Surveying Our Domain

December 18, 2015

Radiologists are as happy to share thoughts about MOC as they are about MOC.

A theatrically-cantankerous science teacher of mine during middle school, sometimes given to the Socratic method, had a favorite quip for students answering his queries with wild guesses: “Where do you get your information?” (Often followed by an imitation of the usual lame/vague response, mocking their lack of enunciation: “Oh? You got it ouffa [out of a] book?”)

I’m often put in mind of him when I’m asked to participate in a survey, because my first thought in response is “What are you going to do with my information?”

I wouldn’t have this thought nearly as frequently if it were still in vogue to give survey participants (especially professionals such as us physicians, whose time and thoughts are theoretically worth something) some token of appreciation. An Amazon gift card, perhaps, or God forbid a few bucks. Give me something for my input, and as far as I’m concerned you can do whatever you want with it.

Within the past few years, payment of any kind has gotten increasingly rare. Evidently, we’re supposed to be grateful that we are even being approached for our opinion on something. Maybe our payment is that we can indulge in the fantasy that our survey answers will have some impact. Maybe our pushback will make airlines stop shrinking our seats, or CMS stop pushing us towards early retirement. (A fantasy, as I said.)

Sometimes, we’re given the option of receiving survey results, in a show of transparency. That’s a nice gesture, but it doesn’t do much to prevent subsequent cherry picking of the data by the surveyors or others using the results to push their own agendas. I might feel satisfaction when a Medscape survey shows 64% of doctors feeling just as burned out as me (I just made that number up; wouldn’t be surprised if it’s higher), but for all I know, that will just be taken by next year’s politicians as being a sign that 36% of us are still game for newly hiked levels of abuse.

Still, when I recently got the ABR’s survey asking for my take on their handling of Maintenance of Certification (MOC), I found myself responding. Although I did briefly muse that SurveyMonkey was aptly named, as my eager participation didn’t strike me as much more considered than what a trained primate might have done if asked its thoughts on whether it enjoyed having to perform tricks to get flung an occasional extra banana.

Did I think having to take an exam at an ABR facility, halfway across the country, every ten years, was an undue burden? How about a neverending series of PQI projects? ABR-tracked CME, which I had to do anyway to satisfy state licensing boards and individual facilities for which I worked? Really, did these questions need asking? Maybe they should have asked whether radiologists enjoyed forking over $300+ per year as part of the process.

I’m not a SurveyMonkey savant, but I’ve heard that at least some of the time their surveys aren’t all that anonymous. That is, if a respondent makes a particularly snarky comment, those conducting the survey can track down who wrote it. So the thought did occur to me that writing anything less than praising about the MOC program might get me earmarked for a “random” audit of my compliance. (To say nothing of writing this column.) I know more than a few radiologists out there were hesitant to respond to the survey with this in mind.

Then again, a number of rads took the approach of referencing the NMPAS in their survey comments, sometimes saying nothing but the acronym itself. Message being, “You want to know what we think of MOC? It’s helped create and nourish a potential rival Board of Certification for our medical specialty and others. Keep doing what you’re doing if you want to help such rivals grow.”

Still, as mentioned above, I have no idea what the ABR is thinking of doing with the information from this survey. Taking it to heart, discussing it in meetings, and ultimately filing it somewhere without further action, or spin doctoring the results to claim that an already preconceived course adjustment to the MOC ship is what the majority of working radiologists truly want.

I guess we’ll find out.