Finally, another indicator of the program’s relevance is that clinically active emergency physicians, including members of the ABEM Board of Directors and the EM community at large, have been involved in the development of the ABEM MOC program. Since its beginning in 2004, the ABEM MOC program has undergone multiple refinements, including reducing the number of readings and questions on LLSA tests, delinking the topics on the LLSA tests and the ConCert examination, and allowing practice performance to include more low-frequency, high-acuity conditions. Changes such as these were largely based on feedback from diplomates.

KK: Why does ABEM require MOC?

FC: The ABMS is an organization involving 24 medical specialty member boards, of which ABEM is one. Every ABMS member board is required to have a defined MOC program. That program should be relevant to its diplomates. ABEM further feels that MOC should provide value to diplomates, which it currently does in the form of cost and compensation. The annualized cost of ABEM’s MOC program is $265 per year, or about $5 per week, which is about the median cost of ABMS member boards and is less than 0.1 percent of the average emergency physician’s total annual compensation. The 2013 ACEP–Daniel Stern study showed that board-certified emergency physicians received $35,000 more in total annual compensation than noncertified physicians.² ABEM also participated in the Physician Quality Reporting System MOC bonus program, which was not the case with the majority of ABMS member boards. Participating in the program will have resulted in emergency physicians receiving more than $3 million in additional Medicare reimbursement.

KK: Can you define ABEM’s relationship with ABMS?

FC: In order for a specialty to have legitimacy in the house of medicine, it must be recognized by the ABMS. This is why emergency medicine fought so hard decades ago to be recognized by the ABMS as the 23rd medical specialty. That is also why, this past fall, ABEM proudly celebrated its 35th anniversary as an ABMS member board. As an ABMS member board, ABEM can also offer subspecialty certification. ABEM has worked hard to gain certification eligibility for emergency physicians in 12 different subspecialties, including critical care medicine, EMS, hospice and palliative medicine, medical toxicology, pediatric emergency medicine, sports medicine, and undersea and hyperbaric medicine.

In order for the ABEM Board of Directors to optimally meet the ABMS MOC standards in a way that best serves the specialty, ABEM continually surveys diplomates at nearly every step of the MOC process.

ABEM has a representative, Michael L. Carius, MD, on the ABMS Board of Directors, and the Chair Elect of the ABMS, John C. Moorhead, MD, is an emergency physician. ABEM has sought broad representation on several ABMS committees so that the views of the emergency medicine community can contribute to ABMS policy decisions.

KK: What would happen if ABEM elected not to comply with ABMS requirements?

FC: Noncompliance with ABMS requirements would put ABEM’s standing as an ABMS member board at risk. At the very least, ABEM’s credibility within the ABMS certification community would be damaged. It is important to recall that ABMS recently adopted a new set of MOC requirements, the ABMS 2015 MOC standards. Prior to their approval, ABEM purposefully sent the 2015 MOC standards to every key membership organization in emergency medicine for comment and input. ABEM and the ABMS received no recommendations for revisions, and there were no concerns about the requirements expressed to ABEM or the ABMS from any emergency medicine organization.

KK: What would happen if ABEM were not an ABMS medical specialty board?

FC: The standing of emergency medicine in the house of medicine would plummet. If ABEM withdrew from the ABMS, decades of progress would be lost. It would be a devastating blow to thousands of physicians who have contributed to our specialty. Moreover, the ability to have accredited residency programs would be in jeopardy.

KK: Has ABEM supported the ABMS MOC initiatives (specifically at the board level)?

FC: As a member board, ABEM must comply with the 2015 MOC standards, and the ABEM Board of Directors supports these standards. As mentioned earlier, every emergency medicine organization had the opportunity to comment on the ABMS 2015 MOC standards.