TMA Testimony by Kim Monday, MD
Testimony for Senate Bill 1148
Kim Monday, MD, FOR CSSB 1148
House Public Health Committee
May 9, 2017
Thank you, Mr. Chairman and members of the House Public Health 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. However, physicians have been 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.
The MOC program began in the mid-90s and granted physicians who completed their training before that date a lifetime board certification, while the remainder of Texas physicians must participate in MOC or lose their ability to care for patients and sustain a practice. For the attorneys on the committee, this is like retaking your high-stakes bar exam every 10 years.
Most physicians feel initial board certification is necessary to validate expertise following residency and training programs. 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. These fees are compounded if a physician holds multiple board certifications. 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.
We are asking that you give physicians a choice in whether they continue to participate in this expensive and monopolistic endeavor. I encourage your support for Senate Bill 1148.
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