Politicizing Certification

For the better part of 2015, the debate over Maintenance of Certification (MOC) has dominated our specialty and various others. Physicians from across the spectrum of medicine have voiced their dissatisfaction over increasingly burdensome and unreasonable certification requirements. While our voices have been heard, recent developments indicate that more work is needed. More specifically, despite recent apparent outreach efforts from the American Board of Dermatology (ABD) to dialogue with physicians on the issue of recertification, each communication we receive only seems to underscore why more action is badly needed.

Recently, the ABD released results from a survey regarding MOC and recertification. The results they presented are incredibly one-sided toward the “pro”-MOC proposals. In fact, no options were given for opposing MOC or recertification. Additionally, the comments included in the so-called “results email” were particularly slanted, as remarks (including my own decidedly negative ones and many others) were not included.

Moreover, the ABD’s stated viewpoint about surgical and cosmetic dermatologists being the only ones who are negative toward the exam/MOC is irresponsible and demeaning to respected colleagues. While I do surgical and cosmetic dermatology, 60 percent of my practice is actually medical and I absolutely am against this test. Clearly, there are other, purely medical dermatologists who have no desire to spend weeks preparing for an expensive test that has no discernable value to their level of expertise.

Clearly, this survey was not designed in the best interest of serving our specialty. With the ABD skewing both the survey questions and the comments, the organization’s political motivations seem to be in question. While I personally commend the efforts of ABD to further the level of care and rigor that pertains to the initial board certification we all strive for upon completion of a dermatology residency, the pathway to ongoing competence and MOC, in particular, seems to be distorted and increasingly politicized.

Despite the disconcerting nature of this episode, recent developments from various other specialties offer a perfect example of how change happens and why it isn’t unreasonable to reformulate our criteria for our specialty. Given the recent stunning reversals by ABIM and Anesthesia, it only seems appropriate that similar actions should take place in dermatology. Additionally, the lack of evidence that either of these onerous procedures/tests provide better care of our patients further illustrates the point that we don’t need them and shouldn’t subject our members to the costs, anxiety, and overall burden of these processes.

It is important that we all work together as a specialty to make our voices heard and continue on the road to a more intelligent process for ongoing certification. n

—Joel Schlessinger, MD 
Chief Cosmetic Surgery Editor