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Physician Quality and Maintenance of Certification

Marc Stephen Frager, MD; Hal Scherz, MD; Alieta Eck, MD
JAMA. 2012;308(24):2562-2563. doi:10.1001/jama.2012.131778.
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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.


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December 26, 2012
Christine K. Cassel, MD
JAMA. 2012;308(24):2562-2563. doi:10.1001/jama.2012.131781.
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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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