Statement from ASH President David A. Williams, MD, on Need for Changes to Maintenance of Certification, Comments on Assessment 2020 Report
Published on: November 05, 2015
As the world’s
largest professional society concerned with the causes and treatment of blood
disorders, the American Society of Hematology’s membership includes most of the
8,400 internists who hold hematology certificates issued by the American Board
of Internal Medicine (ABIM). For more than 14 years, ASH has actively
challenged the ABIM’s Maintenance of Certification (MOC) program on a number of
fronts, including the lack of evidence that the program’s requirements improve
the quality of medical care.
In September, the ABIM Assessment 2020 Task Force
released a report that included several recommendations for the future of MOC. Overall,
the report is disappointing because it largely focuses on means to revoke
internists’ certifications despite the lack of evidence supporting MOC’s
effectiveness in improving patient care. Modernizing MOC will require ABIM to shift
away from a policing function and instead focus on continuing professional
development. Additionally, substantial changes will be required to address the
program’s lack of measurable benefits to practitioners for the time and expense
to comply with MOC requirements.
In response to a request for comments on the report,
this week ASH sent a letter to ABIM President Richard Baron, MD, highlighting the
following key recommendations:
- MOC should be customizable instead of using a
“one-size-fits-all” approach. Specifically, ASH strongly urges ABIM to
recognize the special contributions to clinical care that physician-scientists
provide and develop a more realistic approach to the re-certification process
for this group of practitioners.
- As there is a significant lack of high-quality,
systematic, external research into MOC, ABIM should fund extramural research to
inform the evidence base for decision-making in these processes.
- Hematologists uniformly note that the secure,
closed-book examination required of diplomates every 10 years is not meaningful
given the diversification of career paths in the subspecialty and the wasted
time spent memorizing facts. ASH applauds the Assessment 2020 Task Force for
recognizing these failures.
- ABIM will further diminish its credibility with
the community if it continues to apply a unilateral approach to the development
of a new vision for MOC. Consensus building requires hard work, multilateral
discussions, and shared visions and agendas. The Society looks forward to a
time when ABIM fully embraces such an approach.
We hope ABIM will be receptive to our concerns as
well as the feedback of all subspecialty societies that represent its diverse
base of diplomates. The Society will keep pursuing opportunities for discussion
with ABIM to represent the views of the hematology community and build a new
approach to MOC that is valuable in improving patient care, straightforward for
diplomates, and nonintrusive into the already busy schedules of practitioners
Read ASH’s complete comments to ABIM at http://www.hematology.org/Advocacy/Testimony.aspx.
The American Society of Hematology (ASH) (www.hematology.org)
is the world’s largest professional society of hematologists dedicated to
furthering the understanding, diagnosis, treatment, and prevention of disorders
affecting the blood. For more than 50 years, the Society has led the
development of hematology as a discipline by promoting research, patient care,
education, training, and advocacy in hematology. The official journal of ASH is
the most cited peer-reviewed publication in the field, which is available
weekly in print and online.
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Amanda Szabo, American Society of Hematology