Support Bill to Reduce Maintenance of Certification Requirements

Testimony for SB 1148 by Kim Monday, MD

Senate Business and Commerce Committee
Senate Bill 1148 by Sen. Dawn Buckingham, MD

April 11, 2017

Thank you, Mr. Chairman and members of the Senate Business and Commerce Committee, for allowing me to testify today. 

My name is Dr. Kim Monday. I am a neurologist from Houston. Today I am testifying on behalf of the Texas Medical Association and its now more than 50,000 physicians and medical students. I am testifying “for” Senate Bill 1148.

In Texas, we pride ourselves on being a business-friendly state, with low regulations and other incentives for individuals to bring their business here. We have become the model for the nation for economic development and growth. However, physicians often get left behind when it comes to reducing regulations.

Under Texas law, physicians licensed to practice medicine are required to meet rigorous continuing medical education (CME) standards, including training in medical ethics. Physicians typically seek out CME courses most relevant to their patients and specialty area of practice.

However, there is another form of certification that physicians obtain to be board certified in a specialty. The physician retains this status through a maintenance of certification (MOC) program, administered by the national specialties societies in coordination with the American Board of Medical Specialties (ABMS). While physicians are not required to complete MOC as a condition of state licensure in Texas, many hospitals, employers, and public and private payers require MOC as a condition for working with a physician, thereby creating a de facto mandate on physicians.

Many physicians feel initial board certification is necessary. However, we find the continuous maintenance of certification process to be burdensome, expensive, and filled with irrelevant curriculum. Most importantly, this process steals valuable time from our patients and our practice. 

The cost of MOC can be as high as $10,000 per physician for fees, materials, travel, and time away from practice. MOC has become more of a money-making scheme for the specialties and ABMS versus a relevant tool to help physicians stay current on best practices. In fact, many physicians say the information studied and tested has little applicability to our day-to-day practice.

It is because of this that we are now turning to the legislature to help reduce this irrelevant, burdensome requirement on the medical industry. 

Several states are evaluating legislation similar to SB 1148 with the overarching principle that MOC cannot be the sole requirement for licensure, payment, employment, or admitting privileges at a hospital. Oklahoma actually has passed this into law. 

We are asking that you give physicians a choice in whether they continue to participate in this expensive and somewhat monopolistic endeavor.

I am proud to be a Texas physician, as the practice atmosphere here is one of the best in the nation. But with our vastly growing population, we must continue to make Texas not only a friendly state to practice in but also one that is competitive in attracting physicians to practice here. 

I thank you for the opportunity to testify, and ask for your support of SB 1148 by Senator Buckingham. 

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