Physicians Sue Over "Maintenance of Certification".

• Author: Eck, Alieta

Before 1990, American physicians who had completed three years or more of rigorous training in a specialty and passed an examination were awarded lifetime "board certification." The only exception was the family practice board, which always has issued time-limited certificates. After 1990, all member boards of the American Board of Medical Specialties (ABMS) followed suit and the nightmare of Maintenance of Certification (MOC) began for all board-certified physicians. This has proven to be a $230,000,000 windfall for the administrators of these boards. Strangely, any physician who was board certified before 1990 was "grandfathered"-exempt from this onerous requirement.

To continue to say they are board certified, younger doctors must take the board exam over and over again, spending thousands of dollars for the review courses and the examination, and hundreds of hours away from patients and family. There also are "practice modules" in which the boards' chosen "experts" try to dictate patient care. It is claimed to be "voluntary," but what if doctors elect not to do it?

My husband, John Eck, M.D., is a great doctor with unusual training and experience, but he no longer is allowed to practice at the hospital where he served for 26 years. He was board certified in family medicine, and I in internal medicine.

In 1980, John's general surgery program had a "pyramid" system. Each year, it started with 12 residents and narrowed down to four by the third year. Since John was in that group of four, his path to becoming a general surgeon seemed clear. In fact, he scored the highest grade among the four on his third-year surgery exam but, as he was finishing that third year of the five-year program, John was told his contract would not be renewed. As he found out later, his spot was taken by the son of a well-connected professor.

We had a growing family and needed income, so he went to nearby Somerset (N.J.) Medical Center and worked as an assistant surgeon for several years. He assisted in all areas-orthopedics, neuro, thoracic, and abdominal surgery. He had to dash into the hospital at all hours of the night to do emergency C-sections. He loved it, but realized it would be best to become board certified in something.

He chose family medicine, a field that suited him well. He was given only three months credit in the family medicine program for his three years of surgical training, but swallowed his pride, excelled in the program, and became an...