Tuesday, April 26, 2016

Fearing Exodus: American Board of Medical Specialties Issues Statement on Oklahoma

Fearing a mass exodus of physicians from the lucrative ACGME-mandated Maintenance of Certification (MOC) program, two member organizations of the ACGME, the American Board of Medical Specialties (ABMS) and the American Osteopathic Association (AOA), recently issued statements of "disappointment" or "promising to innovate."

The ABMS stated they were "disappointed" on the passage of the Oklahoma law outlawing the use of the ABMS MOC program for board certification, physician hospital credentialing, or insurance company payments and were "committed to improving their programs for physician certification and assuring that participation in MOC provides physicians with meaningful improvement opportunities." No mention of how they might cut the cost of their "commitment" to physicians was made.

The AOA's statement, issued just after the National Board of Physicians and surgeons open its credentialing process to osteopaths, "promised to innovate" so they could reach their "Rooftop Goals." Too bad the AOA still doesn't seem to understand that their statement promotes just what physicians don't need: another bureaucratic building project.

Neither statement issued by the ACGME member organizations provide convincing arguments of sincerity to practicing physicians that have seen their hard-earned cash squandered by these organizations and have failed to truly prove the clinical relevance or need for re-certification of any kind. Further, no accountability for the financial mismanagementstrongman tactics used by ABMS member boards to assure physician payments into this unproven metric, and fraudulent tax filings by member boards of the ABMS has yet to take place.

This outdated ACGME physician MOC re-credentialing system built on political and corporate cronyism is being rendered obsolete by the presence of real competition to the status quo by the National Board of Physicians and Surgeons' credentialing process that is credible, more affordable, and financially transparent. There is simply no going back.

Good riddance MOC.  Trust me: you won't be missed.

Nor will those who've made a living for themselves promoting this very broken and highly conflicted ABMS MOC program.

-Wes


48 comments:

Anonymous said...

All they would have to do is provide worthwhile educational products at a good price without holding us hostage, come clean on past transgressions of financial shadiness, and most docs wouldn't be so pissed. Its not that complicated Nora, and Baron !

Anonymous said...

There is unanimous support for a MOC-FREE America!
Oklahoma "ANTI-MOC" legislation should be replicated in all 50 states and territories. Once on the legislative agenda, I predict a clean sweep for all fifty states to protect patient/physician rights to receive and give care.
The free flow of care is only possible in a MOC-free America.

PBF said...

Manipulative and obtuse.

ABMS goes to 'press' with three paragraphs on OSS Bill 1148 - Oklahoma Medical and Surgical Licensure and Supervision Act - which frees physicians of the useless burden of MOC and a bad relationship with an obtuse organization, i.e. the ABMS.

Paragraph I.
Expression of disappointment. As before with Kurt Eichenwald's Newsweek articles the ABMS complains - this time - that the state of Oklahoma's entire body of elected representatives misrepresent the ABMS. I suppose they might use the word "shrill" to characterize Bill 1148 - except in reality it is just a fair response to facts in order to remedy and unsound, unproven policy and a coercive relationship that results from such usury between the ABMS and physicians.

Paragraph II.
ABMS recommends autonomy and independence to hospitals and insurers to make MOC mandatory and tied to employment and keep it that way. It is the continuity of the status quo they seek to maintain.

Paragraph III.
ABMS asserts that their voluntary maintenance of certification program is synonymous with a high level of care. This is absurd and a fraudulent assertion and false assurance to the public. There is absolutely no scientific evidence of it.

ABMS strategists and risk managers respond to Bill 1148 by appealing directly to insurers and hospitals encouraging them to consider certification and MOC as important "quality indicators" - tied to reimbursement and granting hospital privileges. This 'appeal' suggests that the ABMS has been instrumental in the past and present in lobbying to make what is stated by policy as "voluntary" into an activity with a hefty fee and schedule into what is coerced or involuntary. We contend that this contradicts ABMS official policy and constitutes public fraud with such a continued bold-faced attempt to bully hospitals, insurers, and legislators through paid and/or unpaid proxies.
What the ABMS suggests concerning a continuation of the MOC mandate and connected to employment is untenable and unacceptable to any thinking physician.

ABMS cannot create meaningful relevant educational and testing material. Period. They have had over 80 years to do so. They failed. Why did they fail? Because they were never sincere about it. The ABMS was never engaged with anything seriously and deeply other than schemes to line their own pockets and serve their corporate cronies. The ABMS is not sincere toward anyone outside their insulated cush Chicago and Philly lives. They are not serious about serving physicians or the public now.
Read the rest of ABMS’ words in response to the Oklahoma bill below carefully. It is not quality of care they want. It is money, political power and the continuation of their profligate ways in life and at work that ABMS executives want.

http://www.medtees.com/blog/ABMS_OK_Statement.pdf

Anonymous said...

Despicable! Lying and propaganda for a living. More public fraud and coercion.

Anonymous said...

Exodus, Bob Marley
https://www.youtube.com/watch?v=nv584jRwh0s
Get Up, Stand Up For Your Rights, Bob Marley
https://www.youtube.com/watch?v=X2W3aG8uizA

Ed Rico said...

In a word, the ABMS response clearly demonstrates desperation. The business plan executed with great success (if measured by revenue) by ABIM and the other certification cartel members for years, Coercion with highly refined tap dancing and smoke show as a distractor is no longer effective.

Even the most casual layman observer can readily understand that physician commitment to excellence and life-long learning can be demonstrated in ways that don't include providing a financial lifeboat for unelected, unaccountable elite professional medical politicians far removed from the daily practice of caring for patients.

Look for the desperation to accelerate at Walnut St as well as at ABMS HQ in Chicago when ABIM's punitive litigation against Dr. Jaime Salas Rushford is dismissed and Dr. Salas Rushford's counterclaim moves forward despite ABIM's predictable efforts to stonewall on discovery.

Anonymous said...

It is good that Physicians are standing up to this atrocity. Obligatory MOC is nothing less than "restraint of trade." If we can't do away with it in the OK and state medical board fashion, no doubt lawsuits rest in the wings.

I'd like to see this end the ABMS/ACGME cartel. I have applied for NBPAS certification.

james gaule said...

Mel Brooks may have said it best .https://www.youtube.com/watch?v=uTmfwklFM-M

Anonymous said...

I disagree with the post "Tue Apr 26, 07:40:00 PM CDT" stating that they should just provide a good product, "at a good price." The ridiculous COST of MOC is certainly a glaring source of offense, but we don't need a lower price. We need it to be completely and totally VOLUNTARY! IF they offer an education product/process, and it withstands the test of the market (great value!) then they will see doctors sign up in droves. Making it obligatory, whether actual (via legislation/litigation) or de facto (the current situation), is the sign that it CAN'T withstand the selective forces of the free market, and SHOULD disappear. We have lots of great educational opportunities available already.

Anonymous said...

providing educational products "without holding us hostage" means whether it is actual or de facto - non obligatory in any way - otherwise I plan on exodus

What's if all about--Alfie1933 said...


"The more we know the more we know how little we [want to] know [them]!"

You don't have to be Einstein to figure this equation out.
The proof is easy to ascertain and cognize.

ABMS = BS squared

If you're on the sidelines said...


Study your history. Their rise to power in 1933 marked our downfall. They slowly built a rigid autocratic empire accountable to no one with a secret police enforcing cooperation with them.
Ask the thousands who have been marginalized or persecuted -- the one's we failed to protect out of fear for their secure system and methods of protection and their demonizing network of propaganda. Their double leger finances are not open to question, and the fraudulent nature of their corrupt regime remains unaddressed to this day. It is the farthest thing form a democracy anyone could imagine with revolving-door crony politics and dissolute high finance.

As I said study their history.
"Since 1933, ABMS has built a solid national system of standards for recognizing medical specialists and providing information to the public."
http://www.abms.org/about-abms/history/

Puzzling questions to consider: Where is ABIM/ABMS'former COO and head of testing security, Lynn Langdon? What did she do to get large sums of money in the form of "unprecedented" bonuses? Why is she now hidden from view? Who is paying the bills for her? Is she still under contract? ABIM/ABMS or ABIMF? Is the ABIM going to retain its secret police formed in 2007-2008 that maligns physicians for no other reasons than that of "strong-arming physicians" and MOC "job security?"

Will Ballard Spahr's lead 'persecutor' continue to make million of dollars by violating civil liberties of Americans and making sure that everyone involved - past and present - keeps their mouths shut. That's a big job.

What will Christine Cassel be doing next with Kaiser really? Working or lobbying?
Consider the fact that she did not really fulfill even her 35 hour per-week contract for the ABIM and we know what she did for the ABIM Foundation to get all that money and deferred compensation!

And where are those deposed characters in the case of ABIM v. Dr. Salas Rushford v. ABIM. The only problem I have with that case is that it should be taken over by the US Department of Justice. The ABIM is guilty of flagrant public fraud and ethics breaches. When will discovery begin for that? The longer the ABIM plays the game of 'playing with discovery' - in terms of date and holding back evidence - the longer the DOJ, et al has to make its case.

FYI the ABMS under NORA is linked at the hip with the ABIM and all of their systematic methods of finance and control. Don't be fooled by their propaganda.

Cautionary note: Don't be betrayed through any acts of appeasement. They are desperate for maintenance of cash and maintenance of control. MOC is the name of their game. MOC is the dark banner and flag they wave.

Anonymous said...

WTFU

James OBrien said...

Don Fanucci cannot "wet his beak" anymore.

https://www.youtube.com/watch?v=cTCDTksSiOE

Oklahoma=DeNiro.

Let's finish him off and stop paying protection money to the Black Hand.

Knight to Queen's Bishop- CHECK AND CHECKMATE said...

The ABIM and ABMS gambit has failed. Here are the thundering legal implications from this Oklahoma Statute. Firstly, the ABIM and the ABMS no longer will get money from the thousands of ABIM diplomates. But more importantly, if the ABIM wants to shove their MOC policy down the throats of Sooner doctors, they will need to expend gobs of money in Oklahoma, suing the State of Oklahoma and Oklahoma physicians. More States are lining up to outrun and outmaneuver the ABIM. Missouri, Michigan, Florida, New Jersey, Massachusetts, Texas........

How ironic is it that a State legislature can move faster than the ABIM and the ABMS? That is good old fashioned American Democracy in action.

So what can the ABIM and ABMS do? Run to the Federal Government? Not anymore now that the white hot bright light of SoMe and Dr. Wes Fisher aimed a powerful ray of light into the dark corner of the ABIM. Incorporate the ABIM MOC into MACRA and MIPS? Good luck trying to sneak around K Street with a lobbyist. Remember that little known Federal law about political pandering as a non-profit agency, Dr. Baron? That's right. You try to buy your way into a Federal Statute, and guess what happens? The AG and the FBI walk up Walnut Street with a subpoena and they haul away your servers and freeze your bank accounts for Federal IRS Tax violations. Rich, remember, not to use the USPS because that will constitute Mail Fraud and then the Postal Master will slap on the cuffs.

Let's say the ABIM/ABMS somehow sneak MOC into some kind of a Federal law. What would happen when that Federal Statute clashes with a State statute? That's right. The SCOTUS is the ultimate stop for this train wreck. Wouldn't that be a great platform to expose the ABIM corruption?

It's amazing but the passage of one law in one State has totally up ended the ABIM ABMS MOC gambit.

You thieves have all LOST THE GAME. The Player just got Played big time.

Oklahoma- O..K!!! said...

Genius. Pure genius.
The good men and women of the Great State of Oklahoma have gone up to the ABIM and squarely punched the ABIM right in the nose with a left hook.
Sucker punched.
The taste of their own blood must be jarring for the ABIM.

As the number of States grows who join Oklahoma (Texas, Michigan, Missouri, Florida etc etc) and pass their version of anti-MOC legislation, the countdown to the final days of the ABIM will have begun. Think of the financial impact of every Oklahoma based ABIM physician not forking over their $3500? Can you say "Massive Finanical Loss", Dr. Baron?

Multiply that by 5 States...how about 10 States?

What's the ABIM or the ABMS going to do now? Sue the State of Oklahoma in an Oklahoma Court with an Oklahoma jury?

What's the ABIM or the ABMS going to do now? Cry to the Obama administration? Let's just say the Democratic Party has no desire to help an organization with a $2.3M Condo with Mercedes Limo service. Try to work MOC into the Federal CMS Code like MACRA? Good luck avoiding the Federal Tax Code for Non Profit organizations, Dr. Baron.

It is only a matter of time before an Oklahoma ABIM physician will sue the ABIM under Oklahoma State Law. When that happens, the Courtroom will be packed with anti-MOC supporters and it will be a legal blood bath for the ABIM. Let's just say, when that Oklahoma doctor sues the ABIM, he/she will win hands down.

The ABIM just opened up a new legal liability for themselves.
Oklahoma depositions
Oklahoma subpoenas
Oklahoma penalties
Oklahoma law enforcement
Oklahoma juries
Oklahoma judges
Oklahoma State Appellate process
Oklahoma State Supreme Court

The ABIM MOC has been neutered and neutralized in the Great, Beautiful, Strong and Sovereign State of Oklahoma.

If the ABIM and the ABMS aren't shaking in their boots by now, they are about to be blindsided.

To borrow a term from the good Dr. Wes.
This is the very beginning of the end.

Pathetic ABMS Open Letter of Whining said...

How PATHETIC is the ABMS open letter?

"ABMS policy states that neither specialty nor subspecialty certification should be the sole determinant in granting and delineating the scope of a physician’s clinical privileges. We strongly support hospitals and health systems having the autonomy to determine the criteria they wish to use when making independent decisions about whom they grant practice privileges."

What a bunch of crap! That was their entire premise for their business model. That was their entire hope for an endless stream of money for themselves and for retreats to the Four Seasons and joy rides in a Mercedes Limo.


"ABMS believes the values that Board Certification and MOC embody are more important today than ever."

You can believe what you want since no one else believes you or trusts you or the ABIM. Btw if there ever is a mandated MOC, nobody wants the ABMS or the ABIM to broker it. We would rather give the money to Paul Teirstein or Eric Topol and the NBPAS. We would rather have the freedom to spend our CME dollars on what we want. Not on what you want, Dr. Baron.

"Physicians’ participation in this voluntary program reflects their commitment to life-long learning, performance improvement, and the provision of high quality care."

The key word is "VOLUNTARY". Not compulsory. Not mandatory. Why? Because MOC and the ABIM and the ABMS are useless, money grubbing organizations in sore need of an ethics audit.

So go around skulking around trying to convince Hospital Med Exec Committees and the Insurance companies that ABMS MOC is the only thing keeping our nation's physicians from falling into an abyss. It turns out all of us are doing just fine without ABIM MOC and we save the nation billions of dollars.

Lisa said...

I thought the Administrative "Rooftop Goals" are to try to get physicians to jump to their deaths from great heights?

Was I confused about their goals?

Probably not. Their day shall come...

Jim Andersen said...

I opted out of the ABFP MOC after my 5th recert. Just prior I had spoken with the then Executive Director inquiring about the "evidenced base medicine" that this was supposed to be based upon , and finding that there was none (as expected) ,and after he hung up on me for the inquiry, I have ever since referred to my status as Diplomate Emeritus, American Board of Family Practice.

Anonymous said...

From the New Hampshire State; " Live Free or Die". Perhaps they need to take a trip up here and clear their heads and maybe gain a new perspective on how they are treating America's physicians. If you do not have your health you have nothing. Health not only includes the American population but physicians too. ABMS has become a parasite killing the physician population by a slow and insidious process of useless and expensive activities of no proven benefit. It is time for them to step aside and cease to exist!

Perry Williams said...

If this type of victory can be won with ABMS and gang, why not go further?

MIPS, MACRA, worthless EHRs? If not, medicine will continue to go down the toilet.

mary martin said...

I am an Oklahoma OB/GYN, and despite the legislation, have heard nothing about my colleagues and I having to fork over nearly $1000/(ACOG membership and MOC fees) per year for American Board of Obstetricians and Gynecologists annual maintenance of certification, which was enacted in 2007. Whereas my geezer colleagues are "grandfathered," anyone who trained after 1987 gets the privilege of annual recertification in a 6 year cycle, which includes annual 120 multiple choice questions, a safety course in year 3 and a written exam in year 6! Granted, the multiple choice questions are open-book, and even the written exam was not difficult, but should I no longer wish to pay for all of the articles (30), register with ABOG for the pleasure of taking the exam, and then take the time to complete the coursework, I will lose my Board Certification status.

Hoping someone will comment.

Mary Wade Martin, MD

Anonymous said...

ABMS instead of ripping off and making more difficult for us to practice medicine; they should be lobbying for us in regards to all the significant constraints and regulations imposed to us by the government that are degrading the medical care of this country and killing the patient-physician relationship.

Anonymous said...

After perusing thru Oklahoma's treatment of the MOC, one is clearly motivated to make a motion to declare that the high-handed and ham-handed handling methods of MDs by the MOC ought to be renamed as Neolithic or Noachian. In particular, after noting many reports of clear absences of correlations between MOC certifications and improved qualities in patient care, these atrociously antediluvian approaches of mandated re-certifying exams need a much closer look, if not total elimination. To cap it all, the abuse of power and finances of the member boards makes one wonder if indeed this has become de rigueur, almost like the horse trading in politics.

On the other hand, if one must keep pace with the vagaries and vicissitudes of medicine, like in any other sciences, one must strive to constantly update his medial acumen by certain prescribed methods. For instance, an MD can be required to take frequent MCQ (multiple choice questions)tests, crafted by certain medical dignitaries, from a whole host of recent advances in a respective field of one's specialty, for nominal fees, of course. This can be worked out with a panel of real experts, who have no penchant for pecuniary pursuits. Just saying.

Vic Strasburger, M.D. said...

The entire MOC situation is sad, frankly. We could keep doctors updated very easily online with a 2-3 hour curriculum every year that they might enjoy and learn something from, give them a short quiz at the end just to show they weren't blowing through the material, and BOOM! They'd be re-certified. At home. On their own computers. For - what - $25 or $50 a year? Very sad....

Christine said...

I am a pediatrician in Kansas. Does anyone know if there is a group working to pass a similar law in Kansas? I would like to help them do so.

Brett@DrSocial.org said...

Thank you very much for this, Dr. Wes. Please consider the possibility that the nefarious actions of state medical boards, the ABMS, and the ACGME are not ill motivated. The actions by these agencies, may reflect a sincere desire for improvement in the quality of healthcare. However, these organizations probably have what Dr. Daniel Goleman refers to as "collective narcissism."

Booger King said...

A word to the wise about folks that serve you junk

The ABMS has become little more than a fast food franchise serving horrible junk in an morally corrupt environment. The franchise cheats on its customers. They do not take care of filth everywhere they have generated. Yet they still expect clients to eat "in network" and cough-up outrages mandatory fees in exchange for their two-bit food.

I prefer to be able to pick and choose from different places where there is better management, products and services. We should all be able to exercise our right to do so.

Read the puffed up crock of ABMS lies from their website below! It is all just expensive advertising (you pay for it) to entice patients, hospitals and purchasers to buy in. Buyer beware!
The management, products and services are lousy. They have strong-armed or shut down all the competition. And they want to over-ride/discourage enforcement of protective state laws by twisting the arms of hospitals and insurers. They are so corrupt and sick they make all who enter their sphere of influence vomit.

"A Trusted Credential

When a physician or surgeon is Board Certified by an ABMS specialty board, it means he or she has chosen to achieve expertise in a medical specialty or subspecialty by meeting the profession-driven standards and requirements of one (or more) of the 24 ABMS certifying boards.

Board Certification and the ABMS Program for Maintenance of Certification (ABMS MOC®) are highly-visible indicators that physicians know today’s standards of practice. Board Certification is the beginning of a physician’s personal commitment to providing quality patient care. The ABMS Program for MOC activities emphasize ongoing professional development and assessment that is aligned with other professional expectations and requirements within health care.

•Patients expect that their physician’s certification reflects ongoing education and practice improvement. They place faith in our certifications and check their physician’s certification at ABMS’ www.certificationmatters.org over a million times per year.

•Many hospitals have independently made the decision to require Board Certification for staff privileges. Their leadership recognizes that diagnostic and treatment knowledge changes rapidly and learned skills in medicine can decline over time. They value the competencies for medical practice set by the profession and create procedures for their own institutions with respect to those competencies.

•Various quality organizations and health care purchasers are committed to increasing value of the care provided. They look to the ABMS specialty certification system to help them identify excellence and commitment to professionalism, and continuous performance assessment and improvement."

James OBrien said...

Mary Martin, M.D.,

Why should you care now? Since there is no evidence the MOC results in better care, be done with them. I'm hearing a little bit of the self-flaggelating PGY-1 one in your concerns. That was adaptive then, it isn't now, give it up. These clowns are not your superiors and you probably know more than they do.

Ed Rico said...

Brett@DrSocial.org:

In the event that your comments above are sincere and you are not clear on the motives of ABIM and other related agencies such as ABMS, ACGME, etc., I'd recommend you find a trusted friend or familty member who understands how to read financial statements and have them review the IRS Form 990s for ABIM and the ABIMF and their published financial reports along with supporting comments provided by Mr. Charles P. Kroll relating his financial analysis of these documents.

There can be no question that ABIM's actions over many years reflect a "sincere desire for improvement" in the personal condition of ABIM insiders. There has been a complete abandonment of ABIM's fiduciary responsibility to the diplomates who have been funding these activities without a shred of "accountabilty to the profession of medicine and to the public" despite ABIM's high-minded ideals published on their website.

Anonymous said...

Unaccountable NGOs control and rule medicine with power not fact. ABMS, Joint Commission, NCQA, URAC/Leapfrog for example are joined at the hip with the ABMS and have power over physicians and their employment through policy, partnered agreements and politico-financial collusion in maintenance of that power and control.

Even a cursory look at ABMS partnerships, executives/officers and their backgrounds/relationships gives us insight into a sordid world of political agenda, financial collusion and accommodative pandering.

Unlike the highly regulated banking and securities industries, the bureacracratic megalopolis of quality assessment NGOs are virtually self regulated and thus self-serving. These lucrative non-profits with enormous profits and payouts to officers have enjoyed corporate and government favor for years. They have been allowed to worked in the dark, under the radar for decades. This often means these NGOs work against patients best interests as in the case of MOC - against physicians and hospitals interests. The money schemes of the ABMS and affiliates are often in conflict with professional needs thwarting the ability to deliver high quality healthcare.

A random look at some of these NGOs (non-governmental organizations) the people and their plans and schemes to maintain/grow money and wield political control with a stranglehold over the healthcare system and its direction.
.
ABMS MOC delivery innovations news. A new web-based-platform for ABMS in the pilot stages. (as I understand seven specialties are participating so far)
http://www.abms.org/news-events/american-board-of-medical-specialties-announces-development-of-new-web-based-platform/

ABMS Solutions is a big revenue generator. This includes healthcare, insurance and hiring data affecting physicians hireability, compensation and future livelihoods.
http://www.abmssolutions.com/

ABMS Display Agent Letter 2014 (exclusive rights for the ABMS certification empire)
http://www.abmssolutions.com/media/1183/abms-official-display-agent-letter-2014-final.pdf

National Committee for Quality Assurance. Current CEO is an ABMS insider and has worked with Healthwise and is an associate at JHSPH.
http://www.ncqa.org/about-ncqa/leadership-team
http://www.healthwise.org/about.aspx
http://www.jhsph.edu/departments/health-policy-and-management/

The Joint Commission has grown into a juggernaut of Hospital quality assessment. MOC freedom advocates will have to fight this ABMS partner. In 1965 JC partnered with the government/Medicare. In 2002 or earlier it partnered with the NQF.
http://www.jointcommission.org/about_us/about_the_joint_commission_main.aspx
Joint Commission Timeline 1910-present
http://www.jointcommission.org/assets/1/6/TJC_history_timeline_through_2015.pdf

URAC/Leapfrog
https://www.urac.org/news/urac-and-the-leapfrog-group-announce-winners-of-the-2013-hospital-website-transparency-awards-program/

URAC's CEO is a Kaiser lifer and insurance co. insider.
https://www.urac.org/wp-content/uploads/Bio_Kylanne-Green.pdf

URAC full list of executives
https://www.urac.org/about-urac/executive-team/

Anonymous said...

Bare bones medicine. Healthcare in crisis.

ABMS frankly speaking is a 'pack' of partisan 'PACs' acting in secret for years.
They have created some of the most lucrative executive positions reserved for a 'bought and sold' club of politically-motivated MDs. I am talking about some of the most legendary salaries in the history of non-profit 'educational' medical societies.

We need to end this corruption together through firm legislation to remedy the financial excesses and onerousness of MOC. We need to do this at the state level and at the national level. We need to act because healthcare is in a deep crisis from unintended consequences equivalent to an ill-advised experimental surgery on the healthcare system. The patient (healthcare) will soon go into a state of sepsis if we do nothing. With few in power who admit their errors or even understand what to do, clinical physicians need to step up and act now.

Also of grave concern and part of the systemic problem is the meteoric rise of a pseudo-regulatory medical bureaucracy - ABMS/ACGME etc. This has resulted in the cannibalization and decapitation of the healthcare system. Fewer clinical physicians and teachers are in practice with a growing/aging population. The resultant burdens cannot be remedied with substitute providers as in a workers strike. Yet the lack of highly trained and skilled physicians has created a condition not unlike what exists when we have a body of striking workers.

Our bureaucratic physician partners sitting in front of beautiful window views in Philadelphia and Chicago need to respond to physician shortages by going back to work at least half-time to help in this crisis.

ABMS, by mandating onerous time-consuming busywork for specialty recertification, forced countless physicians out of clinical practice. This theft of talent has left the US with a dramatic shortage of qualified clinical physicians to care for the sick. This compounded deficit from the bureaucratic cannibalization of physicians needs to be addressed at the same time to have a meaningful and useful effect.

If I were a legislator I would respond to the uncomfortable hard facts and write legislation in Washington to create a national moratorium on MOC and associated bureaucratic red tape that creates bottle-necks in health care. We all know what they are. Bureaucrats need to respond to this national emergency and go back into clinical practice until we can remedy the serious physician shortage somehow.

We also need physicians to stay in medicine and be rewarded for their hard work - not cowed to by greedy removed-from-clinical-life professional medical politicians who force many excellent physicians into early retirement. Likewise the medical profession needs more young physician candidates to enter the difficult path of service with clear visible rewards guaranteed tot them with the security and peace of mind that they will not fall victim to an aimless breed of medical bureaucrats with their selfish financial and political interests and agendas.

The crisis in healthcare has reached epidemic proportions. Look around at what is happening if you can get your head out of EHR clicking, extra prescription paperwork/phone calls and useless red tape for a sustained amount of time. Try to suspend any illusions as to which 'system' of healthcare is better for now. All of this is irrelevant at this point, because we need to act in the interest of patients.

I would hope that the trained physicians sitting in offices in Philadelphia, Chicago and Washington could understand the dilemma, feel some passion of service to the country and do something about this too.


SUE THE ABIM said...

Truths and Lies: Initial ABIM Certification vs. ABIM MOC (aka making money off of pseudo-recertification)

1) Initial ABIM Certification is not just a multiple choice test. The ABIM exam is the very end of a very long vetting process inclusive of many years of observation of clinical behavior and judgment to approve a candidate to sit for the examination. The ABIM tries to take all the credit but in essence the initial certification is a byproduct of program directors and the ABIM working together to ensure physician coming out of training is properly vetted and qualified Once ABIM certified physicians go out into the real world and start working, their clinical abilities are judged by the public, the State, Hospital Executive Committees etc. This is where the years of seeing and taking care of sick patients begins to build a fund of knowledge called WISDOM. This is not something to be "tested" by a money grubbing organization like the ABIM and the ABIMF. Multiple choice MOC tests from the ABIM are useless; busy-work constructed by a cohort of non-clinical, out of touch, treacherous administrator-physicians who have decided to abandon real work and are busy carving a career as a parasite. Much like a tapeworm or a tick or scabies. Much like a virus or a mold.
2) Folks, the ABIM MOC is VOLUNTARY. THERE IS NO FEDERAL, STATE OR LOCAL LAW THAT PREVENTS A PHYSICIAN FROM CONDUCTING THEIR BUSINESS WITHOUT ABIM MOC. Heck even they said so. There is nothing mandatory, compulsory, or necessary about ABIM MOC and their ridiculous fees. The ABIM is praying hospitals and State Boards of Medicine and insurance companies will compel physicians to continue this game of subterfuge. Fat chance. Look at your contracts. It says a physician must be Board Certified. It says nothing about participating in ABIM MOC. What's the difference? The only way you can be fired by your job or be denied your status with an insurance company is if you are DE-CERTIFIED or UN-CERTIFIED by the ABIM. To their credit, ABIM Philadelphia counsel made them change the wording on their website. Physicians who do not do MOC are no longer "de-certified" but are described as "not participating" in MOC.
3) If I lose my job or lose money because the ABIM MOC prevented me from continuing my profession, can I sue the ABIM. YES. You definitely can SUE THE ABIM. Especially in the State of Oklahoma. Think about it. The certification or qualification or competency of a physician after the initial round of vetting is a dynamic process that no one agency possesses; although the ABIM fantasizes of a monopolistic process it can use as commodity for its selfish purposes. If the ABIM MOC process is so onerous and malignant and it inhibits the career of an otherwise competent physician, there are some legal circles that suggest the ABIM as a defendant would be liable for triple damages. Well how is this so? Let's use some Socratic legal logic. If a physician decides to abstain from the ABIM MOC, is that physician suddenly "unqualified" and is subject to "de-certification" by a non-clinical organization like the ABIM? Of course not. This is not a binary process of Yes/No or Certified/De-certified.
Let's jump to the reverse corollary. Are all ABIM MOC participating physicians always certified or qualified? Of course not. The possession of an ABIM MOC stamp of approval only documents that you gave this corrupt organization thousands of post tax dollars under duress and their intimidation tactics. How many of us know physicians who are ABIM MOC participants but are bad real world "doctors"? How many molecular lab researchers are "ABIM MOC" participants but worthy enough clinically to take care of a sick family member?

ABIM MOC non-participating physicians are not automatically incompetent or un-qualified.
ABIM MOC participating physiciens are not automatically competent or clinically qualified.
Thus, the RUB.
The Rich Baron-ABMS-MOC gambit is weak and pathetic.

Anonymous said...

Folks, the ABIM is playing checkers and we are playing chess.
There is too much money at stake and too many upset, smart, aggressive people for the ABIM to avoid civil litigation. Maybe State litigation now that Oklahoma has taken the smart step of legislating their way into freedom and liberty. It is only a matter of time before Class Action Lawsuits, State Attorney Generals, individual lawsuits will work their way into the ABIM's portfolio of really stupid mistakes and strategic blunders.
Dr. Baron- we have 2 words for you and your corrupt, dirty organization.
TICK
TOCK

Anonymous said...

Remembering Sarah Von Muller.

You'll be vindicated.

Will D. said...

ABMS - an Agent of Propaganda, Fear and Cost Control. Complicity in the Hidden Declaration of 'Corporate Law' in the US Healthcare System

ABMS with the ACGME and its associates inherently have two overriding aims.
1. Control physicians thinking with propaganda/fear mongering.
2. Cut health care/pension/social security costs for corporations and the government. No pretense is even made about this. Look at the ABIMF politico/corporate agenda.

The current reality of control/cost savings and the political/financial nature of the ABMS represents an outrageous conflict of interest. It is almost as though a martial law has been declared to support an elite body of officers and their powerful cronies. The only difference between the current situation for physicians in medicine and martial law is that there is no curfew established on how late 'providers' can stay at the clinic or hospital. This is a fact while ABMS officers and their secret police work from home or for so few hours as to be laughable.

As a result this horrendous, overburdened condition that exists there really needs to be a revolution. The ABMS cannot be trusted and must be totally defunded and abandoned. The unjust taxation without representation is MOC with its accompanying ball and chain. The ABMS' MOC must be tossed in Lake Michigan.

MOC must end and certification, if it is to be meaningful with any value at all, must be free of corruption and manipulation. There is only one option imo. Take away the money form certification. Certification must be free to candidates - funded as part of residency and fellowship programs - administered as a manageable/relevant test during the final study/practice/research year.

This test as a rite of passage/competency must be written in the language of medical science and not written with copyright/merger law in mind. This language of "give me dollars for medical science" cripples the viability, relevancy and reasonableness of any test. Current corrupt testing industry standards, with their ludicrous copyrightable expressions, render the understanding of questions and underlying medical science and practice obscure - often obfuscating a current practice notion or plan to the point of complete absurdity.

In a reasonable testing environment clear guides to study content and actual test samples should be made available to all participants - even previous years' tests. The test should be an enjoyable experience for residency and fellowship programs who actually will benefit from the preparation/creation of an honorable/current yearly test that evaluates science and practice - not a test short-changed by ABMS overlords concerned not with content and current science/practice but with how much money they parcel out to themselves. They do this in dereliction of duty to their organization, physicians and the public.

Why do I say this? The ABMS is now an irredeemable obfuscated blur - a corrupted mess as a result of the conflicts of interest and incessant drive for power and fulfillment of their own greedy desires. The lies and contradictions of speech ABMS officers must invent in covering-up their corruption and collusion renders them an unworthy, impractical and untrustworthy partner for physicians and the evolving practice/science of medicine.

Physicians and patients have been deceived and betrayed. I find absolutely no value in the ABMS and wish no relationship with them. There can be no going back to such a horrible relationship!

ABMS has a reptilian mentality basking in their money and position with an inability to change or adjust. They cannot address or admit to real fundamental mistakes - let alone rectify them. Ultimately the only thing that the ABMS can really copyright is the convoluted Ponzi-scheme they concocted and inflicted on physicians, patients, institutions, and purchasers of healthcare that have willingly or reluctantly followed suit.

Dignify Us said...

Ours is a tough profession that requires a lot of dedication and sacrifice. We, as doctors, spend countless hours caring for our patients. And each day that goes by it is harder and harder to give our patients the best care and keep our offices alive.

Oklahoma got the message. For the first time in years physicians are heard, protected and respected. ABIM has been shown to be an entity where ABIM is first and physicians, patients are just pawns and money – giving entities with no value.

I have read the case of ABIM vs Dr. Salas Rushford and it exemplifies the greed, the abuse of power and how little ABIM cares for doctors. How they have tainted and attacked doctors just so they can monopolize, control our profession, squeeze our pockets, determine who works, who has priviledges, and on and on.

So it is most important that out of respect and support to our colleagues and that in numbers we have a voice, we have power, we need to support Dr. Salas Rushford’s case, we need to write to ABIM and let them know our ire, write to our congressmen to promote Oklahoma’s SB1148, we need to guarantee that our young medical students have a solid, respected, protected career.

A 47¢ stamp and letter to ABIM stating: “We support Dr. Salas Rushford”. We need to step foward, out of the shadows, be heard, BE RESPECTED.

Anonymous said...

Well said, Dignify Us!

Blog Administrator said...

Stick a for in MOC/ABMS/ABIM, they're done!

Dr. Pete said...

We are being blindfolded and it is important that the word spreads. Thank you!
We are there for you in our fight!

Gary Levin said...

Congratulations Dr. Wes. Unlike many doctors who gripe and do nothing,, then lose their integrity and backdown when pseudo authorities pontificate from above how MOC improves patient care, you and I and others know the truth. It serves as a money pit for the medical education industry and an income drain far beyond it' ROI. When you take into account the amount of money providers self fund their education for the purpose of CME and relicensure and the additional subscription fees for AMA, State Associations, Medical Boards in each state it becomes obvious to any 'sane' person we have been 'had' under duress. I hope you continue there and others such as myself begin to turn the tide. I for one will pursue the California State Medical Board. I would like to see a paper on how you went about this process.

Anonymous said...

breaking news

https://www.abim.org/news/abim-announces-plans-to-offer-physicians-moc-assessment-options-in-january-2018.aspx

Anonymous said...

Brave New Face of Monopoly

Online proctored testing with big brother watching you while taking your test. Roll the dice. Play the ABMS game. Behave or go straight to jail without passing go.

ABIM plans to make even more money through online secure proctored testing. More testing more often. And a more onerous pledge/contract with civil and criminal penalties for irregular hand or eye gestures. Yes they will take control of your computer and a certified proctored third party agent will watch you in the privacy of your own office or at home.
It is not options ABIM is offering (first to internists and a couple of specialties only) it is enticing gullible physicians the chance to be fooled into giving away their lives all over again. How many gullible physicians are left after the ABMS criminals stole physicians money for decades. Then making it every 10 years. And now they want/have a desperate need for cash flow every year.

If that was not enough in ABIM v ABR the ABMS broke your door down, seized personal property and violated your civil liberties. And if that was not enough punishment they ABIM took that money from the ABIMF to pay themselves extra cash and hire attorneys to sue physicians and sanction thousands just for studying for their damn test with a competing vendor.

ABMS executives were in on the persecution and control.

The ABIM is comprised of criminals. Criminals belong in jail. They should not be sending mail to physicians in order to offer MOC/PONZI SCHEME version 2.0 - just because Rich, Lois, and Lynn want to retire rich.

Tite said...

Open words in response to the ABIM's recent e-mail on MOC. There is only one ineluctable consequence to the continued stonewalling and silence from the ABIM/ABMS. An end of relationship and all requirements from them is the next logical step.

Concerning MOC assessment options for 2018: it would be interesting to read/hear the 12 medical societies responses to the most recent ABIM MOC announcement. The 12 medical societies gave ABIM an end-of-April deadline to respond to questions/roadmap about the future of MOC. The ABMS leading organization puts forth a vague mish-mash of further confusion.

At this point in time we should all stop pretending. Almost everyone understands MOC should end. MOC is useless/expensive/redundant/harmful and should not be required by the ABMS or any hospital or insurer. The right to give certification tests should be stripped from the ABMS/ABIM for their deceitful practices and harm they have brought to physicians, patients and the house of medicine.

Medical Societies should step up and take real action to represent physicians, patients and the mutual public trust which is held in common.

State required CME is sufficient to maintain licensure and therefore is more than sufficient for certification maintenance. The state requirements should be secondary to the coerced mandates from any third party such as an insurer or employer.

The enactment of protective laws such as recently passed in the state legislature in Oklahoma are a logical next step in ending MOC requirements. It is time for the ABMS to relinquish control. The ABMS must submit to this and stop trying to protract the pain of what is inevitable - a separation and termination of relationship. These unfortunate consequences were brought about by the corruption and lack of transparency at the core of ABMS and ABIM.

It is no wonder. Money, power, greed, corruption, partisan politics. The problems are too ingrained to be fixed at this stage. The incriminating habitual silence insurmountable. Financial and ethical liability involving the ABMS/ABIM's wrongdoing is too great to bear for the 24 organizations. It is too great to bear for the violated clients.

Some sound advice to these 24 organizations of ABMS and their Chicago 'don': End MOC. Turn out the lights and close the doors quietly before there is a real investigation with real consequences. Please, move on before it is too late. I and countless others will not rest until there is real justice if these machinations against physicians, patients and the practice of medicine continues.

James OBrien said...

Do not underestimate your opponent here.

They are more motivated than you are because their entire livelihood depends on it.

They are authoritarians and relentless reptiles despite sugar coating everything with platitudes. Since the are criminal extortionists, they are better at the game of politics than we are.

They still hold the cards in 49 states.

This may be the beginning of the end or an anomaly.

Keep the pressure on.

Never get complacent, that's how we got in trouble to begin with.

Anonymous said...


So many thoughts...

So with this shorter annual exam for 10 years...

1. How many questions per year in the shorter exam ?
2. If you don't reach their passing grade can you retake the annual shorter exam?
3. How much ?
4. Why not just use the yearly UPDATE MODULE they offer for MOC and be done with it?

Its really sad when you cant trust the ABIM , esp. given their record of lies and deceit.

And why even continue the insipid 10 year secure exam ? Its got to go.

Anonymous said...

I cannot express the anger I feel toward the ABIM! They are faceless marauders without conscience terrorizing the United States medical system.

Anonymous said...

tite said...

"Concerning MOC assessment options for 2018: it would be interesting to read/hear the 12 medical societies responses to the most recent ABIM MOC announcement. The 12 medical societies gave ABIM an end-of-April deadline to respond to questions/roadmap about the future of MOC. The ABMS leading organization puts forth a vague mish-mash of further confusion."

And they wonder why no one trusts them.

Anything but tell the truth.