After years of taking the federal government to task for its burdensome regulation of medicine, the Association of American Physicians & Surgeons–an organization representing private-practice, direct-pay doctors–has turned it’s attention to the American Board of Medical Specialties.
The AAPS has filed a lawsuit claiming that the ABMS, and its 24 specialty boards, “violate antitrust law and misrepresent the medical skills of physicians who decline to purchase and spend time on its programs.” Specifically, the suit charges ABMS with restraint of trade and causing a reduction in patient access to physicians.
In a press release, AAPS Past-President Alieta Eck, MD, notes that “The Boards invite patients to go online to see if their physicians are enrolled in Maintenance of Certification (MOC), as if they can prove that this has any bearing on their clincial skill or ability to care for their patients.”This creates a coercive force under which doctors feel pressured to obtain and maintain board certification at considerable cost to themselves.
Dr. Eck stresses that the Boards represented by ABMS “regulate themselves with no outside oversight.”
AAPS claims that the certifying pass-fail tests used by boards within ABMS are designed to have certain failure rates, which can be as high as 20%. By promoting board certification as an uncontestable standard of competence, the ABMS is pushing physicians to buy into a costly certification process that has never been proven to improve actual quality of care.
“Many a physician has lost his ability to practice medicine in his current location because of MOC–even though he has been doing an excellent job caring for his patients,” writes Dr. Eck.”Physicians cannot see where they made mistakes on the tests and have no way to appeal or to verify the accuracy of the grading.”
She also points out that specialty certification has become a lucrative business bringing tens of millions of dollars into ABMS’ coffers, and some board directors bringing home nearly $1 million in annual compensation.
“The cost to enroll in MOC and to take the courses needed to answer questions often far removed from the niche specialty the physician has chosen, and the time away from caring for patients all take a toll on the physician,” says Dr. Eck, herself an internist in Somerset, New Jersey. The lawsuit against ABMS was filed in a federal court in Trenton, NJ.
AAPS is seeking refunds of fees paid by its members to ABMS and the 24 boards it represents, as well as “declaratory and injunctive relief” to enjoin ABMS’s continued violations of antitrust laws.
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