What, you haven't heard?
Clearly this MUST BE THE CASE! That's why it's SO important that the Heart Rhythm Society and the Intersocietal Accreditation Commision (IAC) INSIST (seriously) that EVERY electrophysiology laboratory in the United states have a MEDICAL DIRECTOR certified by the American Board of Medical Specialties. Otherwise, your electrophysiology laboratory will be labeled as "NOT UP TO STANDARDS." And we wouldn't want that now, would we?
I just received this disappointing e-mail from David Haines, MD, president of the "IAC Cardiac Electrophysiology Accreditation" on behalf of the Heart Rhythm Society (who is clearly colluding with the American Board of Medical Specialties to assure regulatory capture of every electrophysiology laboratory in the United States) under the guise of EP laboratory standardization:
Last week, I sent an email discussing the recent partnership between the Heart Rhythm Society, the Intersocietal Accreditation Commission (IAC), and other key stakeholders to develop and operate an EP Lab Accreditation Program. Developed by the IAC Cardiac Electrophysiology Board of Directors, the draft IAC Standards and Guidelines for Cardiac Electrophysiology Accreditation are now available for public comment and I am requesting your assistance on this important initiative. Please review the draft standards and provide feedback to ensure that they meet the expectations and the field’s needs.Don't you get it? The new "Standards" are coming whether you like it or not.
Listed below are the instructions to provide comments. The IAC Comment Form must be completed and submitted electronically by December 1, 2015.
To submit a comment on the proposed IAC Standards:
At the close of the comment period, the IAC Cardiac Electrophysiology Board of Directors will review all submitted comments, consider modifications, and vote on the Standards final approval. The new Standards will be posted to the IAC Cardiac Electrophysiology website and available for download in late 2015.
- Visit the IAC website.
- Click on the proposed Standard you wish to review and/or comment from the menu.
- A window will expand with the description of the Standard and a PDF to view the section of the Standards available for comment.
- Click on the PDF to open it in a separate window for review.
- On the right, fill in your name and provide your comments about the proposed Standards in the boxes provided.
- Push submit.
I would suggest every electrophysiologist comment on this decision by the Heart Rhythm Society to insist that EP laboratories must meet certain "standards" regulated by yet another unaccountable body to the physician and patient (who the heck is the "Intersocietal Accreditation Commission?") After all, this is ALL about regulatory capture and the money generated for the ABMS and their member boards.
Where's the proof that patient care will be improved as a result of such standardization?
Instead, everything (including our "re-certification" expenses) will cost us more and more as the regulatory capture of medicine by the ABMS and the IAC/ and their pals continues unabated.
-Wes
ReplyDeleteWow... these pickpockets want to make money the old fashioned was...by screwing people.
I'll post there history below.
They found a little niche, gave it a fancy name and now demand money--"the newest of the accrediting bodies, cardiac electrophysiology that will launch later in 2015."
Tell them to f**k off.
-------------------------------------------------------------------
HISTORY OF THE IAC-- from their website
The IAC incorporated all of its divisions into one IAC organization in 2008, but its history began more than 25 years ago with the inception of the first of the IAC accreditation divisions — the IAC Vascular Testing — formerly the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL). From this first accrediting body, the IAC has continued its path of developing standards and methods for the evaluation of the quality of care delivered. Holding true to its original mission, the IAC’s scope has expanded to provide similar peer review processes for multiple imaging modalities within the medical community. A division was created in 1996 for the accreditation of echocardiography, in 1997 for the accreditation of nuclear cardiology, general nuclear medicine and PET, in 2000 for the accreditation of MRI, and in 2006 for the accreditation of CT. In 2010, the IAC expanded its scope of accreditation from imaging only to include therapeutic procedure-based accreditation programs and developed a division for the accreditation of carotid stenting, in 2013 for the accreditation of vein treatment and management and the newest of the accrediting bodies, cardiac electrophysiology that will launch later in 2015. The IAC has grown strong and successful through the collaboration of the vast array of physicians, technologists, sonographers, physicists and numerous other medical professionals representing more than 40 medical specialties who contribute to its efforts.
Thanks Wes for catching that. We do not need more ABIM requirements in our system.
ReplyDeleteIf you all agree, please go to the public comment for IOC which can be found at http://www.intersocietal.org/iac/comment_period_ep.htm
Open section IA Personnel and Supervision and you'll see right at the top of the proposal
"STANDARD – Medical Director
1.1A The Medical Director must be a licensed physician.
1.1.1A Medical Director Required Training and Experience
The Medical Director must demonstrate an appropriate level of training and experience by meeting the following:
Board certified in his/her specialty:
i. certification or recertification by the American Board of Internal Medicine (ABIM) or American Osteopathic Board of Internal Medicine (AOBIM) in Clinical Cardiac Electrophysiology (CCEP)."
If you wish to comment, there is an easily accessible comment box on this page. Please take a look. It's really easy.
Jay
Edward J. Schloss MD
@EJSMD
Amazing! They are trying to lock themselves in from multiple directions of attack. I suspect part of the ABIM/ABMS silence regarding the MOC conroversy is that they have many other irons in the fire that the do not wish to be discovered. Thanks Wes! for once again shining the light on these robber barons.
ReplyDeleteThe logical next step will be that ABIM EP certification won't be enough, there will have to be a new designation requiring ABIM initial certification (and MOC) for yet another medical subspecialty in EP Medical Directorship, of course requiring mandatory certification and MOC in EP. I'm sure Dr. Baron and Zeke Emanuel, et al have it all figured out.
ReplyDelete
ReplyDeleteRICO INVESTIGATOR. The Quality Assurance Racket.
There are two carts in life. The good cart and the bad cart.
You got a big racket? You're in the wrong cart.
If it's a small scam, the district attorney is amused; but they'll take you down.
If it's a medium-sized scheme, a state attorney general gets frothy and intrigued.
You got a big racket? The hungry young federal prosecutors are drooling to make the taxpayers and bosses pleased.
What about me?
To you, my name is 'RICO'. I work behind the scenes.
Between you and me, after looking at the history of the ABMS and others in their 'complex money scheme', they've got gall.
It's a goddamn complex of "24 sickening money machines"!
But hey, the more jumping in the bad cart the better it is for me. I say the more players there are in this deceitful bureaucratic medical scheme, the more job security for me. I'll sniff out the truth and find the goods on all the perps.
In my business every racketeer is a key player that lead me to the central players of the ongoing crime.
The Feds will sift it all down to four hundred pages. Give or take a few, depending on the few that jumped on or off the 'bad cart' at that unknown critical point in time. Indictment time. That's my favorite time when all hell breaks loose on the office floor. It's seizure time. I show them where the computers and records in question are.
More bad guys jumping on? For the Feds more players just means more individual fines and an even worthier recovery. And they love their roulette wheel game to see who gets to do hard time.
"Welcome aboard to the newcomers of the shady 'quality assurance' scheme!"
When the come in. They come in hard. I know, I've watched it many times. Don't ever tell them you didn't know. Because there's always someone that will 'walk' that 'ratted on' what you did. Guilty or not.
And a word to the wise. The Feds are not all good clean guys. Once they get started. There's nothing ad hoc. They have to win.
They take on the case. They find a willful, but legal way. Perps sometimes walk but they keep they'll keep the 'chip' on you.
Downsides to my job? I don't like pretending to be the night janitor, when I'm much better at being Mr. Fixit IT; and even better working the phones.
I love the new technology. New stuff all the time. I love keeping up.
The worst part of this present case is this: I just hate pretending to be a new or established STAKEHOLDER. I even hate that sick word--stakeholder. It smells bad for miles around and for days after when I wear that foul name. I can smell it in every document those white-collar crooks write.
"Stakeholder." It's like an enema on their beautifully-crafted lying page.
Everybody there is part of the scam lying to the public, grabbing a share of the take...but just wait
As I said, my name's RICO. If your involved in a big racket, you're in the wrong cart.
Believe me.
Restraint of Trade? Sherman Anti-Trust Investigations. I investigate that too. Here's my card; just call me Sherman.
ReplyDeleteWarning regarding scam “Certification Boards”
ABIM has received reports from several of our diplomates regarding letters and solicitations they have received from groups offering “certification” in Geriatric Medicine, Cardiology and Hospital Medicine, among other things. ABIM is concerned about the welfare of patients who may choose doctors representing themselves as “board certified” based on their possession of a certificate from unaccredited “boards” that award certificates but require no accredited training, testing or medical background review.
Have you been contacted by any of the below groups? These phony “certification boards” have been reported to ABIM as fraudulent, and if you hear from them, or receive any certification information that seems suspicious, ABIM would like to know about it.
The United States Medical Specialists Federation (USMSF)
American Board of Diabetes (ABD)
American Academy of Cardiology (AAC)
American Board of Geriatrics (ABG)
American Board of Geriatric Medicine (ABGM)
American Board of Hospital Physicians (ABOHP)
American College of Specialists in Geriatrics (ACSG)
American College of Christian Physicians (ACOCP)
American College of Ethical Physicians (ACOEP)
American College of Family Medicine (ACFM)
American College of Geriatrics Specialists (ACGS)
If you have been approached by an organization calling itself a board that is not a member of ABMS or the American Osteopathic Association or has not established its status by state licensure board recognition, please e-mail security@abim.org for information on these possible “scams” and what can be done to assure the professional integrity of medical specialty certification.
Only physicians who receive certification from one of ABMS’ member boards or another board that requires accredited training, a meaningful review of standing as a physician and a psychometrically valid, secure examination can legitimately represent themselves as board certified. See below for information on recognizing these scams.
Recognizing a Fraud or Scam
Trust your instincts. Check to see if any organization has a history of membership or affiliation with a board, accredited educational body or established organization thoroughly before joining, ordering any services or providing any personal information. Indicators include:
Organizations that do not have an established office address, customer service number or affiliations with established medical societies, residency programs or hospitals.
Programs offering certification without clearly stated pathways, no secure testing process and/or uniform standards for the evaluation or verification of credentials.
Organizations that do not have annual meetings, local membership groups, testing centers or any other in-person interaction.
Any organization that contacts you only by mail, website or e-mail; and does not provide you with a phone number and physical location (not a drop or P.O. box).
If you see the ABIM name, logo or a reference to ABIM on something unusual and you are suspicious, contact ABIM’s Exam Integrity Hotline at 1-800-884-2246 or e-mail security@abim.org. ABIM can help you determine if the item or material you received is legitimate.
But Rich Baron (still LOVE that name) that ABIM certification is "voluntary!" Kinda like paying taxes! Oh wait.....
ReplyDelete#NOMOC
What about the Hospitalist Movement? & What about Bob?
ReplyDeleteRead the Quotes for more on the ABMS-type monopoly of power and restraint of trade.
The Hospitalist May 21, 2009, Jane Jerrard
Watch Out for Phony Board Certification Offers
Physicians routinely are deluged with offers for certifications in hospital medicine, geriatric medicine and other specialties. Unaccredited boards have been set up to solicit phony certifications requiring no training, testing or medical background review, according to Christine Cassel, MD, president and CEO of the American Board of Internal Medicine (ABIM).
ABIM is concerned about the welfare of patients who may choose doctors representing themselves as "board certified" based on a certificate from one of these unaccredited boards.
"Physicians should trust their instincts," Dr. Cassel says. "If a deal seems too good to be true, it probably is. Hospitalists should be especially wary of solicitations from the American Board of Hospital Physicians (ABOHP). The organization is not a member of the American Board of Medical Specialties (ABMS), and is not recognized by key healthcare credentialing accreditation entities."
Robert Wachter, MD, chief of the division of hospital medicine at the University of California San Francisco Medical Center and chair of ABIM’s Committee on Hospital Medicine Focused Recognition, adds, "The ABIM has been working hard to create a pathway that recognizes the professional focus of internist-hospitalists, and I hope it will be available in the not-so-distant future. Personally, I encourage all hospitalists to pursue board certification and keep their certification up-to-date. This scam points out the importance of ensuring that the certification is legitimate."
If an unrecognizable organization sends you a board certificate offer, alert ABIM at security@abim.org.
Hospitalist Ad. You Might Also Like This:
Dr. Wachter Named ABIM’s Chair-Elect
Certification on Our Minds
ReplyDeleteWorld Jeopardy. The Final Answer
64 trillion dollar question?
Category: Strange Bedfellows
And the answer is: Conflicts of Interest.
You have 30 seconds to come up with a correct response. Remember responses must be in the form of a question in World Jeopardy.
Here are your clues:
Assessment 2020 Task Force
http://assessment2020.abim.org/committee/
http://iom.nationalacademies.org/Activities.aspx
http://www.ezekielemanuel.com/bio
http://drwes.blogspot.com/2015/03/why-irs-should-investigate-abim-and-its.html
The Emperor's New Clothes http://andersen.sdu.dk/vaerk/hersholt/TheEmperorsNewClothes_e.html
ReplyDeleteAn Honest Impression of Quality Assurance Officers.
No swans among them. Not even an ugly duckling who will transform.
Just sitting ducks sitting in a row waiting for indictment. Almost all of them.
It saddens me to see them carrying on incessantly pretending there was nothing wrong with their actions or attitudes.
It's like the fable of the Emperor's New Clothes.
Don't they see how naked they are?
Please, won't someone tell them!
BF Skinner Quotes. I'm not a behaviouralist but...
ReplyDeleteEducation is what survives when what has been learned has been forgotten.
Society attacks early, when the individual is helpless.
The way positive reinforcement is carried out is more important than the amount.
A failure is not always a mistake, it may simply be the best one can do under the circumstances. The real mistake is to stop trying.
A person who has been punished is not thereby simply less inclined to behave in a given way; at best, he learns how to avoid punishment.
The real problem is not whether machines think but whether men do.
The consequences of an act affect the probability of its occurring again.
If you're old, don't try to change yourself, change your environment.
Rent seekers. Plain and simple.
ReplyDeleteDear ABIM:
ReplyDeleteRe: Subcommittee chairperson serving on the Assessment 2020 Task Force
I wish to raise concerns about the potential conflicts of interest and lack of transparency and disclosure involving the past track record of Naomi O'Grady, while serving in various official capacities at the ABIM.
I also do not have confidence that the outcomes of 2020 will be in the interest of the physician community and public, which I feel is under-represented.
I would like to ask for the ABIM to disclose for public inspection all of the past roles and outside activities of the 2020 subcommittee chairperson.
Based on public records I have seen, full disclosure would be welcome at this time.
Also, I would feel more comfortable (as a non-physician) if there were clinical/educator physicians on the subcommittee who were not part of the ABIM culture or traditional points of view.
I would like you to consider Dr. Paul Teirstein of the ABPS to complement the discussions and views. Let there be some real discussion and fair results that can only come from sharing differing points of view.
Thank you,
Concerned Citizen
PS I will thank you in advance for my request. I will contact the ABIM directly as well. I would also like to speak directly with Dr. Baron regarding other concerns.
"In collaboration with the internal medicine community, ABIM has started actively exploring the implementation of the recommendations through a subcommittee consisting of members of both the ABIM Council and Board of Directors.
Key recommendations from the report include:
◾Replacing the 10-year MOC exam with more meaningful, less burdensome assessments.
◾Focusing assessments on cognitive and technical skills.
◾Exploring the need for certification in specialized areas, without the requirement to maintain underlying certifications, while being transparent about specialization to the public.
Members of the subcommittee include:
◾Naomi P. O’Grady, MD, subcommittee chair
◾Vineet Arora, MD
◾Marcy B. Bolster, MD
◾Marianne M. Green, MD
◾Mariell Jessup, MD
◾Lesley A. Meng, MD
◾Debra L. Ness, MS
◾Jeffrey G. Wiese, MD"
http://www.abim.org/about/governance/abim-council.aspx#o'grady_n
MOC EXAM (The Panel. 2005 Cassel presentation to AARP)
ReplyDeleteA Usual Review Prep Course, MSKP copyright 2015
http://www.c-span.org/video/?186628-1/quality-medicare-services
What kind of panel is this on the AARP video which was held in the Dirksen Room?
(Former Senator from Illinois)
A. Free lunch entertainment for vulnerable populations
B. Evidence-based scientific committee
C. Unacceptable behavior
D. Irregular behavior
E. "Wasting dollars and lives"
F. Cheating on graphs class
G. Seminar on EHR and the "surveillance state"
What is the purpose of the panel?
A. Cost cutting
B. Quality improvement
C. PAC agendas
D. Propaganda
E. Hostile Takeover/leveraged buyout of American Healthcare System
F. Advertise flu shot shortage
G. All of the above
Section II True or False
Edward F. Howard, Executive Vice President of the "Alliance for Healthcare Reform" led the panel.
True or False
Chris Cassel sitting on the extreme left with extensive experience in controlling a room and microphone led the panel.
True or False.
Kaiser Permanente delivers the best quality healthcare in the world.
True or False
Chris Cassel was a clinical geriatrician treating Medicare patients all her life at Kaiser Permanente.
True or False
Chris Cassel was senior board member of the Kaiser Foundation Health Plan and Kaiser Foundation Hospitals (KFHP/H) chair for the Quality and Health Improvement Committee of the board. She accepted this position in 2003.
True or False
In accepting her appointment at KFHP/H, Dr. Cassel said “I am looking forward to working with the leaders of Kaiser Permanente. I admire their comprehensive integrated system and their serious commitment to quality improvement and public accountability.” - Go ahead! Open book is great; see more at: http://share.kaiserpermanente.org/article/distinguished-health-care-leaders-appointed-to-board-of-directors-for-kaiser-foundation-health-plan/#sthash.HXTKd5h8.dpuf
True or False
Kaiser Permanente pioneered end of life care based on the fact that Americans live longer and Medicare was not prepared financially for it.
True or False
Chris Cassel received millions of dollars for her performance as a board member of Kaiser's Foundation while serving as CEO/President of the ABIM and the ABIM Foundation where she also received millions.
True or False
Kaiser delivered more pain medication than any other institution in the US. (2005)
True or False
"As you know, I am physician involved all my life in the treatment of Medicare patients." The preceding was a quote from panel member Chris Cassel.
True or False
Break: Go have a sandwich and a drink. No talking. Bring the same finger prints.
Remove as much urine as possible. Nothing will be allowed in the testing area.
A Usual Board Review, MKSP Final Test Preparation Questions.
ReplyDeleteRemember, you are under ABIM's pledge, even though you have not taken the test yet. You must know what those rules and policies and laws are; and you should not have to be given anything in writing just to remember what was/is innately given to you to know from before your birth. Subject to change at any time. -ABIM
As Socrates said, "you are born knowing these truths.
UBR, MKSP Questions: True or False
Medicare research found that the highest quality of care was delivered in the states with the lowest expenditures on medicine.
True or False
Oregon had the highest quality of care with the lowest cost nationwide (2005)
True or False
CMS Payment Advisory Commission was led by Oregon's Glen Hackbarth (Chairman) and presented data proving that there was an inverse ratio to cost and quality of care.
"High cost states had the lowest quality of care."
True or False
Chris Cassel did her medical training in Oregon at OHSU. She returned to the program as dean just a short time before she was awarded the highest rate of compensation in the history of the ABIM.
True or False
Chris Cassel as ABIMF Chair signed the Pennsylvania registration document of the ABIMF in 1999. Five years before she would be named CEO/President.
True or False
Chris Cassel was dean-stepping her way up the pay ladder in order to extract that higher salary from ABIM at the expense of politically dumb but hard working physicians.
True or False
Studying for ABIM examinations makes sense for physicians. It is the gold standard for science and highest integrity of data. It is relevant and current. You can trust the ABIM trademark without question. Certification is absolutely necessity for insurance and hospital privileges. (old question, probably will not be on test)
True or False
ABIM policy of requiring practice performance measurement was voluntary at the time of this video in 2005.
True or False
We need to change physician behavior by introducing payment incentives and disincentives. 2005
True or False
The United Kingdom is represented on the panel.
True or False
Chris Cassel now (2015) works for the National Quality Forum. She was quickly caught up in multiple scandals that finally got media attention concerning her "egregious conflicts of interest". This involved coi with Kaiser Foundation and Premier Inc. (Stock and cash.) Coi involved: receiving millions of dollars from outside sources while working at the ABIM and for the government. Geez, she forgot to vet herself on conflict of interest. No policy existed to vet anyone at the ABIM for coi.
True or False
The thought of vetting anyone never occurred to the ABIM since the year 1965.
True or False
All ABIM candidates come from a carefully groomed and selected few with great clinical knowledge of medicine but "politically dumb".
True or False
The White House never vetted Cassel because she was considered a neoconservative and the Ethics Committee did not want to offender her in any way regarding her global expansionary policies.
True or False
Vetting was retroactively honored from Cassel's last 1997 appearance before both chambers of the house during her confirmation hearings.
True or False
[Throwaway test question currently under audition for 2017 Initial Certification.]
Bob Wachter, ABIMF Chair 2014 never heard of the ABIM in his life. What? Who?
True or False
All of the above question samples involved cheating and fraud by Chris Cassel et al, that usurped the voter and government by preventing informed democratic methods and protocols. The patient and physician was pushed to the back of the bus regarding decisions in healthcare systems and delivery.
True or False
MOC is:
True or False
Assessment 2020 Task Force egregious conflicts of interest should have been disclosed.
ReplyDeleteNaomi O'Grady, while serving in her official capacity at the ABIM on what is known as "the Panel" is currently in litigation regarding the persecution of a young physician who attended an ABR course in 2009.
O'Grady is being sued by the physician for breach of ABIM policy and disregard of legal facts in the case. The ABIM has been accused of ignoring or withholding exculpatory evidence in a time-barred case, with no jurisdiction--which Lynn Langdon initiated about three years ago.
In our assessment this is malicious vengeance resulting from Ms. Langdon's sheer frustration and guilt for squandering so much of the ABIM's legal fund, which spilled over into operations. Langdon was COO last time I checked and has quite a bit of lead in many of the operations. I believe she should be put on notice.
Why should O'Grady step down and recuse herself.
O'Grady is in litigation for God's sake. Why did you not inform us of this conflict.
And in Naomi not expressing any dissent she is clearly in the wrong from what we can readily tell from the documents. Why did she not raise hell or advise Rich Baron or Langdon to leave well enough alone. Therefore O'Grady has become complicit in opening up yet another can of bad legal worms for the ABIM. Stinks.
O'Grady, has shown that her objectivity and sound rational judgment is not in keeping with the responsibilities and obligations she has to the ABIM and its Foundation. Nor does her complicity to help persecute yet another young phycians who was sent by and compensated by his residency to attend ABR.
ABR was accredited by the ACCME and recommended by the ABIM and ACGME. It came with gold rank and money back guarantee. The physician was highly respected and liked.
In sum, this all demonstrates that O'Grady cannot possibly be free of emotion and subjective response. She cannot do her job serving physicians on 2020, while she is being sued by a physician. She may not have been part of the past persecution, but the connection and association with the past misjudgments and harms inflicted on so many physicians over time will make her ineffective at least and will not muster confidence.
The ABIM snap judgment, public defamation, bullying, and quickness to litigate has harmed more than just this current young man. There have been thousands.
What else is the ABIM totally subjective about that has obfuscated reality for them. Has anyone told them that they lost nearly a million dollars persecuting and demoralizing Sarah von Muller. Is that known? Where is the fiduciary duty!
This case is bound for trial and under the circumstances Naomi O'Grady is not an objective party and must recuse herself from any committee, which will affect the ABIM's welfare or what will certainly affect rank and file physicians to their detriment by being allowed to remain on Assessment 2020.
I would like to ask for full disclosure for all of the parties involved in this case of vengeance against, from what I can tell, an exemplary physician.
I have read the court documents and can clearly state that Lynn Langdon is not the right person to be advising Rich Baron. Langdon deserves her money, but she needs to be placed in another position where she can get her money, but not harm the ABIM or the clients it serves.
Over-reach? No it is a display of personal animosity and frustration that I cannot put into words and the clouded judgment of Ms. Langdon sheds a great deal of light on the past.
I have tried to reach Richard Baron to discuss this matter, but I can never reach him for important issues like this. I would like a comment from the ABIM on their website.
On behalf of the physicians you harm: You have broken into our homes. Violated our rights. God damn you!
What you do to another you do to me! I will not tolerate this.
Hi Wes,
ReplyDeleteOur EP lab is in the process of getting ready for the IAC EP lab accreditation. I am appalled that they are pandering to the ABIM MOC process as a standard for physician competence and as a qualification for any EP lab. We have a short window to give the IAC feedback about this fiat and the ABIM. I would urge all EPs to log into the IAC website. Leave comments about how the ABIM MOC process is never to be trusted until the leadership structure is completely overhauled and their fiscal excesses be fully exposed.
http://intersocietal.org/iac/comment_period_ep.htm
Committee to Remove Christine K. Cassel, et al from the White House and NQF
ReplyDeleteThere are signs that Obama has admitted listening to bad advice on foreign policy which has led to such chaos in the middle east, Africa, and other parts of the world - death, destruction of ancient cultures and social structures, refugees everywhere.
Has he awakened sufficiently enough to think for himself about healthcare reform - all the problems, just getting exasperated by the day?
Can he listen now to outside advice for some changes that could help?
Maybe it is time to put a wedge between him and his bad advisors and help him out of this mess. Help the country out of this mess. We must abandon what does not work and seek out what does. Or modify sufficiently until we find a cure.
I'm sure Chris Cassel is not telling him the truth but leading him astray, just like she always did with her people.
Is it time for Obama to distance himself from the foreign policies of Christine K. Cassel and her corporate cronies at Kaiser-Permanente and all the other corrupt stakeholders she works for.
I say yes. One can't wait for the next president or congress. One must seize any open door. Physicians must speak out from every party, get rid of the stupid ideologies that divide.
Medicine has just become a breeding ground for these high-ranking corrupt medical politicians, always on the take, while creating their matrix of morbidity and crime.
Push the lying bureaucrats out of their cushy positions.
Help the president out.
I might be wrong, but he might be looking for sound advice.