Strongmen, Bosses, and the American Board of Internal Medicine

From John Kass, political reporter from the Chicago Tribune, this morning:

"Chicago is the most American of American cities," Emanuel has said, repeatedly. "It's not just any city. If you want to come and see America, you come to its heartland. And what is the capital of that heartland? Chicago."

Democratic political stars with Chicago ties — from his old boss President Barack Obama to presumptive 2016 Democratic nominee Hillary Clinton — must enjoy hearing it.

Politicians running for the office of emperor in a Republic just love fairy tales.

But there's one thing wrong with the mayor's favorite saying: It's wrong.

Chicago is not the most American of American cities. Chicago is the most Soviet of American cities.

The people of Chicago know this and it's time the rest of the nation understands it, too.

Chicago may appear to be an American city. But it is actually run on the old Soviet model, where the people were bossed for generations by ruthless and cynical strongmen.

The Russians call them strongmen. In Chicago, we call them bosses. But strongman-boss, boss-strongman, what difference, at this point, does it make?

The strongman of Chicago rules by fear. He holds the terrible hammer of big government in his hand. And if you're a corporate titan or a corner shopkeeper, you don't want that hammer to strike you down.

While Chicago is embroiled in a horrible police scandal uncovered by the flow of information via the digital age, I couldn't help but think how true Mr. Kass's words were in terms of US medical care and the control of practicing physicians on the front lines of health care today.

While nowhere near the seriousness of the police story in Chicago, the story of similar strongmen/boss tactics used against practicing physicians is a sad story that has been growing for years. Until recently, physicians have been oblivious to these tactics used by the American Board of Medical Specialties (ABMS) (based in Chicago) and the American Board of Internal Medicine (ABIM) who used their political and professional connections to foist their Soviet-style strongmen tactics on practicing physicians via their board re-certification requirement called "Maintenance of Certification®."

Participate every two years or lose your job.

Participate every two years or never see another penny from a major insurer.

Attend a board certification course that does not bow to the ABMS/ABIM strongmen?

Get sued or sanctioned.

Here's a redacted copy of the ABIM sanction letter sent to a physician who attended the former Arora Board Review course.  It came FedEx to the physician labeled with the instructions "destroy if undeliverable." To my knowledge this letter, sent to some 2000+ physicians who attended the Arora Board Review Course over the years it operated, has never been made public by the ABIM:

ABIM Sanction Letter issued by Lynn O. Langdon, MS,
Chief Operating Officer, ABIM (Click to enlarge)

It is a threatening letter, issued by a non-physician Chief Operating Officer of the ABIM who served as strongman for the ABIM and ABMS and later earned a $297,646 bonus from the ABIM in FY2012 (Page 22). The letter suggests the physician-attendee of the Arora Board Review Course violated a "Pledge of Honesty" and failed to call the obscure and unvetted ABIM Exam Integrity Hotline. And because the ABIM now has "ethical and professional concerns" about that physician, it is "placing a copy of this letter in your file."


Threats. Intimidation.  Strong-arming.

Maintenance of Certification®: the Chicago Way.

To think this whole process was been transported from Chicago to Washington, DC and is now deeply embedded in the Affordable Care Act as a physician quality registry, courtesy of heavy lobbying by the ABMS (and likely the ABIM), is sickening and wrong.

Practicing physicians, like the citizens of Chicago, deserve to know the truth of how and why this occurred.

-Wes

PS: Ms. Langdon no longer serves as Chief Operating Officer of the ABIM. She was quietly replaced by Nkanta “Nick” Hines, MSc, MBA. Ms. Langdon now serves as a board member of the American Board of Medical Specialties.