Background/Purpose: There continues to be a debate about the value and purpose of maintenance of certification programs (MOC) created by board-certifying organizations. Physicians, echoed by multiple societies including the American College of Rheumatology (ACR), have raised concerns questioning the recertification process. The goal of this survey study is to assess the impact, value, and purpose of maintenance of board certification in rheumatology.

Methods: A survey designed to assess the impact and perceived value of maintenance of board certification in rheumatology was sent via email to 3,107 rheumatologists within the US. The survey addressed issues related to how rheumatologists perceive negative and positive impacts of MOC, and how this program might affect various aspects related to rheumatology practice and patient access to care.

Results: A total of 515 rheumatologists completed the survey. With an estimated number of ~5,000 full-time practicing rheumatologists in the US, this sample size gives a margin of error of <5% with 95% confidence that the responses accurately reflect the views of rheumatologists. The majority (74.8%) did not think there is significant additional value in MOC, beyond what is already achieved from Continuing Medical Education, or that MOC is valuable in terms of improving patients care (63.5%). The majority felt that the primary reason for creating MOC is financial well-being of board certifying organizations (43.4%) or to satisfy administrative requirements in health systems (30%). Only 15.1% believed improving patient care was the primary reason for MOC. The majority of rheumatologists believed board certification should be a life-long credential (63.7%), and 75.2% favor a state legislation to remove MOC as a requirement for employment, insurance reimbursement, or securing clinical privileges. Notably, when asked about positive and negative impacts, the majority reported that MOC results in time away from providing patient care (74.6%), time way from family (74%), and psychological stress (69.7%). 65.6% perceived staying current with new knowledge as a positive impact of MOC. When asked about anticipated effects of requiring MOC, 77.7% reported physician burnout, 67.4% early physician retirement, and 63.9% anticipated an effect on reducing the overall number of practicing rheumatologist. Of interest, 58.9% believe board certification in rheumatology should be administered or overseen by other organizations such as the ACR. Of the respondents who reported participating in research activities, 39.6% believed MOC is adversely affecting their ability to perform research or research related activities.

Conclusion: The majority of rheumatologists in the US do not believe there is value for recertification and maintenance of certification in rheumatology. Negative impact was clearly more than any positive impact perceived. Importantly, there is evidence for lack of trust in board certifying organizations among rheumatologists, and the majority of rheumatologists believe MOC contributes to physician burnout, early retirement, and loss in the rheumatology work force. This is alarming given the current and predicted shortage in rheumatologists in the future.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/evaluating-the-perception-among-rheumatologists-of-maintenance-of-board-certification-programs-in-the-united-states/