Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.

Tuesday, March 25, 2014

Webinar F/U

I mentioned in my last post that I was going to be participating in an MOC Update Webinar sponsored by the AAPS. Let me start off with a disclaimer: I don't agree with a lot of the views of AAPS, but they have some important ideas, and contributions to make, including their suit of the ABMS (American Board of Medical Specialties), so I find them useful.

The webinar didn't cover much new territory. Some highlights:

The main speaker, Paul Kempen, touched on something I'm not sure I agree with, but that I thought was interesting. Namely, the idea that the Performance In Practice (PIP) modules, which involve implementing the use of rating scales, and then following up on patient outcomes, is a form of using patients for research without their specific consent.

There's a lot of corruption-kickbacks, conflicts of interest, among the higher-ups in the ABMS. Even without the corruption, it costs doctors a lot of money to recertify, and even though ABMS is not-for-profit, executive salaries can hover around $1 million a year.

The ABMS is not regulated, and calls itself the sole official monitoring body. In fact, it doesn't do any monitoring of incompetence, in the form of disciplinary actions. And of course, there is no evidence that it improves patient care.

One question pointed out that if you're being judged on the basis of improved outcomes, such as lower blood pressure, and your licensure is riding on that judgement, you might just tend to "round down" a patient's BP.

Those doctors participating in PQRS will be financially penalized if they don't maintain certification.

Even those physicians who are grandfathered in will have to take a recertification exam by 12.31.23, or they will be given the official descriptor, "Certified Without Meeting MOC Requirements".

Exam questions are clinically irrelevant, out of date, or inaccurate.

What scares me is the way Maintenance of Licensure (MOL) is insinuating itself into the picture. If the ABMS is trying to promote itself as the only game in town, what better way to make sure it stays that way than to make licensure dependent on participation in MOC/recertification.

If you'd like to watch it, you can view the webinar in full here.

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