Tuesday, March 10, 2015

Physician Civil War or Revolution?

Today, Kurt Eichenwald published a report in Newsweek on the American Board of Internal Medicine (ABIM) scandal entitled "The Ugly Civil War in American Medicine." Here's a small exerpt:
Slass says the suggestion that the ABIM is “purposefully failing candidates on their exams to generate more revenue is flat-out wrong.” Maybe so, but according to the Form 990s filed with the Internal Revenue Service, in 2001—just as the earliest round of new-test standard was kicking in, the ABIM brought in $16 million in revenue. Its total compensation for all of its top officers and directors was $1.3 million. The highest paid officer received about $230,000 a year. Two others made about $200,000, and the starting salary below that was less than $150,000. Printing was its largest contractor expense. That was followed by legal fees of $106,000.

Twelve years later? ABIM is showering cash on its top executives—including some officers earning more than $400,000 a year. In the tax period ending June 2013—the latest data available—ABIM brought in $55 million in revenue. Its highest paid officer made more than $800,000 a year from ABIM and related ventures. The total pay for ABIM’s top officers quadrupled. Its largest contractor expense went to the same law firm it was using a decade earlier, but the amounts charged were 20 times more.

And there is another organization called the ABIM Foundation that does...well, it’s not quite clear what it does. Its website reads like a lot of mumbo-jumbo. The Foundation conducts surveys on how “organizational leaders have advanced professionalism among practicing physicians.” And it is very proud of its “Choosing Wisely” program, an initiative “to help providers and patients engage in conversations to reduce overuse of tests and procedures,” with pamphlets, videos and other means.

Doesn’t sound like much, until you crack open the 990s. This organization is loaded. In the tax year ended 2013, it brought in $20 million—not from contributions, not from selling a product, not for providing a service. No, the foundation earned $20 million on the $74 million in assets it holds.

The foundation racked up $5.2 million in expenses, which—other than $245,000 it gave to the ABIM—was divided into two categories: compensation and “other.” Who is getting all this compensation? The very same people who are top earners at the ABIM. Deep in the filings, it says the foundation spends $1.9 million in “program and project expenses,” with no explanation what the programs and projects are.

There are some expenditures, though, that are easy to understand: The foundation spends $153,439 a year on at least one condominium. And it picks up the tab so the spouse of the top-officer can fly along on business trips for free.
Be sure to read the whole thing.

What the American Board of Medical Specialties and their member boards (like the ABIM) don't realize is that America's practicing physicians are sick and tired of funding organizations that serve as little more than job boards for non-practicing physicians looking for their next career.



james gaulte said...

Wow!,[in 2013]"the foundation earned 20 million on 74 million in assets"this would be a 28.57 % return.Maybe the ABIMF should open up a investment fund for internists to make up for their parent's organization's overcharging on exams.Seriously that hard-to-believe number needs to be looked into in regard to fraudulent reporting.

DrWes said...

Here James -

Maybe this little IRS Form 3949-A you could complete and send to the IRS would help?


James Gaulte said...

Well, that is tempting.

Anonymous said...

Guys, the S&P 500 gained 29.6% in 2013. It was unusual for sure, but that kind of gain was open to anyone and everyone.

DrWes said...

Anony 09:12 PM -

So tell me, how did the ABIM Foundation amass $52 million just three years after it was supposedly "created" in 1999 (please see every Form 990 of theirs since 2009) so they could enjoy those FY 2013 investment returns? Might it have been because the ABIM consistently moved doctor testing fees from the ABIM to their Foundation over the preceding 10 years? (Note that public record shows the Foundation was actually created 10/17/1989).

Heck, my portfolio would look pretty good with that kind of cash earned on the backs of my colleagues, too!

Oh wait. We shouldn't ask such probing questions, should we?

I'll stand down now...

John Hayes said...

Keep up the good work spreading this Dr Wes, you're not allowed to 'stand down'!
Of course, the ABIM response addressed none of the relevant financial information and even sought to shame the author for not disclosing his wife is an internist. That has nothing to do with ABIMs decades of financial maleficence. And ABIM chatising others on ethics is the stuff of comedy. Dr Johnson is just one of many ABIM "leaders" who for decades avoided participation in MOC and recertification while he approved others having to do something different. He was listed as not having recertified and sitting on his grandfathered status as of this publication in 2013: http://www.mayoclinicproceedings.org/article/S0025-6196(13)00571-5/fulltext
I suppose we will soon find out to what depths ABIM will sink given the crumbling of clinical evidence and bright light brought to the financials. These people with no shame, untenable talking points, and and an uncanny ability to obfuscate are having a harder time trying to control their message of nonsoense to the highly educated mass that finally appears to have come out of hibernation.
John Hayes,MD

Anonymous said...

Inspired by @CharlesPKroll, review of restated ABIM articles of incorporation on Iowa SOS website, dated 10/24/2012:

Article IV: The Corporation does not contemplate pecuniary gain or profit, incidental or otherwise, and no part of the net earnings of the Corporation shall inure to the benefit or be distributable to its members, directors, officers or other private persons, except that the Corporation shall be authorized and empowered to pay reasonable compensation for services rendered and to make payments and distibutions in furtherance of the purposes set forth above.

Article V: Except as otherwse provided by Section 501 (h) of the Code, no substantial part of the activities of the Corporation shall consist of carrying on propaganda, or otherwise attempting to influence legislation, and the Corporation shall not participate in, or intervene in directly or indirectly (including the publishing or distribution of statements) any political campaign on behalf of or in opposition to any candidate for public office.

Sounds like the Iowa Secretary of State might be interested in ABIM's activities, especially those involving "pecuniary gains" and "propaganda" which have direct impact on non-profit tax advantaged status.

sue55888 said...

all the graphs go up, up and away!!!!