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, February 10, 2015

I Really Should Be Studying, But The ABPN Is Too Outrageous

My MOC exam is in 2 days. I'm headed into the home stretch right now, and I plan to spend tomorrow memorizing CYP 450 stuff, as well as various elimination half lives. Oh, and seeing patients. 

But I got this email just now, and I'm reproducing it in full. I can't figure out if the people who write this crap actually believe it. Look at the ABPN patting itself on the back for having already put in place the changes the ABIM plans to implement!

Check it (and the boldface is theirs, not mine):

Dear Diplomates,

The purpose of this letter is to respond to inquiries from many American Board of Psychiatry and Neurology (ABPN) diplomates concerning the recent communication from the American Board of Internal Medicine (ABIM) about changes it plans to make in its Maintenance of Certification (MOC) Program.  The ABIM has now pledged to engage the internal medicine community in an effort to make its MOC Program more relevant and meaningful for physicians involved in patient care and clinical leadership.  While all 24 Member Boards of the American Board of Medical Specialties (ABMS) have agreed to follow its MOC Standards, the specific manner in which those standards are met is largely up to the Member Boards.  It is gratifying to note that most of the changes now planned by the ABIM are consistent with policies and practices already in place in the ABPN MOC Program.
At the heart of the ABPN MOC Program are several core beliefs that serve as the foundation for our specific requirements.
The ABPN believes that the vast majority of its diplomates already pursue life-long learning.  The main tasks for the ABPN MOC Program are to support the ongoing professional development of our diplomates and to reinforce and document their life-long learning efforts in a manner consistent with the expectations of outside organizations and the public. 
The ABPN believes in a collaborative approach to MOC.  We work very closely with our related professional societies like the American Psychiatric Association, the American Academy of Neurology, and virtually every subspecialty society.  We encourage those societies to develop relevant MOC products for their members and we have a streamlined process in place for the review and approval of those products.  We also recommend that societies provide those MOC products to their members for free or at reduced cost, and many societies have recently followed our recommendations. 
The ABPN believes that it must avoid any potential conflict of interest in its MOC Program.  We develop no MOC products other than the MOC examinations, and we depend upon our professional societies for the development of MOC products for self-assessment, CME, and performance improvement.
The ABPN believes that its MOC requirements must not place an onerous burden on diplomates.  As a result of recent feedback from diplomates, we significantly reduced the self-assessment and performance improvement requirements for diplomates in our 10-Year MOC Program.  We also recently made a decision to give 3 years of MOC credit to diplomates who have completed accredited subspecialty training and passed our subspecialty certification examinations.
The ABPN believes that it is crucial to allow diplomates to select the specific MOC products that best fit their needs for self-assessment, CME, and performance improvement.  We have never required that diplomates complete specific MOC activities that are not relevant to their own practices.  With the flexibility afforded in the new 2015 ABMS MOC Standards, we recently expanded the range of options available for diplomates to meet its self-assessment and feedback requirements.
The ABPN believes that it is important to recognize and give diplomates MOC credit for what they do already.  We know that many diplomates work in organizations requiring quality improvement and feedback activities that are very similar to our MOC requirements, and we want to recognize those diplomate activities.
The ABPN believes that the vast majority of diplomates should be able to pass its MOC examinations.  All of our MOC examinations are clinically relevant and have reasonable passing standards.  To date more than 95% of diplomates have passed our MOC examinations, and diplomates are given two chances to pass an MOC examination before their certification is rescinded.
The ABPN believes that it must only report whether or not diplomates have met its MOC requirements.  While we encourage diplomates with “life-time” certificates to participate in MOC, we also maintain our covenant with them by being clear that they are not required to do so.  We also recently modified our requirements to make it easier for our "life-time" diplomates to enter our Continuous MOC Program should they choose to do so.
The ABPN believes that diplomate attestation and random audit are acceptable methods to document their performance in MOC.  We never require diplomates to submit any MOC or practice data to the ABPN. 
The ABPN believes that its MOC fees must be reasonable.  We carefully review MOC fees annually.  Fees in our 10-Year MOC Program were reduced 25% in 2008, another 6% in 2009, and will be reduced another 7% in 2016.  All total, MOC fees will have been reduced 34% since 2007 and are at a level significantly below the average for all Member Boards.
While the ABPN recognizes that its MOC Program is continuously evolving, we are planning no other changes in our MOC requirements at this time.  The ABPN is continually looking for more ways to improve its relevance and flexibility and to reduce the burden it places on our busy diplomates.  As we have done in the past, we welcome any constructive recommendations in that regard.  Our sincere hope is that the ABPN can be seen by diplomates as an important ally that can help them to document their life-long learning for their patients and those organizations who license, credential, and pay for their services.  We commit to doing all we can to make that hope a reality. 
Dr Faulkner sig .tif
Larry R. Faulkner, M.D.
President and CEO


  1. 16 Questions to Test Your Knowledge of the Mad-Capped Financial Adventures at the American Board of Internal Medicine and ABIM Foundation http://www.charlespkroll.com/episode/one/gang.html

  2. " As we have done in the past, we welcome any constructive recommendations in that regard."

    I think that is the most stunning remark. I hope that a parallel certification organization can be developed. Without it this monopoly will continue to consolidate its power by making MOC a condition of state licensure and eventually part of the credentialing business.

    1. I'm not typically optimistic but now I've become hopeful. Read the links below.



      Dr. C.B. Child/Adolescent Psychiatry Fellow

  3. Wishing you luck. I have no doubt you are MOC-worthy.

  4. Replies
    1. I hope someone with some power figures that out soon.

  5. This was sent in from Anonymous on 07.21.16. I was reading it while walking down the street, and I tripped and hit "delete" instead of "publish". But this is the message:

    Dr. Faulkner "earned" over $900,000 in compensation in 2014 for serving as President of the non-profit ABPN. 2014 tax return also reveals over 16 million $ in examination, application, continuous MOC income. Furthermore, it appears that Faulkner is responsible for approving his own salary.