I ask my readers to indulge me as I provide some background about the strongman tactics used by the American Board of Internal Medicine (ABIM) to protect their board certification monopoly.
It started with a press release sent by the ABIM dated 9 June 2010, resulting in a story by Katherine Hobson making national headlines in the Wall Street Journal entitled "Medical Board Says MDs Cheated." Ms. Hobson also cross-posted her story on the Wall Street Journal's Health Care blog which she helped moderate at the time.
With this article, the public learned that five physicians, Monica Mukherjee of Washington, D.C.; Anastassia Todor of Aurora, CO.; Pedam Salehi of Los Angeles, CA; Sarah Von Muller of Tulsa, OK and Frederick Oni of Warner Robins, GA were sued by the ABIM "for what it deemed were ethical breaches involving the disclosure of test questions—which aren't supposed to be repeated, copied or reproduced." Another 134 physicians were "sanctioned" by having their Board certification revoked for at least a year, and thousands more were sent "letters of reprimand." Labeled as an "unprecedented action," the sanctions were "immediate" and resulted in the revocation of these physicians' Board certification for at least a year or more without trial. Hiding behind the legalistic "Pledge of Honesty" that physicians have no choice but to sign when they enroll in the ABIM certification program, Dr. Christine Cassel, president and chief executive of the ABIM at the time, called the sanctions "a message and a deterrent."
It's was also an unprecedented strongman tactic by a self-appointed and unaccountable non-profit corporation. Should the entire unaccountable American Board of Medical Specialties and their 24-member boards be allowed to intimidate, threaten, and professionally destroy physicians to protect their financial stranglehold on their own version of professional certification?
To those in their isolated executive perches, it seems they feel they can. And so, the story does not end there.
Using undisclosed methods and personnel, it seems the ABIM traced emails from a computer seized from Arora Board Review to a physician in Puerto Rico four years later. In a letter dated May 8, 2012, from Ms. Lynn Landon, Chief Operating Officer of the ABIM, Jaime Antonio Salas-Rushford, MD, was accused of sharing board review questions with the Arora Board Review course. On the sidebar of that letter were other names: Chair Catherine R Lucey, MD, Chair-Elect Robert M Wachter, MD, Secretary-Treasurer Talmadge E King, MD, President and CEO Christine Cassel, MD, Chief Information Officer John K Davis II, MBA, Senior Vice President and Chief Medical Officer Eric S. Holmboe, MD among others. With only 10 days notice, the ABIM imposed its harshest penalty: to "indefinitely revoke" Dr. Salas Rushford's Board certification and "notify the Medical Board in every jurisdiction you are licensed." The ABIM then sued Dr. Salas-Rushford for alleged Copyright infringement.
What the ABIM had not anticipated is that Dr. Salas-Rushford's parents are lawyers and they countersued the ABIM. Currently, the case has moved from Puerto Rico back to New Jersey and continues in its discovery phase. Lawyers from one of the largest law firms in Philadelphia, Ballard Spahr LLP, are representing the ABIM - all paid for by millions of dollars of practicing physician testing fees.
As you can imagine, the legal fees for Dr. Salas-Rushford's defense are significant. Last evening, a website (doctorsjustice.com) went live to help crowdsource Dr. Salas-Rushford's legal costs. The website contains more about Dr. Salas-Rushford and copies of documents important to his case (including the Langdon letter and the ABIM's final sanction determination). I encourage everyone to review his information carefully.
Given what we know about the ABIM's recent actions, the secret funneling of funds from the ABIM to the ABIM Foundation from 1989 to 1999 to define their version of "medical professionalism," the use of physician testing fees for luxury condominium purchases, the concerning undisclosed conflicts of interest within the leadership of the ABIM (see here and here), the revolving-door collusion between CMS and the National Quality Forum, the undisclosed political lobbying of this tax-exempt 501(c)(3) organization, their strongman tactics, and their propensity to advertise their self-determined sanctions to mainstream media before due process, it is time practicing physicians demand justice and a full investigation into the ABIM's methods of securing their lucrative physician "quality cartel."
Dr. Salas-Rushford's suit against the ABIM promises to shine a very bright light on the practices of the ABIM whether his case is upheld or not. For that reason, I encourage all practicing physicians, irrespective of specialty, to donate in whatever way you can - $5 or $500 - to his legal fund. You can also help by sharing his website and encouraging others to do the same.
It's time for practicing physicians everywhere to hold the ABIM accountable.
-Wes
We stand shoulder to shoulder with you, Jimmy, in fighting this horrible injustice.
ReplyDeleteYou can count on our wholehearted support and help with your legal fund, Doctor Jimmy!
ReplyDeleteWe consider the ABIM's unjust actions to be an affront to dignity and honesty in the world. Rich Baron, Bob Wachter, Eric Holmboe, Lynn Langdon and the other ABIM "officers" chose what they considered to be another soft target to go after. Boy, did Rich Baron get this one wrong! Lynn Langdon's letter shows herself to be not just highly inaccurate, but personally vindictive. What else has she gotten wrong. How many other times has Langdon exceeded her job description and committing egregious ethical violations regarding this exact same kind of obvious overreach?
ReplyDeleteThe ABIM proves itself to be in their own greedy, angry, vengeful head again.
ReplyDelete
ReplyDeleteWe reject all such legal intimidation from the ABIM. We will not rest until the ABIM's financial chicanery, strong-arm tactics, and hidden political activities are exposed and they are held accountable. Hard working practicing physicians everywhere will prevail over ABIM’s inhumane disregard and abuse. We send our best wishes and strong show of solidarity to all who have been wronged and suffered from the direct legal backhandedness of the ABIM and ABMS.
You can count on us to keep checking in with you, your case and your site.
The ABIM, with Langdon's sanction letter, proves to the "court of public opinion" that this organization is irrational and time-bound - committed to an illicit past that they will not admit, thus digging the hole deeper and deeper for themselves.
ReplyDeleteIt's no wonder the ABIM "fired" Lynn Langdon for what she, Cassel and Baron have done! When asking to speak with Lynn Langdon by phone, the ABIM claimed that Ms. Langdon no longer works for the organization.
ReplyDeleteWhy was there no official announcement of this?
What does that mean? Does that mean Rich Baron really let her go; or are they are hiding her - paying her hundreds of thousands in hush money?
I want to know. It is my right. Is Langdon still living off physicians' misfortune and suffering - getting more money while she tries to evade the public outrage against her running from her past and equally unpleasant present.
Thanks for posting this important information about the ABIM's ruthless legal tactics.
ReplyDeleteIn looking over the ABIM v. Salas Rushford pacer.gov documents, I can't believe this bogus ABIM saber-rattling. It's a wasteful hail-Mary court action against another innocent victim.
How desperate Lynn Langdon, Bob Wachter, Chris Cassel, and Rich Baron appear.
This is going to be the ABIM's last lawsuit and attack on a physician. Already the native American bone tosses from the Allegheny Mt oracles are predicting ABIM's gushing Achilles from a distant Puerto Rican dart.
Ballard Spahr said to Rich Baron when he was uneasy - questioning the validity of the legal pursuit - feeling the heat on his heel.
"No sweat, Dr. Baron, it's just a prick. Let's have another round of vermouth."
Is it good advice from her/him? Was it good advice in the past. The lawyers get the physician MOC fee money whether you win or lose. What do they care, Rich? But how much dignity will you lose. How much money actually goes to produce those certification gems in the end after "all is said and done?"
The corrupt police/surveillance/testing security culture invited into the ABIM in 2008 has literally ruined the ABIM - the COO's investigative office has brought such damage and shame to the ABIM.
Keep the ball, Rich. Don't make the wild angry throws at physicians anymore. Just take a dignified knee to the ground. This is friendly advice. Please take it, Rich.
ABIM's copyright infringement lawsuit against Dr. Salas Rushford was filed in a frantic attempt to distract us from the culpability ABIM officers have had in pursuit of personal/partisan politics and high finance.
ReplyDeleteProblems with following IRS rulings and a strong habit of opaque finances shadow their steps while they lobby in Washington or elsewhere. They make corporate software deals that boost their unvetted officers share prices. All this busy work while being perfectly negligent toward the actual work of running a viable non-profit certification "society."
They hide like jackals from transparency in order to continue the lavish lifestyles executive officers reward themselves with - all approved of course by egregiously conflicted board chairman who know very well the current "fair price" to pay.
They take and take without regret or remorse the lion's share of power and money
- while the deer in the headlights with the dwindling time, money and everything else just continue to keep clicking away.
Your words are like pure water, Wes - so very clear. It is a call to action summoning a response from the deepest level of our being. We really can't allow the ABIM culture to continue as it has.
ReplyDeleteAs you mentioned, Dr. Salas Rushford, Monica Mukherjee, Anastassia Todor, Pedam Salehi, Sarah Von Muller, Frederick Oni were sued. I would say with what we now know there were "put to the question" by the ABIM for obvious fraudulent reasons. These purposes involved trade restrictions - specifically growing market share by ruining the competition's right to exist. Also, the testing/security empire was stretching its wings at the time and made inroads infiltrating the ABMS, ANSI and many other quality assessment and standards setting organizations - at the same time.
ReplyDeleteYou are absolutely right these unscrupulous testing/security experts with unvetted checkered histories were assisting in creating these monopolies within the ABMS. We cannot look at the ABIM as the only culpable target of our scrutiny when it is the entire ABMS steering and supporting it.
These testing "security investigators" were looking to shore greater power for themselves and their corporate sponsors as well utilizing unethical lawyers creating ever more onerous and binding "pledges of honesty" where civil and criminal penalties were written in to vilify almost any "irregular behavior" in testing environments.
The trouble is these testing security folks were often even more unethical than the executives running the profitable certification/verification with all their profitable side shows.
The testing/security mercenaries were paid employees or contractors doing the heinous acts which strengthened - but inwardly maligned - the umbrella organizations further. The ABMS with the help of these new "unscrupulous insiders" for example, were transforming the ABIM and ABMS into true racketeering enterprises. The "quality assessment" then starting yielding some power and authority. The executives were complicit getting their hands dirty in legal pursuits that they were not supposed to be doing in their job description or areas of expertise as "quality assessment bureaucrats. These executives relied on police-like/homeland security directors who took their cues in turn from greedy corporate-minded individuals who had no concerns about honesty and traditions of decency.
They sought special favors and aligned themselves where they could find other conflicted individuals who were willing to turn a blind eye on the conflicts of interest and deceit.
The result is the ABIM is now a fallen house. It is a house of shame as someone implied here. As the current ABIM board chair stated. "It got away from us." Does he know how much it has gotten away from him? Perhaps a physicians weakness is their honesty and goodness. It can be controlled and manipulated.
This conditioning coupled with the use of fear is how you groom an ABIM physician to be so compliant. It starts with med school and the ACGME in residency. Even the officers of the ABMS can be perhaps manipulated and used like a dumb tool too?
Maybe they are angry as well at how it has all gotten so far away from us.
ABIM claimed they spent >$859,000 litigating the copyright issue alone against Von Muller. http://law.justia.com/cases/federal/district-courts/pennsylvania/paedce/2:2010cv02680/363083/190/ "ABIM President Christine Cassel, MD, told Courthouse News it has "spent millions of dollars defending the integrity of the ABIM examination process." http://www.courthousenews.com/2012/03/13/44652.htm
ReplyDeleteIt's important to support this physician, if you do not think ABIM should be able to say their tests are "trade secrets" and they can copyright medical knowledge. http://drwes.blogspot.com/2015/10/can-medical-knowledge-be-copyrighted.html
In order to sign up for MOC now, you must sign, ..."I understand that by applying, I am entering into a contract with ABIM to provide certain health care operations services, including practice assessment and evaluations. The ABIM HIPAA Business Associate Agreement is a part part of this contract." [My comment: ABIM is not my business associate, so this appears to be fraud.]
"I agree to indemnify, release, and hold harmless ABIM, its employees, officers, directors, members, agents, and those furnishing information about me to ABIM from any claims, liability, or damage by reason of any of their acts or omissions, done in good faith, in connection with: this application; information furnished to or by ABIM; the evaluation of my qualifications; ABIM examinations; the enforcement of ABIM's Policies and Procedures for Certification, and the policies for recertification outlined on ABIM's website, as well as all terms, conditions, and rules set forth in this website, as they may be amended from time to time; and any other action taken with respect to any certification or recertification granted by ABIM.
I understand that all ABIM materials are protected by the federal Copyright Act, 17 U.S.C. § 101, et seq. I further understand that ABIM examinations are trade secrets and are the property of ABIM. Access to all such materials, as further detailed below, is strictly conditioned upon agreement to abide by ABIM's rights under the Copyright Act and to maintain examination confidentiality."
My vote is for free online medical education to replace MOC, FOAMed instead of MOC.
http://lifeinthefastlane.com/foam/
People who like to teach could teach online.
Docs could vote for best presentations, and what is necessary to learn.
Inexpensive, good quality medical education...
MOC could become maintenance of competence.
I still think American medicine is the best in the world. American physicians could help educate physicians in other countries without the exorbitant cost and poor quality of MOC.
Interesting report on NPR today: Standards, Grades And Tests Are Wildly Outdated, Argues 'End Of Average' http://www.npr.org/sections/ed/2016/02/16/465753501/standards-grades-and-tests-are-wildly-outdated-argues-end-of-average
Good job, Dr. Wes,
ReplyDeleteThis disease of ridiculous self importance is not confined to medicine.
Other professions have such stupidity inflicted on them by groups they're required to kow tow to for certifying CE et al.
Both the ABIM and ABMS's high handed actions in recent years have been, and should be, a cause for concern to all physicians I know. I don't know what action we can take. This has been festering for more than a decade. I remember writing about MOC when it was first proposed probably 15 years ago. No body listened then and no one does now. I challenge any one to hold a fair referendum of all practicing physicians in this country about some of the actions of our specialty boards including MOC, most will vote to do away with MOC and change some of the others so that physicians in this country can breathe. Imposition such as MOC is unnecessary, physician and patient unfriendly and takes time away from patient-physician interaction. Other cumbersome bureaucratic impositions have done a lot of harm to physicians' freedom to practice medicine as they learnt in medical school. There may be some bad physicians and when found they must be given fair hearing and punished as necessary and even disbarred.
ReplyDelete#patientshateMOC2
ReplyDeletethat includes the filth at ABIM (and the like) who put up docs to this stuff.
Anonymous wrote: ABIM claimed they spent $859,000 litigating the copyright issue alone against Von Muller.
ReplyDeletehttp://law.justia.com/cases/federal/district-courts/pennsylvania/paedce/2:2010cv02680/363083/190/
"ABIM President Christine Cassel, MD, told Courthouse News it has "spent millions of dollars defending the integrity of the ABIM examination process."
http://www.courthousenews.com/2012/03/13/44652.htm
ABIM v Von Muller v ABIM, Cassel, Langdon, Holmboe, et al.
The ABIM was billed $859,000.00 by lead attorney Hara Jacobs on behalf of Ballard Spahr for suing Sara Von Muller. Sara was a gastroenterologist and mother of ten at the time who attended an Arora board review course. ABIM claimed she infringed on their test copyright. With strong language the ABIM committed to a public campaign of character assassination against her and many other physicians. ABIM called them cheaters with out due process and painted guilty based on "ABIM's ongoing investigation." I am sad to see that the prosecutions are still going on.
Here is a little data for the ABIM and physicians to consider: the costs of suing and being sued are enormous.
Just one trial cost the ABIM well in excess of 3-4 million dollars when you calculate in the cost of ABIM's "unvetted" and unregulated "security investigators" under the management of Lynn O Langdon, MS.
Lynn Langdon received a bonus of nearly $300,000.00 for her overreach, cover-up, and the strong-arm bit she played. Ruining lives to maintain/increase market share and boost one's trademark is immoral.
Adding it all up; it does not add up.
Hara Jacobs billable hours according to the court were 537.2 hours @ $293.262.00 in prosecuting Von Muller for "sharing impressions of an ABIM-like test." I have read the court documents. I concluded, if I were on the jury, I would have found Von Muller clearly not guilty based on copyright merger law and the lack of any substantial evidence against her. A grave injustice to harm other physicians. I can't make sense of it, because it makes no sense.
After the first trial ABIM's lead attorney, Hara K. Jacobs billed the ABIM another $1,000,000.00 ($1 million) in legal fees for defending Von Muller's counterclaim charges that the ABIM wantonly and maliciously maligned her reputation and harmed her ability to make a living to support her quite large family.
Out of ten or eleven attorneys working for ABIM on the counterclaim. Hara Jacobs working at $546 or more per hour would have received another $300,000.00 from the ABIM to sue Von Muller. This time Jacobs gets a big payday to defend the ABIM from Von Muller. $600,000.00 is a lot of "motivating reasons" for bringing a law suit against Von Muller and several other physicians.
Money and perhaps political power for the democratic healthcare reform machine is a lot of motivation for bringing a new lawsuit now after going on six years. It's money whether you win or lose for Hara Jacobs who is utilizing a former NJ supreme court judge - now a Ballard Spahr New Jersey partner - to sue the young Puerto Rican physician, Dr. Salas Rushford.
For Lynn Langdon, maybe she got an early bonus or retirement package. She maliciously wanted payback or vindication for squandering so much money in the past. She thought Dr. Salas Rushford was a soft target. Well she was wrong and she is gone already because of it and her mismanagement/negligence.
We are putting our money on David, not Goliath.
The six digit identifier and the ABIM. Look at what they are doing to us.
ReplyDeleteThis sanction-revocation letter to Dr. Salas Rushford enrages me. At the same time it frightened my daughter who is only sixteen, when she glanced at the letter from behind me - reading it off my computer screen. She wanted to know what I was reading as I appeared to be upset about something. "Politics?" "No, it's the ABIM." "Oh, them again. What are they up to now? When are they going to leave us alone."
Look at what the ABIM has done to him. Look at what they are slowly doing to us! This outrageous sanction letter to Dr. Salas Rushford gives only 10 days to respond to the revoking of his certification! This would disorient you completely to the point of irrationality when you realize you may not be able to work, and may also have to even give up your apartment and car. Your whole way of life.
In the letter from Lynn Langdon, her security and legal "experts": "We gather the facts," they say. "Only our facts are pertinent." "We determine who is ethical." "We determine what is irregular behavior." "We determine guilt." "We have determined that you are guilty." "This is what you have done." "You have shared actual ABIM test questions." "Our ongoing investigation into the practices of Dr. Arora has concluded that you have colluded with him."
"What? With who?"
"If you have any information to provide before we institute the recommended revocation send it to submissions@abim.org. Provide your six digit numerical identifier when responding."
Then without warning they sued him in New Jersey. What!
Now he may have to give up everything he owns to pay for the legal fees. Who are these people with the unilateral power that even the federal government should not and does not possess? I thought the ABIM was registered in and operated out of Pennsylvania. Why New Jersey?
Then suddenly without warning ABIM also threw him off balance by suing him in Puerto Rico. More money for legal expenses!
Months later, they are suing him in New Jersey again. The legal document suing Dr. Salas Rushford says the ABIM is registered in Iowa. I heard about someone who called the ABIM's agent at their legal address in Des Moines, who responded by saying that they never heard of the ABIM!
Lynn Langdon's ABIM revocation letter.
http://www.medtees.com/content/LandonLtr.pdf
Later I asked my daughter why the letter frightened her so much. She told me.
This sanctions letter to Jaime Salas Rushford really frightened my daughter, because it reminder her of a movie she saw recently where a young Jewish woman - a victim of the Spanish Inquisition - was stripped naked, hoisted up on ropes and made to confess to crimes against the church that she did not commit. Tell us of your sinful thoughts and the foods you have ingested, the Inquisitors said in loud voices or they would continue to stretch her body until it came apart.
The girl was kept from her family for days where she remained frightened and out of her wits. Finally she lost all sanity when she was imprisoned, starved and repeatedly raped by priests.
When my daughter was seven she had a frightened response also to scenes from the "Sound of Music," which is still one of our favorite movies, because the family escapes to a freer better place.
I love the United States, however elements within our country have turned dark. This action by the ABIM to sue another physician in an attempt to vilify physicians has turned me completely sour on the organization. The sanction letter and lawsuit has had the opposite effect. It vilifies no others than the executives and officers who float up and down the left margin of the introductory page.
ReplyDeleteLynn Langdon...you are really something.
Lynn, remember...Karma is a bitch.
They may have shipped you to ABMS but we will NEVER forget what you did.
Finding the lodestar of justice
ReplyDeleteI have an important legal question to ask about the ABIM. Can the ABIM be legally considered a “State Actor”? With an informed mind in possession of factual data, we believe ABIM is clearly a State Actor. The ABMS and each of its medical specialties is a State Actor.
The organization has been in a "symbiotic relationship" and "pervasively entwined" with the federal government and actors of the federal government since inception. Yet the ABIM (and ABMS) tries to downplay this relationship and even pretends the situation to be otherwise.
The Supreme Court has ruled on situations and complaints where an individual or entity has been legally considered to be a State Actor through its "public function" - and not mere identification as being a party or entity of the State.
"Public function" is sufficient to consider an ABMS member a State Actor. We will write more about this in a moment.
https://en.wikipedia.org/wiki/State_actor
The case of Sarah Von Muller versus the ABIM and the dismissal of her 14th amendment rights.
ReplyDeletehttps://en.wikipedia.org/wiki/Fourteenth_Amendment_to_the_United_States_Constitution
When the ABIM sanctioned and legally pursued this physician mother of ten, they violated Sarah Von Muller's 14th amendment rights. Sarah countersued the ABIM for "theft" of personal property without due process. (They stole her ABIM certification.) The ABIM stole the same property and violated the 14th amendment right without due process as it pertains to every other candidates and diplomates who the ABIM publicly sanctioned after being granted an "ex-parte" writ to seize Dr. Arora's property in December of 2009 for alleged copyright infringement. This was never admitted nor was it ever proven by the ABIM.
Consider this: An investigator/employee of the ABIM gathered evidence (ABIM "evidence") and through an ABIM private attorney or attorneys presented that "evidence" to a judge who then issued a writ to ABIM employees, attorneys and federal marshals with the “right” to bash down the doors of two physician families in order to gather evidence before it was "destroyed". The order was sealed and therefore could not be contested at all.
There was no factual evidence that this method of discovery was necessary. Imagine federal marshals entering the ABIM 17th floor to seize computers, etc. What federal judge would order a writ to seize ABIM's property? In the case of Dr. Salish Rushford versus the ABIM, it appears the ABIM is stonewalling his legal team during the discovery process. Would the New Jersey Judge order federal marshals to enter the premises and seize property of the ABIM in order to satisfy discovery. No, probably not, they are protected by the “State” even though they have a great deal of financial and political scandals to hide from the “State”.
In the case of Dr. Arora and his associate Dr. Kachadourian, it was a stealth attack in the early morning. These physicians who should have been contacted directly and given a chance to discuss and explain or have an attorney fight the ABIM's highly embellished and extremely exaggerated allegations (I am being civil with my words) could have simply opened their doors and discussed things. But instead these and the other physicians were actually traumatized for life by being treated like terrorists or murderous kingpins of a drug syndicate.
Think about it. Is this the kind of aggressive and exploitative "society" that you would want to be voluntarily certified with? I think not, and when more facts come out, I think that physicians will walk away en mass. Disgusted physicians will storm the Dirksen building in DC demanding legislation that protects their rights and ends this false (MOC) situation.
What about the "State Actor" and the ABIM "pledge of honesty"?
ReplyDeleteThe "pledge of honesty" someone mentioned here is illegal and at the same time as you can see this ABIM "pledge" as interpreted by federal judges and others is completely binding - even though it is a "take it or leave it" contract agreement - euphemistically called "a pledge".
Now back to the main question. Is the ABMS or ABIM a State Actor? Did Judge Joyner err in his dismissal of Von Muller's claim that the ABIM violated her 14th amendment rights? The Supreme court has ruled that an organization which fills a "public function" which is ordinarily a state function, then one would have to argue adamantly against Judge Joyner dismissal of Von Muller's 14th amendment rights when he opined that the ABIM is not a State Actor.
Von Muller was sanctioned and sued over copyright infringement. According to a Supreme Court ruling the ABIM is a State Actor. In 1948 the Supreme Court ruled when an "organization sues to judicially enforce a contractual right it is state action (Shelley v. Kraemer, 334 U.S. 1 (1948));
Furthermore, providing direct proof that the ABIM is a State Actor, Walter Bierring, the ABIM founder and first chair of the ABIM states that the "medical specialty board" is literally serving as "state actor". Dr. Bierring knowledgably and qualifying states that the function of certification in Europe in the 1930's was a state function as government was involved. Voluntary certification was ABIM's solution to the government solution; thereby ABIM is clearly a State Actor serving a "public function". It evaluates, organizes, and according to medical specialty society leadership the ABIM is considered to even be a regulatory body. The ABIM motto: "We are of the profession, for the public."
The Chairman of the ABIM in 1937 wrote directly about the "state function" of this "public body". In the following ACP archival document, Dr. Bierring tells us the ABIM (or any of the medical specialty boards that were forming and evolving) serve the function of being a "State Actor".
"In certain European countries legal provisions control the licensure of specialists, but such measures did not seem practicable for this country. In the many discussion on the subject, the consensus was that the responsibility lay on the organized medical profession as represented by the American Medical Association, and that any form of legislative control was undesirable."
THE AMERICAN BOARD OF INTERNAL MEDICINE*
WALTER L. BIERRING, M.D., F.A.C.P.
Ann Intern Med. 1937;10(12):1746-1751. doi:10.7326/0003-4819-10-12-1746
Chairman, Des Moines, Iowa
In Von Muller's counterclaim Von Muller versus the ABIM, Cassel, Langdon, Holmboe, et al, the judge gave an opinion that the ABIM was not a State Actor. So, Sarah's 14th amendment rights, which were violated quite dramatically when ABIM revoked her certification suddenly without due process.
Even a suspension would take away her status and ability to work. They defamed her in ways that you can't imagine unless you really put yourself in her shoes. They posted in the Wall Street Journal and almost everywhere that mattered - supplanting fact with fiction, their fiction - thus demonizing a good woman and highly valued physician.
"State" influence
ReplyDeleteAnother important question. Did Chris Cassel or anyone affiliated or associated with the ABIM use her federal or state influence in getting a federal judge to write a writ to seize physicians’ property, which opened the whole Pandora's Box for constitutional rights violations and privacy abuses.
Another question: did Cassel et al use state/federal influence improperly to benefit the ABIM's financial and political aims?
Did Christine Cassel et al use their federal/state/political influence to demonize physicians in a high ranking nationally syndicated journal in New York? The Wall Street Journal. Did Christine Cassel and her arsenal of Ballard Spahr Attorneys use federal/political/state contacts or with even the slightest blush of influence to push through copyright infringement writs and subsequent lawsuits and sanctions - which in a fair and just world would not have been issued or pursued.
What went wrong with one of the top political medical professionals in the country that this highly orchestrated attack was perpetrated utilizing un-vetted ABIM employees and/or contracted individuals to be carried out against physicians? Were these physicians not considered as citizens/permanent residents of the United States with constitutional rights and guarantees? Or were they considered to be of lesser value, sanctioned without due process, rounded up in court, and demonized for political show - sheared of their dignity for the ABIM's political and financial gain.
Are Robert Wachter (UCSF,HHS, AHRQ), and Richard Baron (CMS, Commonwealth Fund, NQF) "State Actors" How can we distinguish corporate and state actor today?
ReplyDeleteDr. Robert Wachter, a safety/medical quality expert of IPC/USCF fame - another highly conflicted political medical giant - held positions as director, trustee, assessment 2020 taskforce committee, and chairman of the board of the ABIM. Wachter is also a federally funded employee under contract with US Health and Human Services (HHS) where he edits, writes, and coordinates information flow at the AHRQ. Is not Wachter a State Actor who also used the ABIM as a political organization?
Is not the ABIM Foundation also a State Actor for the HHS, particularly the CMS where policy of cost cutting and quality comingle in corporate and financial circles, aligned with the federal government. It is obvious with the interconnectedness of "quality assessment" organizations that the federal government itself through the ABMS, ABIM, ABIM Foundation, AMA, ACP, NQF, AHRQ and others push a politically sensitive agenda to reduce healthcare costs. The evidence of this is everywhere.
“Choosing Wisely” exemplifies the manipulation of medical science where it coalesces with government propaganda as it is mandated by Christine Cassel in her role now as CEO of the most powerful hospital safety and quality assessment board in the country - the National Quality Forum. This comingling of individuals, QI organizations, financial institutions, corporations all become a great mega-actor for representing the state and special interests where the lines and definitions may become blurred in the head, but they cannot be legally or factually obscured whatsoever in cold the stark reality that Medicare and social security funds/pools of investments are spent at alarmingly fast rates – much quicker than these accounts can be replenished.
Judge Joyner - "the ABIM is not a State Actor". A court document. http://www.paed.uscourts.gov/documents/opinions/11d0254p.pdf
Yet we can see it is nothing other than a STATE ACTOR in "public function" and in its predatory legal pursuit. I call on Judge J Curtis Joyner to look at these ABIM versus Physicians cases and put them in the right light. A “State Actor” beguiled another “State Actor” by providing ABIM-funded, ABIM-certified evidence. Just ask any physician scientist what such ABIM propaganda and tainted “evidence” is worth.
Wes. There is little evidence to suggest the ABIM will cease to exist or will change its ways. Their MOC policy changes are only temporary. In 2018 the PIM mandate is hard wired into MACRA and MIPS. Physicians are politically weak and lack courage to slay this beast. Only a handful of us as a proportion is taking the effort to fight back. Look at the recent Petitionbuzz list of physicians. It's barely 180.
ReplyDeletePathetic.
More sheep like behavior.
Or rather lemmings.
Comments are nice, but this please consider using your real name here and doing the following:
ReplyDeletePaid with
MCARD x-0565
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Arbi Khodadadi
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Jaime Jimmy Salas-Rushford MD
jsalasmd@yahoo.com
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Dr Khodadadi, we deeply appreciate your dedication to the anti-MOC movement and the example you give in helping us find the right balance of intelligence, courage and wisdom. We all wish to make the changes that are vital to the medical profession and faltering health care system. Patients are suffering.
ReplyDeleteWe are all in this together.
I will also keep funding Dr Salas Rushford. Donations on his legal defense site are given anonymously, which is quite typical for donations. One gets an email receipt. This legal battle is important to our fight with MOC.
In for $500.
ReplyDeleteGuys,
ReplyDeleteAlso, please. If you go to the ABIM page, they tell you who is on the subcommittee for your field, i.e. cardiology, rheum, etc. It is usually 5 MD's plus one non-MD. You can easily find these "experts'" email address online, usually on articles they have published.
Please email these MD's directly and ask them why are they helping the ABIM. Most of these guys purport to be scientists, yet they are prescribing expensive, proprietary education plans with NO EVIDENCE WHATSOEVER to back them up.
Three of these guys responded to me defensively. I pointed out to them, NO EVIDENCE = NO MOC and any defense of MOC beyond this is circumlocution.
Please reach out to your committee members and tell them what they are doing is hurting real-life practicing physicians.
Thank u.
Qualitative easing in the quality assessment bureaucracy
ReplyDeleteThe ABMS and the public must understand the rational and necessity for ending the onerous MOC requirements related to a physician’s certification.
MOC is redundant. The cessation of MOC will immediately enliven and stimulate a focused interest in CME and the well-founded original practice of meeting annual educational requirements in the fifty states and territories through exciting the free market in developing individually-designed annual educational opportunities.
It is the view of almost everyone that “qualitative easing” on the part of the ABMS when implemented will substantially increase quality, not diminish it. Therefore the only thing that the ABMS has to fear in ending MOC is fear itself.
Individually developed and focused CME, as already prescribed by state boards, will increase qualitative results. By giving the opportunity for physicians to choose what is necessary and useful, the burdensome redundancies imposed by the ABMS will drop off like a heavy weight.
Freedom of choice will stimulate and enhance continuing medical education in the United States and improve quality of care when the burden of MOC is lifted.
The imposition of MOC appears to be more for the ABMS’ own financial benefit than any real benefit to the public. So qualitative easing of redundant and mixed requirements will result in a better and more efficient healthcare system and its delivery. With less going to quality assessors who mostly have their own extravagant lifestyles to maintain and protect, more money will be freed up for actual clinical care.
As outlined above, less truly is more. Ending MOC is more; when MOC is ended there will be a confirmation of the quality assessment bureaucracies’ main thesis that we achieve more when wasteful and often harmful practices like MOC are carefully weeded out of the system.
The financial savings, time benefits and release of healthy energy will be dramatic. Physician burnout will decrease. It is an ideological win for the bureaucrats and they can be satisfied in their achievement of introducing and implementing the concept in their own offices in Chicago and Philadelphia.
The only ones who thus far have failed to realize this necessity of eliminating the wasteful and the constrictive factors inherent in the redundant ABMS MOC are the executives and officers who derive their outrageous incomes from MOC.
Inherent in this growing understanding of the need to reduce bureaucratic waste and redundancy we also become aware of the vital need to nominate and elect ABMS representation who will actually serve the healthy intelligent goals of all practicing physicians who are daily engaged and concerned with the quality of patient care.
We have been alerted that organizational redundancy and waste at the highest levels of our quality assessment bureaucracy only produces financial strains and bottlenecks in the healthcare delivery system. Currently both civilian and Veteran Affairs systems are experiencing various organizational and financial strains reaching crisis levels.
Ending MOC will ease part of the underlying causes for this crisis by reducing cash flow constraints, reducing physician burnout and keeping more phycians in the system who would be tempted to leave for "greener pastures" in the quality assessment bureaucracy. Taking the green out of the equation at the ABMS with an entirely volunteer leadership - democratically elected by clinical physicians - will improve things dramatically overnight.
What does the ABIM/ABMS stand to lose in reinvigorating medicine and helping make it healthy again?
How healthy is it to sue a stellar young physician who was a first responder to the Haiti earthquake devastation in 2010? How intelligent is it to misconstrue facts in an ABMS/ABIM sanctions letter.
ReplyDeleteHow fiscally responsible is it to spend another $3 million or more of physician's money defending what was claimed by Christine Cassel to have already been defended using millions of physicians money between 2008 and 2014?
Who is ultimately responsible for this fiscal irresponsibility?
Does corporate ruthlessness espoused to zealous political ambition give the elite medical bureaucrats at ABIM/ABMS the right to ignore ethics and to act outside the system of laws, which are designed to protect the public and those who serve the public. Do we have a dualistic legal system where elite medical politicians are protected from prosecution with one system and the public is indicted and often not even tried, but "plea-bargained" into "accepting" lesser prison terms by pleading guilty.
Who is responsible and who will be held accountable for the violations of thousands of physicians constitutional rights between 2009 and 2016 stemming from the seizure of property unlawfully? Will it be investigated as it should be?
Who? Who is responsible, and who will be held accountable?
This is just the tip of the iceberg.
ReplyDeleteABIM is a grave and horrific disappointment for all of us.
I stand with all of you to support justice for Physicians.
http://www.huffingtonpost.com/rose-kumar-md/the-personal-toll-of-corp_b_8323686.html
http://www.huffingtonpost.com/rose-kumar-md/the-dark-side-of-healthca_1_b_9214490.html