Physician Quality and Maintenance of Certification—Reply

In Reply: In surveys by the ABIM, physicians who complete MOC say they find it to be a valuable experience but also raise some of the concerns voiced by Dr Frager and colleagues. The ABIM continues to look for ways to make MOC more relevant to practice and reflective of real-world medicine. At the same time, the assessments must be rigorous enough to reliably differentiate physicians in setting a psychometrically valid standard (of performance).

As to the research on the benefits of certification and MOC, there have been several studies linking certification to quality. Because MOC is a relatively new program, there is less research, but 2 studies^1- 2 reported that higher scores on the ABIM's MOC examination for internal medicine are associated with better performance on quality indicators for diabetes and mammography screening. In addition, a positive association was found between the rate at which preventive care services were delivered for Medicare patients and certification status in internal medicine or family medicine.³ Additionally, time since a physician's last board certification correlates with decline in quality of care for patients being treated for high blood pressure.⁴ More research needs to be done in this area.