A survey released by the Tennessee Medical Association regarding physicians’ required maintenance of certification (MOC) by various medical specialty boards revealed that most Tennessee physicians feel the cost and effort associated with certification and/or recertification of a medical specialty is unreasonable and does not produce a measurable return on investment in terms of patient care.

The MOC process for years has stirred controversy in the medical community from physicians who have grown weary of what they consider to be excessive fees and overly frequent testing requirements. The TMA House of Delegates passed a resolution during the Association’s annual convention calling for the Board of Trustees to report the findings of the survey, which was conducted in 2014, and study the results to determine what, if any, national advocacy efforts it can support to improve the MOC process. MOC is not a state-level issue.

Key findings of the survey:

• Approximately 64 percent of respondents have had multiple recertifications after their residency or fellowship, and more than half of those have undergone recertification two or more times.
•   Other than a written test, 88 percent of respondents said their board has additional requirements to satisfy a specialty certification.
• The average cost among respondents to become certified by their specialty boards is approximately $2,250, and sometimes thousands of dollars more to be recertified. More than 80 percent felt these costs are unreasonable, especially when adding indirect costs such as travel, time away from the office and lost productivity.
• A majority of respondents invested significant amounts of time and money in review courses to prepare for recertification. More than one in three physicians begin preparing at least one year in advance.
• One in four physicians said they intend to relinquish their board specialty certifications before retiring from medicine, while 74 percent plan to let it lapse after they retire. Only 20 percent of respondents plan to retire within the next five years. 

According to the American Board of Medical Specialties, programs for board certification and MOC provide a trusted credential and uphold the integrity of medical specialty care. Certification is a voluntary process designed to demonstrate a physician’s expertise in a particular medical specialty and/or subspecialty. MOC is a system for ongoing professional development.