An Inside Look at ABIM Certification

The ACC’s Board of Governors and Board of Trustees heard from Richard Baron, MD, MACP, president and CEO of the American Board of Internal Medicine (ABIM) as part of a joint Town Hall leading up to ACC.14.

With new ABIM Maintenance of Certification (MOC) requirements in effect this year, this was an important opportunity to hear more about the new changes, as well as gain a greater understanding of the ABIM’s history and role moving into the future as the representing voice for internal medicine.

The ABIM was created in 1936 by the ACP and the AMA with the goal of publically differentiating members who met a peer standard from other physicians wh could not (or chose not)  to meet the standard. Cardiology was the first subspecialty to be approved in 1940 by the ABIM.

Baron noted that the recent changes are the result of the changing health care environment. He highlighted a statement by Brend James, MD, that says a typical clinician needs to learn, unlearn, then relearn half of their medical knowledge base five times during a typical year. An exam every 10 years is not enough.

Looking ahead, Baron said the ABIM is changing its governance to include the development of specialty boards that would support society relations, training, exam and MOC II and IV. The cardiology board, which is currently being developed, will be a two-tiered distributed board with a stronger more uified voice.

The spirited discussion following Dr. Baron’s address allowed for ACC leaders to express their concerns — and those of their colleagues and state chapter members — about the new changes. It is clear there are very real issues associated with meeting the changes and this meeting provided a much-need opportunity for ABIM to hear directly about suggestions for improvement.

These discussions will only continue. As part of the College’s three-pronged MOC strategy, the College is committed to taking member concerns directly to ABIM and advocating for improvements. You can learn more about the College’s strategy, which also includes education materials on the new changes, as well as tools for meeting the requirements, at CardioSource.org/MOC. Stay tuned to the ACC in Touch Blog tomorrow for a guest post from Dr. Baron as well.

9 thoughts on “An Inside Look at ABIM Certification

  1. I believe that re boarding is economic credentialing and the Abim is taking advantage of physicians who’s income is falling. Cme is enough. The average cost to the physician is 6-8?thousand dollars when you consider time lost, travel review. All of us have dedicated most of our youth and lives to the profession . We do not need a supervisor of our reeducation which is injurious to patient scheduling, relationships and travel away from our practices. A pledge of reeducation and Cme should be enough . Consider physicians with multiple boards whom will have to bear the economic brunt of several boards perhaps costing as much as $20,000.
    Sincerely
    Leslie hershkowitz MD

  2. If MOC were truly beneficial, physicians would want to participate. However, most only participate because they are forced by insurances or hospital staff rules. Since there is no high quality evidence MOC benefits patients or physicians, MOC participation should be truly voluntary and not linked to hospital privileges or insurance panels.

    The ABIM has a 40 year history of changing certification rules to force more and more physicians to comply with their MOC process of uncertain value. This is the opposite of how we want to deal with patients and is the opposite of providing high quality care.

  3. MOC is analogous to corruption in other parts of our society. Where a handful of people can insert themselves between you and your money, they do so. The outrageous expense of this, in light of so called impending shortages of physicians is very, very suspect. With costs of licensure going out of the roof, costs of DEA yearly fees approaching a thousand a year, and now this, the costs of maintaining licensure are approaching 20% of take home for many physicians. OUTRAGEOUS. That precludes any physicians from doing part time work as their entire pay goes to these follies. I say to the mafiosos, back off of this unnecessary folly now. What respectable profession would stand for 20% licensure fees? And besides a handful of people controlling what information physicians receive (bribery comes to mind right away), what benefit is this? None.

    • The ABIM has unfortunately transformed itself into an opaque quasi-regulatory organization whose recent sloppy decision to subject physicians to odious “recertification” burdens, at a time when the profession is already under massive amounts of redundant oversight, has provoked a violent reaction from physicians across the nation. There is no reason why we, as cardiologists, need to be subjugated by the ABIM. I would suggest that the ACC, HRS, TCT organizations, who have all had a strong track record supporting clinical activity and clinical physicians, lead the effort to offer our own recertification process totally independent of the ABIM. Why do ACC members need ABIM certification when the Steering Committees for the Cardiology Exams are all ACC members anyway? The ACC has the resources, the background and the talent to construct our own Board Certification process that is more economical, more relevant, less onerous, more common sense filled, and most importantly more respectful of our sub speciality. I find it oxymoronic that the ABIM leadership relies on overpaid, aloof non-clinicians to adjudicate what makes a competent cardiologist, interventional cardiologist, cardiac electrophysiologist and transplant cardiologist. I would like to appeal to my colleagues, peers and friends to lobby the ACC to construct an independent Board Certification process that is not reliant on the ABIM.

      – See more at: http://blog.cardiosource.org/post/acc-response-abims-moc-requirements/#comment-881505

  4. The recent changes in the ABIM are purely a result of corporate (ABIM) policy and profits and the statement “…that says a typical clinician needs to learn, unlearn, then relearn half of their medical knowledge base five times during a typical year. ” in pure nonsense. Physiology and patho-physiology have remained very constant over the years, while the pharmaceutical, testing, and many ancillary INDUSTRIES have proliferated to the point where diagnosing an appendicitis now requires a CT or MRI scan to justify that time consuming laparoscopic operation at GREAT cost involving 3 abdominal incisions, instead of the traditional, physical examination, CBC and 15 minute “open” appendectomy.
    Learning, unlearning and relearning simply describes the fact of “medical reversal” (rejection of prior “scientific” studies) which have been based on misuse of “big data” and questionably biased retrospective reviews, emphasizing that corporations are pushing “data” to meet corporate needs and sales. THIS is exactly what the ABMS/ABIM are doing with THEIR corporate MOC program. After decades of trying to prove Board Certification makes any difference and failing, they have used Bait and $witch techniques to force consumption to the completely non-validated MOC program and much like the ACA, “we need to pass it to see what is in it”-Nonsense.
    It is time for physicians and respective medical societies like the ACC to band together and REJECT this corporate Regulatory Capture and extortion of physicians, patients and insurance payments. Remember-the American Board does not have any influence in medical care in Europe or Canada-so where is there any need, recognizing healthcare is cheaper and in no way inferior in scope in THOSE advanced systems!

  5. MOC is nothing more than legalized extortion. I figure that to maintain more 3 boards that fall under MOC will cost me about 20000 dollars every 10 years. It would be indicated if MOC was proven to provide better patient outcomes but it has only be proven to reduce my checking account. I have to practice evidence based medicine, why does the powers that be ( ABIM, ACC etc…) only make decisions based on their financial gain!

  6. MOC is not totally useless as I have learned quite a bit while studying for my recertification of my interventional cardiology boards. I cannot say the same for the part IV of the MOC process where we are compelled to complete pseudo-science project to satisfy the ego and misguided efforts of someone to make us jump through a meaningless hoop. It is a complete waste of my time and will not make me a better or smarter cardiologist. I, for one, refuse to complete it. I have passed my board exam and I am willing to complete the ongoing MOC but will not be completing the BS project.
    Why has the ACC capitulated to the ABIM regarding this? Has the ACC asked the members if they think it is worthwhile use of our precious time? Shame on the ACC for acquiescing.
    How much money does the ACC make in perpetuating this fraud? The ABIM makes a lot.
    Has the ACC taken note of the petition by Dr. Paul Tierstein? Over 10,400 signatures is not to be ignored.

  7. I believe that re boarding is economic credentialing and the Abim is taking advantage of physicians who’s income is falling. Cme is enough. The average cost to the physician is 6000-8000 dollars then when you consider time lost, travel review. It is really expensive.

  8. The ABIM has a 40 year history of changing certification rules to force more and more physicians to comply with their MOC process of uncertain value. This is the opposite of how we want to deal with patients and is the opposite of providing high quality care.

    So what are you going to do bout it.

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