Maintenance of Certification, Self-regulation, and the Decline of Physician Autonomy

Physicians who have earned initial certification by one of the 24 American Board of Medical Specialties (ABMS) specialty boards are required to recertify by completing Maintenance of Certification (MOC) requirements, which vary across specialties. According to ABMS, the "privilege of self-regulation" that physicians have is confirmed through MOC, a process intended to assess "each physician's continued expertise, judgement, and skills."1(p 105) Because this process aims to "uphold the trust-based relationship between medical professionals and patients," physicians have the autonomy to establish their "own educational standards and the right of self-regulation through external assessment holding [self-regulation] to high standards" (Box 1).

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