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February 2004

 
Letters to the Editor
 
 

Speaking Out About MOC

Do Unto Others


Speaking Out About MOC

I am writing in response to the article concerning the American Board of Ophthalmology and its proposed plan for Maintenance of Certification (“MOC Takes Flight,” September). I recently satisfied the requirements for the 10-year recertification, and should not need to do anything additional until 2014. The process went smoothly, and I actually learned several things. Even though I would have preferred to spend my $1,000 on a new guitar, I suspect that the mission of the ABO was accomplished.

Through MOC, the ABO aims to weave the recertification process into the fabric of ongoing eye care so that learning new things and staying current is not just addressed in 10-year bursts, but is done more on a continuum. This idea sounds reasonable to me, and I hope it works—for those of whom it is required.

To extend the analogy Dr. Shields described in EyeNet, let’s get on an airplane. On this plane, I see a pilot who finished his training 10 years ago and one who finished his training 20 years ago. Which pilot is likely to be less connected to the “technology advancing at lightning speed”? The older pilot, I think. For the record, pilots are required to keep their certification current irrespective of age or time of training. (I checked.)

If it is truly important to ensure that the “skies are safe” for the patients who see Eye M.D.s, then it makes no sense for the ABO to exempt any ophthalmologist from compulsory recertification. For the purpose of ongoing quality assurance, artificially creating two classes of ophthalmology diplomates is not only unfair, it is irresponsible. Sure, the exempted ophthalmologists could offer to spend $1,000 and many hours of their discretionary time to recertify voluntarily. Those willing to do this would likely be drawn from the same diminutive pool of people who exercise every day, eat no red meat and never exceed the speed limit. Apparently, all ABO board members have decided to undergo the recertification process, even though they don’t have to, as a symbol of the importance of this movement to ophthalmology and its transcendence over a lot of other issues. If MOC is so important and transcendental, then it should be for everybody.

Even though it appears that the lifetime certification is carved in stone, it really is not. The ABO could decide that it has an obligation to the American public to ensure the competency of all Eye M.D.s, and require that all ophthalmology diplomates recertify by the same mechanisms. To fail to insist on an all-inclusive recertification flies in the face of reason.

I am formally requesting that the ABO respond to this letter and explain why it has not insisted on a fair and equitable set of requirements for all ophthalmologists. It’s the right thing to do, and the transition into the MOC era is the time to implement it.


Michael S. Korenfeld, MD
Washington, Mo.


Do Unto Others

As a younger ophthalmologist, I read with great interest the recent article about Maintenance of Certification. I share many of the concerns my peers have expressed. I particularly agree with the statement by Andrea V. Gray, MD, that she “would like to see representation from my generation in the decision-making.”

We, as a group, cannot help but feel we are being taken advantage of by lifetime certificate-holders in positions to make the decisions on recertification. It is easy for them to require recertification and charge thousands of dollars for testing that will ultimately benefit their agendas, while they remain protected from such demands and fees.

If you take an anonymous poll of lifetime certificate-holders to see how many of them would voluntarily submit to testing/recertification and its fees, I guarantee fewer than 10 percent would volunteer. With that in mind, they should strongly reconsider their proposed process of recertification that they deem “fair and reasonable.” Just as in patient care, if you would not do it to yourself, do not do it to others. To do otherwise is unethical.

Kurt K. Lark, MD
Concord, N.C.

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