Member Forum

1.  MOC - anyone not doing?

Posted 03-18-2017 05:45
I apologize if this has been discussed; I tried to search it. 

Is Board certification needed to participate in Medicare and private insurances? I love medicine, patients, my staff, office, EHR. 
But I feel like quitting when I think of the "practice improvement project" and am wondering what the purpose is. I passed my 3rd board exam in 2014 and it's good until 2024 except for the issue of MOC. We already have county privilege license, state license, DEA license, CLIA license and pay for liability insurance. Those are all necessities. Is a board certification a necessity. I doubt my patients would judge that at this point after 18 years in practice. 

Last time I did the meaningless handwashing module. Not sure if we are allowed to do that again. It was embarrassing in this tiny solo practice to put up signs and do surveys. I am already fanatical about handwashing and sanitizer as is the staff. 

Mamatha Agrawal, MD
Family Doctor CaryNC
Cary, NC
Live in Raleigh, NC
Solo since 2012
Practice Fusion and NueMD

2.  RE: MOC - anyone not doing?

Posted 03-19-2017 05:58
I am curious about this same question:
Is Board Certification (eg ABFM) required to participate in Medicare, Medicaid, and private insurances?

PJ Parmar

3.  RE: MOC - anyone not doing?

Posted 03-19-2017 10:51
Hi Mamatha,
the internists have had much more intense debate over this-google ABIM and MOC- you'll get an eyeful.

NEW applications to insurances, hospitals, etc.  are easier w BC;  you'd have to check individual insurances for their policies.  

You should also look at NBPAS, founded by an interventionalist cardiologist/professor/head of department at ?Scripps? who rebelled over having to look up wrong outdated answers refuted by his own research.  It offers BC to those who have already been BC once by their board.

Peter Liepmann
My mission is to fix US health care
Bakersfield CA

4.  RE: MOC - anyone not doing?

Posted 03-20-2017 04:27
How about if you actually do something that ACTUALLY improves your practice and doesn't take that much time?
I submitted HowsYourHealth results with an improvement project I did  3 MOCs ago
The head of the ABFM said " this is fantastic" when he reviewed the project.  ( not that that matters, but it really is useful)
You get REAL DATA, things that really matter, easy to work on and helps you improve your practice!

Make lemons from lemonade !

link that explains how to use HYH ( see page 16)
and publication that explains the method here ( sidebar)
Wasson, "Clinical Microsystems Part 2: Learning from Micro Practices about Providing Patients the Care They Want and Need” JCAHO Journal, 2008, p 445-452

Lynn Ho

5.  RE: MOC - anyone not doing?

Posted 03-21-2017 08:56

We also used HYH for our MOC 'project'.   Was relatively painless and was something we were looking at in our office anyway.

6.  RE: MOC - anyone not doing?

Posted 03-26-2017 11:10
Can someone explain to me how HYH helped you do MOC, how it shows Quality Improvement activities and how it does Customer Satisfaction too?

Kathleen Saradarian, MD
Branchville, NJ

7.  RE: MOC - anyone not doing?

Posted 03-28-2017 06:32
you can submit as a part 4 project using the ' alternative pathway'

what I did in a nutshell was work on patient confidence in my practice
got baseline practice confidence numbers with 30+ patients
then did things to increase confidence for example - 'used the free problem solving pathway at hows your health with each patient who reported low confidence over the next year'   and then remeasured another 30 patients one year afterwards
so you just report the project and the before and after numbers from HYH

can do for simple things like access over shorter times
patients answer ' how easy is it for you to get medical care when you need it'  : answers very, somewhat, difficult or I have not needed medical care
get baseline and then institute open access, online booking, dedicated text line for appointments, a food truck for appointments whatever you want  or you think will work to increase access
and then remeasure the number again in 6 months -  it should go up   - if not your improvement project is not working and find another way

that's the quick and dirty .

Lynn Ho

8.  RE: MOC - anyone not doing?

Posted 03-28-2017 06:48
customer satisfaction is not the same as what HYH measures though it is close
a problem with customer satisfaction surveys is that 1) they are commercial and cost a gadzillion dollars
2) they dont actually help you with clinical care as HYH does by summarizing the 10 important primary care things ( emotions, pain, lifestyle habits confidence) 3) they are often gathered from an outsider organization in a very non systematic fashion with a very low response rate ( either they hate you or love you so you get outlier data) 

HYH measures the basics of primary care which are access, continuity, coordination, information, efficiency
these things in HYH are summed up by a summary question which is
"I get exactly the care I want and need when and how I want and need it "  answers strongly agree, agree, disagree
it is helpful to have an actual useful thing to measure so that you can go after a specific thing that is not perfect in your care ( like access etc)
 Most of the time when people feel that they get excellent access continuity coordination, efficiency and information
these correlate with strongly agree with the above statement about care ( most people are lumpers not splitters)
as a matter of fact we ( our imp group data)  did show an excellent correlation with  the separate constructs above in a paper in JACM
" the right tool for the right jobdrug addict with ' I get exactly the care...'

customer satisfaction is ' would you recommend this provider to your family'  or 'did you like your visit'

often they are the same but not always

Lynn Ho