Many diagnostic radiologists with lifetime certificates choose not to participate in the American Board of Radiology (ABR) Maintenance of Certification (MOC) program, according to new findings published in the American Journal of Roentgenology. Does this mean those radiologists have negative feelings about the MOC program?
Beginning in 2002, the study’s authors explained, ABR policy shifted and all diagnostic radiology certificates were time limited, meaning MOC participation was required for them to be valid. Individuals who had already been issued a lifetime MOC certificate, however, are not required to participate, though it is still “encouraged” by the ABR. The team behind this study wanted to compare participation rates between diplomates with time limited certificates and those with lifetime certificates.
“If radiologists believed that MOC's benefits exceeded its costs, one would hypothesize high participation rates, even among those whose participation is not mandated by the ABR,” Andrew B. Rosenkrantz, MD, department of radiology at NYU Langone Medical Center in New York City, and colleagues. “Information regarding mandated versus nonmandated participation could thus provide insights to inform ongoing debates around the value of MOC and guide innovations to validate radiologists' lifelong learning.”
Using CMS data and corresponding ABR certification information, Rosenkrantz et al. found that 56.4% of diagnostic radiologists participated in the MOC program. That includes 99.6% of specialists who are required to participate by the ABR and just 13.9% of those who have lifetime certificates and are not required to participate. Nonmandated MOC participation was higher among academic radiologists, subspecialist radiologists and those who work in larger groups. Nonmandated participation varied from state to state, from 0.0% in South Dakota to 32.6% in Virginia. States with a less dense population were associated with less nonmandated participation.
“For those mandated, participation is nearly universal,” Richard Duszak, MD, professor and vice chair for health policy and practice in the department of radiology and imaging sciences at Emory University in Atlanta, said in a prepared statement from the Harvey L. Neiman Health Policy Institute. “In contrast, among lifetime-certified diagnostic radiologists whose participation is not ABR-mandated, participation rates are low.”
Rosenkrantz et al. noted that these findings could suggest “diplomate dissatisfaction or negative perceptions about MOC.”
Another sign that radiologists are unhappy with the ABR’s MOC program is a federal class action lawsuit filed in February 2019 by a radiologist in Tennessee against the ABR. The ABR was also named a co-conspirator in another class-action lawsuit claiming the American Board of Medical Specialties, American Board of Emergency Medicine and American Board of Anesthesiology violated federal antitrust laws.
The American College of Radiology also wrote a letter to the American Board of Medical Specialties in January 2019 about specific complaints related to changing certification policies.