Benefits of Maintenance of Certification Unclear

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

The American Board of Internal Medicine's Maintenance of Certification (MOC) program has had unclear benefits in terms of patient care but might lead to lower healthcare costs, two JAMA studies suggest.

In the first, researchers examined rates of potentially avoidable hospitalizations among some 150,000 Medicare beneficiaries treated by internists who were either required to complete MOC recertification in 2001 or were grandfathered out of recertification. While the rate of such hospitalizations increased with time for both physician groups, there was no between-group difference. The MOC-recertified group did, however, have 3% lower mean total healthcare costs.

The second study included roughly 70 internists with time-limited certification and 30 with time-unlimited certification at four Veterans Affairs centers. Over 1 year, the two physician groups didn't differ in any of 10 primary care performance measures, including colorectal cancer screening rates and post-MI aspirin use.

An editorialist writes: "The medical profession may never fully understand the effect of MOC, but that does not mean that physicians should give up or stop trying to make it better. The MOC program is a work in progress, as are all good physicians."