Pulling the Plug on ABIM; Pulling the Plug on MOC

Kurt Eichenwald in Newsweek strikes again:

Dr. Jones has been a physician for decades. His hundreds of online patient reviews are consistently positive, with an average of just under five stars and raves that he is caring and attentive. Based on those assessments, it’s clear he is the kind of physician who focuses on quality patient care and eases America’s critical shortage of internists.

Unfortunately, as a single father with a disabled child, Dr. Jones can’t manage his practice, care for his family and study for the certification exams administered by the American Board of Internal Medicine. The tests purportedly insure doctors’ competence, but, like many physicians, Dr. Jones says the questions often have nothing to with what he sees in his practice and are little more than a game of medical Trivial Pursuit. Dr. Jones can’t afford the thousands of dollars for study guides and classes to learn obscure, often irrelevant information, and has no time to review the material every night for months. He failed the test, so his hospital will no longer allow him to admit patients because he couldn’t answer questions about diseases he will never encounter.

And so, Dr. Jones—who asked me not to use his real name out of fear the ABIM will somehow block him from ever treating patients again—has closed his practice. The patients who love him will have to find someone else, and America’s shortage of primary care physicians has become just a little bit worse. “I’m hoping that maybe I can find a job as a high school science teacher,” he told me.

It’s a horror story that has played out for years throughout the U.S. as the ABIM abuses its monopoly power to force doctors to do whatever it decrees, while ignoring the many doctors who have demanded for years that independent researchers conduct comprehensive studies to determine if ABIM’s requirements do anything to improve patient care. This medical protection racket has made millionaires of ABIM top officers, financed a ritzy condominium, limousines, and first-class travel, all while sucking huge sums of cash out of the health care system.

But now, after decades of unchecked rule by ABIM, cracks are appearing in the organization’s facade of power. Thousands of doctors began a widespread revolt months ago and, in the last few weeks, evidence that their efforts are succeeding has started rolling in. ABIM officials have proclaimed that they are rushing to make changes—and indeed have announced some changes—but it seems they waited too long and are changing too little.

Read the whole thing.

Then ask yourself the real question: why have all of us practicing physicians allowed the American Board of Specialties and it's 24 member boards (including the ABIM) to be unaccountable to us when we pay all the fees?

It is time to change that model and insist out specialty boards have elected officials and not act as a membership society.

It's also time to end the ABMS MOC program - every bit of it. It is hurting doctors and, in turn, hurting patients without any credible proof it improves patient care or quality. When will our professional organizations quit this insanity and return to physicians maintaining continuing medical education credits like before? No other country in the world wastes this much time and money on such an unproven metric.

Not one.

-Wes