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December 26, 2012

Physician Quality and Maintenance of Certification

Author Affiliations

Author Affiliations: East Coast Medical Associates, Boca Raton, Florida (Dr Frager; marcsf@hwmail.net); Georgia Urology, Atlanta (Dr Scherz); and private practice, Piscataway, New Jersey (Dr Eck).

JAMA. 2012;308(24):2562-2563. doi:10.1001/jama.2012.131778

To the Editor: The Viewpoint by Drs Conway and Cassel1 stated that Maintenance of Certification (MOC) has “ . . . the clear aim to improve quality. . . . ” However, the authors provide no convincing data to show that this goal has been accomplished. We are unaware of data that MOC produces better clinicians or benefits patients.

Certification was developed to prove that a physician had become knowledgeable in a specialty. Voluntary recertification began in 1974; but what began as a reasonable way to keep up with advances in medicine has turned into a costly, mandatory process. Forcing physicians to retake tests every few years requires expense and time off work for test preparation. In our opinion, a flexible approach with self-directed continuing medical education and voluntary self-assessment products would be less time-consuming, less expensive, and more effective than MOC. Additionally, taking a test without access to tools physicians use daily, such as smart phones and computers, seems not to reflect the actual practice of medicine.