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In Reply: As discussed in our articles, more efforts need to be made to determine both the effect of participation in maintenance of certification (MOC) programs and the ability of the process to discern quality of care between those who do and do not participate.

While we agree with Dr Gloth that the public has little idea what is involved in either initial board certification or the MOC programs, we believe that a greater understanding would result in more intense pressure from the public for physicians to participate in such programs. The components of MOC include demonstration of participation in and commitment to lifelong learning, participation in practice improvement efforts, quality-of-care assessments, and a proctored examination on a regular basis to ensure that physicians remain up to date in the practice of clinical medicine.

It is unlikely that there will ever be a randomized controlled trial to compare the care . . . [Full Text of this Article]

Gary L. Freed, MD, MPH
gfreed@med.umich.edu
Division of General Pediatrics
University of Michigan
Ann Arbor

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