification

I, like many of you, are facing the reality of sitting for the Maintenance of Certification (MOC) recertification exam. For me it will be the second time I have had to pass a recertification examination. Time limited board certification is not a new concept. The subject has been on the American Board of Internal Medicine (ABIM) agenda for over 30 years, but didn't become a reality until 1990 for internal medicine. The bad news: the first time pass rate on last year's Internal Medicine exam was a dismal 79%. The ABIM contends the low pass rate was an aberration, suggesting the physicians who took the test were simply not prepared for the exam. This pass rate is even more striking when you consider that other specialties are reporting pass rates in the mid to high 90% range for their first time test takers.

With such a high failure rate, it stands to reason that 1 in 5 internists could end up losing their board certification. The ABIM, in response, contends board certification isn't required to practice and physicians can still maintain their state licenses without board certification. While it is true that board certification isn't required to obtain or maintain a state license, the reality is that physicians must be board certified in order to practice in large health systems, hospitals or to be credentialed by insurance carriers. As we all know, non-board certified physicians have very few options to practice and are generally stuck accepting lower salaries than comparable board-certificated physicians. Indeed, I have heard from ACP members who are aware of physicians being decertified by insurance plans and losing their hospital privileges, all because of the inability to maintain their board certification.

In discussions with other Governors and the ACP leadership, we have learned that no other board recertification process is as onerous as that of Internal Medicine. Furthermore, there is no proof that the current MOC model has a positive impact on quality patient care, even though that is one of its stated goals. In the moments that I regress to my middle-school self, I focus on the fact that the ABIM, whose members approved the MOC process, do not have to sit for the recertification exams because they are deemed to be lifetime certificate holders. Sign me up for that classification.

So, what to do? At the Annual ACP Meeting in Orlando, FL the Board of Governor's passed - and the Board of Regents approved - a Resolution giving the ACP authority to investigate alternative methods of board certification. In fact, the ACP is currently involved at the national level in discussions with the ABIM regarding the MOC process.

Those formal discussions are likely to be influenced by a class action lawsuit filed by the American Association of Physicians and Surgeons (AAPS) against the American Board of Medical Specialties (ABMS). The correlation is obvious, since ABMS, like ABIM argue that board certification isn't required to practice and physicians can still maintain their state licenses without board certification. I'll keep you informed as that lawsuit progresses.

While the MOC debate plays out at the national level, we are unfortunately left with the MOC process. In response, this fall, the Kentucky Chapter of the ACP will present if first MOC session which will help you earn points toward your MOC requirements. The ACP has an excellent web page describing the process for MOC, how to get started and resources to best prepare for the examination. You may also find useful this MOC factsheet.

I will continue to keep you updated on the MOC discussion as it progress. In the meantime please feel free to share your experience or concerns regarding MOC with me at


Smart Medicine

ACP Smart Medicine Clinical Decision Support Tool - FREE to current members

ACP Smart Medicine is web-based or app tool that provides evidence-based recommendations on diagnosis, prevention, treatments, screening and more for hundreds of diagnoses. Available on the web or on your mobile device. ACP Smart Medicine automatically tracks your usage and free CME is available by documenting what you read and how it impacted your practice. For more information or instructions on how to get the app visit.


2014 Leadership Day Attendees

Our chapter will be represented by Drs. Barbara Casper, Curtis Cary, Clayton Smith and Greg Hood will be traveling to Washington, DC May 21-22 to talk with members of Congress and their staff about SGR, ICD-10, Medicare reimbursement, and graduate medical education financing. Leadership Day is an opportunity to meet directly with our politicians and their staffs regarding issues which directly affect us in the practice of medicine every day. If you have a specific concern or position on these or other issues, please send them to me.


Board of Governors Resolutions

The Board of Governors (BOG) resolution process is a means for chapters to forward ideas or concerns to the Board of Regents (BOR) to consider adopting as ACP Policy. At the National Meeting in Orlando the following resolutions were forward to the BOR:

Adopted and Referred for Implementation:

3-S13. Advocating for Studies that Assess Financial Collaboration between Long-term Facilities and Hospitals to Reduce Overall Healthcare Costs and Improve Patient Care

2-S14. Conveying Membership Dissatisfaction with the Maintenance of Certification (MOC) Process

4-S14. Requiring Education and Training in Team-based Care in Undergraduate Medical Education

8-S14. Studying the Impact of Underinsurance

10-S14. Updating College Policy on Healthcare Disparities to Include the Unique Needs of the Lesbian, Gay, Bisexual and Transgender (LGBT) Community

Adopted and Referred for Implementation as Amended by the BOR:

3-S14. Studying the Feasibility of Implementing Alternative Certification Methods

5-S14. Seeking Collaborative Partnerships to Study the Impact of Duty Hour Limitations on Resident Performance and Patient Safety

11-S14. Updating ACP Policy on FDA Regulation of Electronic Nicotine Delivery Devices

Adopted as a Reaffirmation of College Policy:

6-S14. Supporting Changes in Graduate Medical Education Funding to Help Address Projected Physician Shortages