It's time the IRS takes notice.Dr. Centor, In an email to me regarding the ABIM and the ABIM Foundation financial behavior, Dr. Baron stated in the email that the ABIM has never had any inappropriate financial behavior. (I can send you the email from Rich Baron if you would like to read it yourself) Is that so? Myself and folks like Dr. Fisher, Dr. Cutler and legions of other hard working clinicians take great issue with a group of aloof administrator physicians spending vast amounts of money on themselves via Mercedes Limo Service, Condos, and "retreats" to the Four Seasons. Is it appropriate to pool the fees from graduating housestaff and hard working clinicians so they can reward themselves with nauseatingly gaudy creature comforts? How can an organization designed and run by non-clinicians tell the rest of us to "Choose Wisely" and to embrace cost efficiency/austerity while making themselves multi-millionaires off the sweat equity of the everyday clinician and graduating house staff? Would you trust such an organization? Dr. Fisher's point is very, very well taken. More so since the ABIM and the ABIM Foundation are both registered "non-profit" organizations. In essence, the American Taxpayer is subsidizing their operational status and their capital budget when in fact the ABIM is totally, hugely, and utterly profitable. That hypocrisy has never been fully addressed by Dr. Baron or any other ABIM representative. Can you trust an clinical regulatory organization that is utterly devoid of any contemporary clinicians? Dr. Cutler pointed out that Dr. Zeke Emanuel is "not certified" by the ABIM continues to be "not certified" and yet remains as a leader for ABIM Assessment 2020. According to the 2012 Medicare database, Dr. Krumholz has no patient E/M contacts and read a handful of echos. Yet he is another leader of ABIM Assessment 2020. Isn't the lack of inclusion of active, high volume clinicians into the structure of the ABIM and the ABIM Foundation patently wrong? And yet you trust and "hope" this clubby cadre of "ethical" non-clinical physicians will magically do the right thing when it is clear they been doing it wrong for almost a decade. The irony of this oxymoronic situation is troubling and sickening. Even more ironic and more sickening is the ABIM's driving point- that their mission is somehow a product of pure altruism and promoting honesty and integrity to its Diplomates. If that were to be true, the ABIM leaders should immediately vow to take an oath of fiscal modesty and financial mediocrity. Do you think the ABIM leaders would ever take a significant pay cut and promise never to abuse the money from an impoverished senior resident on Mercedes limo service? When you look at your residents at Morning Report, can you honestly and whole heartedly tell all these young folks that your friends at the ABIM are doing them right? Do you think the ABIM has the courage to set aside their own financial interests and to show leadership when they are apt to state their financial misbehavior were inherited? How cowardly is the ABIM to place all the blame on Christine Cassel? Would you have to courage to ask the ABIM and the ABIM Foundation to take such an oath of modesty and fiscal/financial mediocrity? Or is your sense of cronyism clouding your judgment? In the end, we have a growing schism between those who are placing their bets on a sclerotic ABIM whose leadership has failed its Diplomates and those who welcome change, competition and Darwinian evolutionary forces in Medicine. The loss of trust and faith in the ABIM cannot be ignored by their leaders and the proof in the pudding will be when the Diplomates who are sick and tired of the ABIM selling them out will defund this organization and turn to more responsible organizations willing to document their lifelong learning without pricing in a condo, a limo, a retreat to the Four Season, and massive salaries for themselves. At low tide, everyone will find out who is swimming naked.