MOC is here to stay; now it's time to educate yourself

January 1, 2007

Be sure that your knowledge of MOC is based in fact and not preconceived notions.

The legislation, regulations, and directives have ushered in new administrative processes for physicians to follow, not to mention new acronyms to learn.

In 1996, Congress began work on a plan designed to protect patient privacy and improve efficiency in health care delivery through electronic means, and provisions of what became the Health Insurance Portability and Accountability Act (HIPAA) went into effect in 2003. Physicians were forced to develop several new procedures to ensure patient privacy and security.

As part of the Medicare Modernization Act of 2003 (MMA), the practice of reimbursing physicians 95% of the average wholesale price (AWP) for drugs administered in the office was essentially eliminated. In its place, the MMA established a new average sales price (ASP) drug payment system, resulting in deep reimbursement cuts that hit urologists particularly hard.

There have been other rules and mandates, but none has drawn the ire of our readers like maintenance of certification (MOC), which will begin to take effect for some urologists this year. A requirement of all member boards of the American Board of Medical Specialties (including the American Board of Urology), MOC encompasses re-certification and establishes additional processes designed to ensure that physicians are keeping up to date clinically.

Since our coverage of this controversial issue began 5 years ago, a number of angry letters have reached my desk. One contained vicious attacks against organized urology that had to be removed in the interest of decency. Another lobbied readers to "just say no to MOC" and included the ABU's fax number, generating at least 30 letters to ABU headquarters.

Urologists' frustration over another seemingly invasive mandate is understandable. But MOC is not going away. Therefore, I would encourage you to learn as much as you can about it. Be sure that your knowledge of MOC is based in fact and not preconceived notions.

Start by reading the article that begins on page 1 of this issue ("ABU plans MOC to be flexible, relevant") and the related article in this issue ("ABU addresses concerns about cost, value of MOC"). I also recommend that you attend a session at this year's AUA annual meeting in Anaheim, "Issues of Urologic Training and ABU Certification," on May 21. If you still have questions, let them be heard.

I believe ABU President Linda Shortliffe, MD's claim that the ABU is doing all it can to make the MOC process flexible and relevant for practicing urologists. In the end, if MOC achieves the goal of better care and improved outcomes, it will certainly be worth the effort.