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MOC, Continuous MOC, MOL & MOST

The War on Doctors Fighting Back Lawrence R. Huntoon, M.D., Ph.D.

Association of American Physicians and Surgeons

Maintenance Of Shoe-Tying



Created by former shoe repair guys who figured out a way to make a lot of money (more than they were making in the shoe repair business). They got together and formed the American Board of Shoe Tying (ABST). They lobbied legislators in each state and got a law passed which required everyone using shoelaces to have a shoe-tying license. They constructed a written examination on proper shoe-tying and charged examinees a hefty fee

The former shoe repair guys claimed that millions of people were tripping over untied or poorly tied shoelaces every year and injuring themselves and others.
They also claimed that over the years, people tend to get sloppy and forgot how to tie their shoes properly.

So, to protect the public from poor quality shoe-tiers, they claimed a continuous maintenance of shoe-tying program is needed.
MOST, they claimed, is all about saving lives by ensuring high quality shoe tying by all citizens.

Sons and Daughters of the former shoe repair guys saw how much money was being made by the former shoe repair guys and decided they too would like a part of the lucrative revenue stream. So, they formed the American Academy of ShoeTying (AAST), and they sold all of the continuing shoe-tying modules, self-assessment modules and performance-in-practice models needed to comply with the American Board of Shoe-Tying Maintenance of Shoe-Tying Requirements.

AAST MOST Requirements

1.) Professional Standing Requirement

- continuous possession of an unrestricted shoetying license ($700)

2.) Lifelong Learning Requirement

($2,500 per year)

25 Continuing Shoe-Tying Education (CSTE) modules and 2 self-assessment modules per year

Example of Continuing Shoe-Tying Education (CSTE)



Self Assessment Module

(Special Mirror Available For Sale By The American Academy of Shoe-Tying (AAST)


3.) Cognitive Examination

Must pass a written examination constructed by the American Board of Shoe Tying (ABST) every 5 years ($2,000 exam fee)

Example of Exam Question:

Which type of bow tie knot is most appropriate when going through airport screening?

Single Bow Tie Knot

Double Bow Tie Knot

Answer: Neither.
While the single bow tie takes less time to undo while waiting in the airport security line, shoes must be removed before going through airport security. Therefore, neither a single bow tie or double bow tie knot is appropriate when going through airport security.

4.) Practice Quality Improvement Requirement (performance in practice)

Others must assess your ability to tie your own shoes Must keep records of shoe-tying metrics to compare with national benchmarks Must develop a written plan for shoe-tying improvement Must implement written plan for shoe-tying improvement Must compile data to show results of improvement plan implemented Must demonstrate you are meeting systems-based shoe-tying standards.

Shoe-tying metrics:

Avoiding uneven bow tie knot

So, What Do MOC, & MOL (essentially mandatory MOC) Have In Common With MOST?

They are NOT evidence-based They are designed to enrich those who have found a way to capture the regulatory mechanism They restrict access (i.e. MOC/MOL restrict access to physicians & MOST restricts access to using shoelaces to tie ones own shoes)

(No evidence that those who participate in MOC provide higher quality care any more than those who participate in MOST are able to tie their shoes in a higher quality fashion)

Fighting Back Against MOC and MOL Requires Personal Commitment and Follow Through Cannot Delegate the task of fighting back to someone else

Medical Licenses are granted by states, and, therefore, it is important to work through your State Medical Societies to get resolutions passed that oppose mandatory MOC and implementation of MOL. AAPS provides Model Resolutions on the AAPS website.

Getting resolutions passed begins at the County Medical Society level.

Arguments You Will Hear about Why Physicians Should Not Oppose MOC or MOL

Opposing MOC/MOL is anti-continuing medical education and anti-quality media will view physicians as being against quality care If we dont impose MOC/MOL on ourselves, someone else will do it and it will be much worse the more self-regulation, the better. More Bad Regulations like MOC/MOL are the solution to getting rid of the bad apples in medicine

You might earn a bonus of $9,000 if you comply with MOC i.e. do it for the money If it isnt mandated, physicians wont do it. Resolutions opposing mandatory MOC and MOL are too inflammatory and too confrontational translation: might upset those who are oppressing physicians AMA likely would not support resolutions opposing MOC and MOL AMA benefits from regulatory capture in other areas - e.g. secret agreement with government to use CPT coding system exclusively If we pass a resolution opposing MOL, the medical board in our state might find out about it and we will be waking a sleeping giant. - Medical boards, of course, already know about the FSMB and MOL.

AAPS Has the Educational Resources To Help Fight Against MOC and MOL

Model letter to help educate county and state medical society physicians on MOC and MOL (E-mail addresses of the officers and executive directors are often available for all county medical societies in the state look on State Medical Society website) Model Resolutions opposing mandatory MOC and MOL Model legislation to prohibit implementation of MOL - Need to follow through by contacting/meeting with your state legislators

AAPS is conducting a Cost of MOC/OCC Survey - We are collecting

data designed to look at the true cost of participating in MOC/OCC.

If you participate in MOC/OCC or have participated in MOC/OCC in the past, please take the time to fill out the AAPS Cost of MOC Survey.
Or Search Cost of MOC Survey on AAPS Website

Also, Please Donate to Our American Health Legal Foundation to support our lawsuit against the American Board of Medical Specialties and other important lawsuits like AAPS vs. ObamaCare.
Or Search AAPS Takes MOC to Court on AAPS website:

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