Saturday, May 02, 2015

Why Electrophysiologists Need to Flood the MOC "Debate" at HRS2015

Anti-MOC Bling
Anti-MOC Buttons
Click image to order yours
On 13 May 2015 at 8 am in Room 162A of the Boston Convention Center, a session called "Controversies in Public Policy"will occur at the 2015 Heart Rhythm Society Scientific Sessions. As part of that session, a "debate" on Maintenance of Certification (MOC) entitled "Maintenance of Certification is Important for the Practice of Quality EP and Should be Endorsed by HRS" will occur at approximately 10 AM.  Every cardiac electrophysiologist should attend. (Yes, the Atrial Fibrillation Summit can wait a bit).

Doug Zipes, MD will serve as the protagonist of the "debate" and Fred Kusumoto, MD will serve as the antagonist.  I am sure the so-called "debate" will be cordial.  Both speakers are class acts and I'm sure each will do their best to up-end the other.

But I have many concerns about this "debate," some of which I articulated earlier. Now after reviewing the program format and disclosures for the "debate," I have more concerns.

First of all, the limited time for the debate does not allow time for input from the audience.  This is a shame.  HRS needs to hear concerns from ALL of their membership. Granted no one wants a shouting fest, but polite and pointed discourse should be encouraged at meetings, not squelched.

Secondly, let's look at the disclosures for this debate, because I think this is important.

Dr. Zipes lists his disclosures for the  MOC "debate" as follows:
Douglas P. Zipes, MD, FHRS. Krannert Institute of Cardiology, Indianapolis, IN

  D.P. Zipes: E - Royalty Income; 3; Elsevier. I - Research Grants; 1; Medtronic, Inc.
  There is no abstract associated with this presentation.
No where in his current disclosures does Dr. Zipes mention his long relationship with ABIM as a paid "Director," "Chair-Elect," and "Chair" of the organization. Here is what Dr. Zipes earned from the ABIM between July 1, 1998-Jun 30, 2003:

FY 2003 $31,133 as "Chair"
FY 2002 $17,469 as "Chair-Elect"
FY 2001 $13,907 as "Director"
FY 2000 $20,996 as "Director"
FY 1999 $30,484 as "Director"

No doubt Dr. Zipes has good friends at the ABIM and will find it easy to take the "protagonist" role in the "debate," but is he the right person for a non-biased recommendation for endorsement of the  ABIM's MOC program by the Heart Rhythm Society?

We should recall that Christine Cassel, MD was the acting President and CEO of the ABIM and the ABIM Foundation during the time Dr. Zipes' had his appointments there.  Dr. Cassel now is President and CEO of the National Quality Forum (NQF), a non-profit organization called a "consensus-based entity" that sets quality metrics that soon will influence how physicians are paid.  The NQF has close ties to the ABIM and derives most of its revenue from the Center for Medicare and Medicaid Services (CMS) by way of government grants. Recall that the current President and CEO of the ABIM, Richard Baron, MD worked for the National Quality Forum before coming to the ABIM and may have been slated for a leadership role there as evidenced by a screen shot I captured from the National Quality Forum's website in July 5, 2014 (the web page is no longer present).  Also realize that the National Quality Forum continues to employ Ms. Cassel who was responsible for (1) the repeated piecemeal funneling of $30.6 million of our physician testing fees to the ABIM Foundation (and that purchase of the now infamous $2.3 million luxury condominium), (2) the creation and write-off of $3 million dollars for the now defunct "Institute of Clinical Evaluation" created by the Foundation, and (3) the non-disclosure of grants the ABIM Foundation received from the Josiah Macy Jr. Foundation and the "Institute of Medicine as a Profession," a non-profit created by George Soros and his Open Society Institute.  Needless to say, Dr. Zipes' conflicts are very significant in light of this interplay of money and politically-connected individuals and organizations.

Let's now look at Dr. Kusumoto's published conflicts of interest for this "debate:"
Fred M. Kusumoto, MD, FHRS. Mayo Clinic, Jacksonville, FL

F.M. Kusumoto: None.
There is no abstract associated with this presentation.
(I did not see Dr. Kusumoto's name on any of the ABIM's Form 990 tax disclosure forms either. )

The Heart Rhythm Society must make a clear choice after the upcoming scientific sessions. They can side with the working community of cardiac electrophysiologists or they can side with continuing their support of government grants, cronyism, and an increasingly political agenda that promises cash flow from the government.  Which will they choose?

So let's show up with a sea of buttons and other bling and make it clear that the HRS's endorsement of MOC must go.  All of it.

To promote the anti-MOC movement, I have created a section of my website specifically to purchase anti-MOC bling. All proceeds I receive (about 1-5% of the prices) will go to the ABIM's competitor, instead. The rest of the costs go to the manufacturer of the bling,, including the high shipping prices (sorry, out of my control).

If you'd like to get a FREE 2.25" Anti-MOC button from me before the "debate" session at HRS2015, I will have a hundred of them to distribute(limit one per doctor - I paid for them myself), so get there early.

I look forward to seeing everyone at the meeting.



Anonymous said...

Dr Zipes as protagonist for ABIM, though understandable, is extremely unfortunate as numerous leaders and bold "trailblazers" in the world of EP that have shaped EP into what we know today have been mentored by him. It is unclear to me how someone with such a presence as Dr Zipes can be systematically debated to "defrock" the ABIM of their established ponzi scheme that shackles all MDs. I do know Mark Josephson has spoken out against perpetual recertification publicly,however though compared to Dr Zipes, even one of the premier founders of EP as Dr Josephson, may not have enough of a presence to impact, modify and be as far reaching to speak out against and end MOC and perpetual recertification nonsense, in our specialty. This continues to be a David and Goliath battle to fund the ABIM which is now known to be a bankrupt organization with shady monetary practices going back as far as 1990s when they instituted recertification all in the name of "public protection."

Anonymous said...

It may seem like just another day of practice for the average doctor--seeing 25-30 patients in the clinic, rounding on 3-5 patients and doing several procedures. This is what most doctors do except if your name is Rich Baron (that's really his name). Everything and I mean everything in your rich baron life, your very being, is about begging, borrowing, stealing any and all power to make MOC a government requirement. Maybe linking it to meaningful abuse or PCORI or any other acronym associated with controlling physicians. These are desperate times and all favors must be called in.

Robert Weinmann said...

Physicians contemplating ABMS board certification or recertification should look up IRS' Form 990 for ABMS and for the specific specialty board of personal interest. Look at the financial allocations to the presidents, CEOs and key officers. Learn to what extent your MOC fees and fees for MOC courses fund this largesse. Commentary on this subject appears on The Weinmann Report and numerous elsewheres.

Robert L. Weinmann, MD, Editor,

x said...

the battle of american freedom was not the battle against British but actually the battle against Tories. this plot has been repeated many times across continents and centuries. Old age demands security . even the Greatest men known to the world (eg Gandhi ) played Tories. those who stood against Tories (have been removed from history chapters) eg Washington. Still men like washigton inspire, teh more you read about them, and men like gandhi bring the feeling of disgust - when u try to read about them. how much ever one can be great in his profession, but in the end the final The choice is his. whether we want easy politica, security at the end of his life or whther he wants to leave a legacy. medical profession will/has not forgotten those who were used/misused (rosalind franklin) and those who used them. there is a reason why the name of imhotep has survived while most of the romans/greeks who plundered the vast resources of egyptian knowledge and used it to glorify their legacies will always stand the scrutiny of time.

Robert Weinmann said...

Whether or not there is a reasonable argument that ABMS and specialty board salaries are tied to revenue generated by MOC (Maintenance of Certification) fees is discussed in the 17 April 2015 issue of The Weinmann Report, -- Robert L. Weinmann, MD, Editor

Robert Weinmann said...

MOC (Maintenance of Certification) and possible conflicts of interest: see also the following commentaries from The Weinmann Report,

1) "Money & Medicine," 7/21/12;
2) "How Physicians Eat Their Young, 2/12/14;
3) "Do Doctors Expire in 10 years?"

Robert L. Weinmann, MD, Editor