Here is what "cocreation" in action looks like:
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| As seen on Twitter |
(Note the comfy chairs, uplit curtains, and microphones, all provided at ABIM diplomat expense). Real practicing physicians understand that words "co-create" are little more than corporate marketing-speak. Worse still, when the term "cocreation" is being used by members of the ABIM Foundation that has received a majority of funding from ABIM diplomat Board certification and re-certification fees, we see the breadth and depth of just how out of touch this organization is to the challenges practicing physicians face as they try to deliver real health care in America today.
Should front line practicing physicians be funding such waste? What the heck is the ABIM Foundation really for other than forwarding some perverted social agenda? Are they so flush with cash that they feel moved to hold expensive small group sessions with members of the insurance industry? Seriously? How is this helping patients? How is this helping our residents who can't afford the current testing fees at the ABIM?
Here is just a smapling of what just transpired at this year's ABIM Foundation 2016 Forum (just search hashtag #ABIMF2016 on Twitter to see what I mean):
- A plug for rethinkhealth.org, a website for "dynamic modeling and strategy" funded by the Fannie E. Rippel Foundation, a $35-million financial conglomerate that issues selective grants to "organizations or individuals with whom we have developed partnerships or who we have identified as advancing our core initiatives." In other words, people who share their "vision" for corporate health care, like the Robert Wood Johnson Foundation.
- A "Human Diagnosis Project" that promised "crowdsourcing will enable us to solve medical problems." (Seriously?)
- "Health raising" (whatever that is) with multi-colored uninterpretable charts (More gobbledegook)
- Don Berwick "discussing the complexity and imperative of co-creation in healthcare"
- And my favorite: "Clinicians/dieticians... try NG tube on themselves(!) as part of cocreation:"
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| "Co-creating" NG tube placement? |
No wonder the real ABIM Maintenance of Certification program and its myriad of conflicts has never been shown to benefit patient care quality or physician outcomes.
They're too busy wasting our money on themselves.
-Wes
Agreed!
ReplyDeleteZoomed into the white board and tried to decipher it.
https://twitter.com/WolfsonD/status/760509804926283778
Pure mental masturbation. Sick of my money being wasted on this.
Seriously?
Hypothesis: "Unleashing" capabilities creates exponential gains - we can unleash
Seriously? What drivel.
Stop (Choosing Wisely) in the name of love before you break more hearts.
ReplyDeleteThink it over! Unlimited liability without statutes of limitation.
Law is the ultimate measure. Think it o-o-ver!
http://www.empr.com/medical-news/acc-withdraws-one-choosing-wisely-recommendation/article/374179/
Stop (MOC) in the name of love before docs sue you and your cush assurance scam. Think it over! Unlimited liability. Law is the ultimate measure.
ReplyDeleteStop in the name of love before you go to jail. Think it o-o-ver!
Bob Wachter, orator of the open air (TED TALK)
ReplyDelete$40,000+ speaking fee to tell us medicine has finally become a digital enterprise and that there are dangers to the democratization of digital healthcare technology.
And something about a pebble in the shoe . . .
I listened to Bob Wachter annoyed by his lip smack and the fact that there is a lack in Bob Wachter. There is a lack of taking public responsibility for his company, IPC, the Hospitalist Company, regarding the systemic Medicare fraud and overbilling they engaged in. Bob Wachter should have denounced the company when the DOJ took over a whistleblower lawsuit in Illinois a couple years ago.
https://www.justice.gov/usao-ndil/pr/us-files-lawsuit-against-ipc-hospitalist-company-alleges-overbilling-federal-health
Wachter should have promptly resigned from the board of directors and given back the hundreds of thousands of dollars in stock and cash. He should have also discussed USCF giving back the millions in "grants for IPC training", which in retrospect we all see for what it was - a relationship for money and appearances. Highly conflicted appearances which gave respectable veneer to IPC until they could roll through the DOJ lawsuit either in court or through the sale of the company.
The rich entrepreneurs and Wachter chose the latter path as we understand was recommended by the executives, board and university as the best course. After all the shares they printed and the cash bonuses for meeting production goals had made many of them very rich. These production goals came at the expense of seniors and retirees' shortchanged health and bank account and placed a burden on the financial health and reputation of the CMS.
Instead of doing the right thing, Bob Wachter said nothing so he could keep the money with the hope that nobody would find out so he could keep his reputation and eat the icing on the "Hospitalist Company's" cake too. The stock grants, options and cash plus monthly stipend was a lot of icing to consider. Rather than doing the brave moral thing, Bob showed us how easy it is to cover up yet another case of medical billing/safety fraud that needs to be desperately addressed by a high ranking medical politician like Bob Wachter.
Wachter like all of us I'm sure had life changing events taking place during those years and just found it too difficult to give up the dirty paycheck and lucrative stock.
http://www.modernhealthcare.com/article/20131211/NEWS/312119947
But we did find out! We found out how he helped move the company to a speedy sale to pass on the bad publicity of Medicare fraud on to another healthcare firm. The SEC approved the sale of IPC in record time, despite the warning signs and written protests to the SEC from shareholders crying foul. The SEC did not really listen and did not respond to the outrage.
ReplyDeletehttp://brodsky-smith.com/773-ipcm-ipc-the-hospitalist-company-inc.html
I listen to this TEDTALK lecture delivered by Dr. Wachter. Instead of honest public discourse on important healthcare topics that matter, we get more useless propaganda and empty talk.
Needless to say, I am very disappointed in Bob Wachter. He has fallen off the moral pedestal and into the ethical gutter along with Christine Cassel and Richard Baron. The money Bob Wachter took from IPC as monthly advisor, leadership teams trainer, chair of the quality committee and board member is a scandal of high import and the media ignored it - just as the SEC ignored the DOJ False Claims Act lawsuit against Wachter's company. Just as the SEC also ignored the class action lawsuits filed against IPC, the Hospitalist Co.
https://www.propublica.org/article/senator-cites-serious-concerns-demands-national-quality-forum-records
http://drwes.blogspot.com/2016/01/love-ethics-and-quality-assessment.html
This is scandalous 'criminal affair' is yet another example of Stockholm syndrome where we see their 'criminal faces' and get used to them; they talk to us forgetting that they are robbing us all blind putting us on "government medical stamps" rationing out medicine as though we were at war, imposing Choosing Wisely, MOC and now live digital Bob Wachter on TEDTALK.
Bob Wachter's smack when he talks annoys me because he tells of broad grand useless things that are no more than subtle political persuasions. He fills the uncomfortable silence with pressure and air. He dribbles on like a Demosthenes spitting out orator's practice pebbles mistaking them for winged pearls as they flop onto the polish of his black shoes and the shiny enamored stage full of mostly unsuspecting faces that do not know.
All this soft shoe dancing, buffering and scuffing occurs on the stage, while Wachter fails to tell us about his obvious moral blunders, which today due to his silence on the scandalous matters, have become an obvious bulging boulder in his shoe.
http://tedmed.com/talks/show?id=530888
Question: Why do Bob Wachter's lectures always begin with 1986, the year he finished his residency and was board certified - the very year the ABIM should have been administratively dissolved by the Iowa secretary of state's office. If ABIM had stuck to its 50 year plan, just think how much better we all would be. No MOC and ales corrupt smaller bureaucracy. No huge healthcare reform grants given out to the ABIM CEO's in the form of huge compensation packages. I suspect Bob Wachter would have been a better doctor and a better man for it too. After all we want to forgive our captors and villains who talk to us so nice like they owned everything - even the air.
I've gotta bad feeling about this . . . RWJF Clinical Scholars
ReplyDeleteEight Robert Wood Johnson Clinical Scholars Named to top 50 most influential list (2013)
The number one ranked medical politician of the year was Dr Kizhaber, Oregon's 3 term governor who had to step down in his 4th term when placed under investigation for obvious corruption - conflicts of interest and government contracts.
Also, an investigation into his responsibility for losing a quarter of a billion dollars in federal taxpayer money is still ongoing by the DOJ. (ACA healthcare access portal.) Kizhaber has close ties to Christine Cassel, with her egregious conflicts of interest who was ranked at number nine.
Cassel is a close associate of the RWJF and has been responsible for appointees. Kizhaber and one of his largest medical institutions has a very large number of RWJF scholars. Bob Wachter ranking number 26 in 2013 was involved with IPC which was under investigation by the DOJ for Medicare fraud as mentioned above.
http://www.rwjf.org/en/culture-of-health/2013/05/rwjf_clinical_schola.html
http://www.modernhealthcare.com/gallery/20130420/PHOTO/420009999/PH
100 million dollars in the ABIM Foundation coffers! It is clear to me that this is a political extension of the Democratic party with social suggestions and fairly well tailored propagandistic thrusts into the mainstream media serving to color society politically and socially and guide the electorate. It is not even subtle.
ReplyDeleteI was a supporter of Hillary Clinton in 2008 and to me this kind of thing is not funny or cute. It is a manifestation of what is wrong with American today. It is dishonest and manipulative and it lies to the American public. I cannot support the message or the messenger.
This is the kind of profligacy that the ABIM founding members intended to avoid when they wrote in their articles of incorporation in 1936 that it was a non-pecuniary organization. The board and its rotating officers were not there to fulfill their profligate lifestyles like today, but rather to serve voluntarily without stipend. Non-pecuniary means no money! This is like Christianity turning into the Inquisition. Oh, I guess it has become just that with its secret sanctioning panels. But they keep those panels hidden from the public. This now the organization of their new CEO/President/CFO Benjamin Mannes who has files on everyone for his new overriding policy and management style - MOC Maintenance of Control.
ReplyDeleteDonald Berwick? Why am I not surprised that egomaniac is trying to inject himself into the food fight for administrative dollars. It's the same old story. IOM. NEJM. CMS. ABIM. Each one of these parasitic organizations is trying to proclaim themselves as the most fit group of professional administrators clamoring for the 30% premium spent on every administrative healthcare dollar. The healthcare system is mathematically designed to fail because of these administrators.
ReplyDeleteThere are 10,000 new Medicare beneficiaries coming on line DAILY.
The projected expenditure will increase 25 to 50% in the next 10 years.
The amount of projected tax revenue will decrease 25 to 50% in the next 10 years.
Every clinician is burdened by ABIM MOC B.S. and seeking relief by passing State Statutes.
As hospitals close and practices fade away, there is less access to care.
As competition dwindles, prices will continue to rise (has anyone noticed their health insurance premiums going up with higher deductibles and co-insurance?)
Less choice. Higher prices. More waiting. More administrators.
Guess what happens? More body bags.
Here's an idea Dr. Berwick: Instead of using NG tubes on yourselves, how about you come to work with a White Coat and a Stethoscope and you hold on to my pager for a holiday weekend? How about you remind yourself what it is like to take care of a hospital of desperately sick patients?
Yes, I agree, "The healthcare system is mathematically designed to fail because of these administrators." We have a bunch of incompetent, but industrious, amateurs and liberal airheads running medicine eating a third of the pie.
ReplyDeleteWell, all I can say is they have berry stains on their avaricious little mouths, as it is becoming more and more apparent of the horrific and deadly results.
We are measuring meaningless BS without being required to register the most important obvious general trends and outcomes.
You don't need to be a rocket scientist to calculate the very bad outcomes we are seeing. And we need for our government to respond to the broad truth - not lies and selective data interpretation.
Here it is: There is more death and disease in America today than at any other time and at a greater cost.
I've seen more patients coming with foot and leg amputations this year than in my entire life. Uncontrolled diabetes - patients say they can't afford insulin. Or they refuse to take insulin because they read consumer reports or Choosing Wisely malarkey. Patients can't make the connection in their heads between diabetes and disease. I'm hearing of many more deaths.
ReplyDeleteNQF "memos" from their executive committees recommend "this or that" confusing hospitals, hospitalists, and specialists. Combine that with the insurance nightmare, measurement requirements and greater restrictions to even practice medicine properly, the end result is more and more harm. It a damn mess.
Patient safety buffs and quality assurance experts like Bob Wachter and Christine Cassel have "get out of jail cards" as they play "proxy monopoly" for the big boys and girls - their crony elites and ever-merging healthcare corporations rapidly gaining the most control, money and toys.
The ABIM Foundation and NQF are quickly becoming the #1 and #2 silent killers in America. It's no wonder that Christine K. Cassel, Dr. D, just keeps moving on to the next "once in a lifetime job opportunity." Now its Kaiser Medical School, which will cannibalize existing "non performing assets".
This sums it up, Drs. Baron, Cassel, Kocher and Berwick:
More internal organs and internists turning out the lights and patients pulling the plug on themselves. That translates as fewer physicians seeing fewer patients and the results are clear - increased morbidity, co-morbidity and as we are already painfully observing as noted above - more body bags.
"I don’t know how we got here, but I do know that the tension is nearly unbearable, and if we’re not careful, it can break us.” - Donald Berwick
ReplyDeletehttp://www.hhnmag.com/articles/6798-don-berwick-offers-health-care-9-steps-to-end-this-era-of-greed-and-excessive-measurement
Bringing it all back to reality and discuss the real bottom line
Bottom line is we need to rescind the ACA. End it. First of all it is corporate-backed greed and cost control that inspired it and is not good healthcare at all.
In fact the ACA does not protect the patient, but just rips them off and makes it difficult to get healthcare at all. What's more it is not equitable at all. It discriminates against the seniors, minorities and the poor. So that is all a lie. We are seeing the data. It is written on the faces and in the anguished, anxious hearts of almost every patient that walks through the physician's institutional door.
The ACA's many rambling pages of legislation are only a user's manual that everyone should have read and studied much better before packaging it up and selling it to the American people. It does not pass the consumer report's inspection. That consumer report is coming from the vast majority of Americans. Their voices and their opposition. The untested value of this theoretical improvement called the Patient Protection and Affordable Care Act is not true to its name.
The ACA now puts the cost to value ratio at a negative value. It is losing billions of dollars and providing worse healthcare for more. The ACA failed the consumer before it even left the manufacturing site, and it failed the consumer before it was even taken out of the box in many of the health exchanges.
We need to continue the movement of creating a solid pushback on the political powers to be and the numberless NGOs in the quality assurance industry. The theoretical social change they wish for is creating medical and economic dissonance. These NGO's like the ABMS, ABIM Foundation, ACP, AMA, ACGME, AHA, and NQF have far to much power and control. And they are populated by unqualified people who can't even keep a simple deadline. NQF has never met one CMS deadline yet. Nor has it ever delivered full and comprehensive studies. It has been wasteful with the government's money - the taxpayer's hidden contribution. We need to get better results for our money. Put real physicians on the committees and not the corporate stakeholders with their conflicts of interest and history of various forms of influence if not outright bribery as we saw with the Chuck Denham NQF scandal.
Look at how out of control it has all gotten. It has all gotten away from us.
There are now almost as many quality assurance NGOs as there are stars in the sky. And the vast majority of them provide little value at a tremendous cost to members of our society. We should and must reallocate the physicians and money back to healthcare's front lines - taking care of patients. That is the greatest egalitarian and shared humanitarian gesture and decision that the professional MD bureaucrat can contribute to today - the migration and exodus back to serving patients on the front lines where it really matters and counts.
The measures will only get better without needing to measure or fuss with the measures at all.
And that is good for everyone's bottom line.
Wes, when you look at all this waste and fluff and it just raises your hackles.
ReplyDeleteI just looked at new documents in the case of ABIM vs. Salas-Rushford vs. the ABIM. After the Mannes and Arora depositions and some progress on discovery Rushford's counterclaim has been clarified and streamlined to express a very cogent defense and expression of how the ABIM has damaged his life and professional career as a physician. One of the interesting points that came out in discovery is that the so-called copyrighted contents of the ABIM test may not have been copyrighted by the ABIM at all.
They appear to be very confused at the ABIM and leapt before they had any proof.
What's more fascinating is that ABIM has not yet coughed up actual proof that any of the questions they claim copyright to actually have a clear authorship and assignment of authorship. The ABIM just gave batches copyright numbers hoping that nobody would challenge the actual legitimacy of the proper procedure of copyrighting and assigning authorship. It all seems sloppy and loose just like everything else. Negligence. I may sue them for wasting our money of this persecution and crusade against physicians. It has been over six precious years since they seized Arora and physicians private files and property illegally.
And what's more there is a problem or big question mark with the dating of the copyrights. "It don't jive." Just like they forgot to register in 2009 with the state of Iowa and were administratively dissolved, there is another big screw up with the copyright dates. They recklessly put off filing their copyrighted questions on time. Maybe they thought the castle and the tall tales would be impervious to assault, but here we go. It is like years later that they dated the copyrights when they saw that the screwed up. And some smart lawyer would dare to question their authority. What a f up after f up.
The judge should properly throw the whole mess out and let Salas Rushford pursue his damages and claims against the ABIM to save time and money for the hard working physicians who are paying for all this.
Plus the ABIM was supposed to have retired many questions which it may not have done as they should have after going after Dr. Arora. "Exposed." Nothing was done properly. (They got that writ to seize by cheating also and lying. Will they ever get their just punishment for that crime?) It is a messy affair for them and it is quite embarrassing to see them fall into the lion's cage for a change totally unmasked as the frauds and careless f ups that they are.
That picture of the cush chairs above tells it all. Do-nothings full of air collecting money from hard-working phycians. I say the shut down the god damn ABIM welfare system. The easy dole for f ups and do nothing sleazebags is over. They can work like all the rest of us in this free democratic society where everyone was created to work equally and treated with equality.
One thing is missing Dr. Baron. Why can't you promise to cut the ABIM MOC fees? Why can't you promise never to price in a Condo, Limos, Four Season Retreats, and massive salaries? Why can't you promise never to turn the ABIM into a Gestapo like Police Nanny Agency? Why can't you "Choose Wisely" and cut your salary like the rest of us? Why can't you promise not to steal money from Fellows and Residents so the ABIM spouses can fly Business Class? Why can't you lead effectively?
ReplyDeleteWhy can't you do anything effective?
Why can't you quit?
I'm the last person to defend Dr. Baron, but he clearly is a symbol of the problem at ABIM, and not the problem itself.
ReplyDeleteThe unremitting sense of entitlement, the deliberately obtuse blank stare when anyone asks about the complete lack of evidence supporting the gravy train that is #MOC, the abandonment of even a shred of fiduciary responsibility to the Diplomates e.g. Cayman Islands financial adventures, the cash laundering scheme perpetrated on the people of the State of Iowa as well as the Diplomates and Candidates, the malicious prosecution of practicing physicians using a felon goon squad, the unreported lobbying with goal of influencing legislation and promoting the elites' political agenda, the ridiculous arguments to attempt to justify $812K in compensation as commensurate with market value for medical school deans and dept heads as the pool from which the ABIM CEO would be drawn when Dr. Baron has no credentials or experience that qualify him for such a position in academia is what can be expected from any of Dr. Baron's ilk: the self-appointed elite professional medical politicians.
This is exactly what they were promised by their predecessors, that despite a little grumbling now and then, just as in the late 1980s with the move to time-limited certification and the dialing up of the ABIM perpetual revenue stream, the incessant delaying/hiding/obfuscating that Dr. Baron constantly denies (non-denial denials?) is the foundation of the Ostrich Strategy that has served ABIM faithfully for 30+ years.
No substantive changes can be expected with the oligarchs now running the show in Philadelphia and Chicago until they are overthrown in favor of true self-regulation by practicing physicians following dissolution of ABIM with recognition of their mission accomplished, as envisioned by ABIM's founding fathers.
Well said, Ed!
ReplyDeleteIt is "GANGLANDIA" where an opaque hierarchy of oligarchs rules in luxury while their carefully-selected and democratically-elected cleptocrats appoint professional bureaucratic thugs to control GANGLANDIA's vital foreign and domestic agendas and all important money flows.
It is time . . . for the self-appointed shadow play to go away
ReplyDeleteOnly one problem with the tightly controlled system of "GANGLANDIA". The founding framers of our country, the United States of America, and their domestic partners said and wrote the words REVOLUTION over and over - even writing it into the country's founding documents with their own blood.
They still, even today, make the people of "GANGLANDIA" swear an oath to this important document born in the spirit of revolution. Even though the cleptocrats and thugs cross their legs and arms when they swear, they are still bound to a higher law - greater than the ad hoc self-serving corrupt laws of "GANGLANDIA".
The founding document is called the constitution and all have an obligation to serve and protect that constitution and its subsequent amendments.
Even those who control our country from the shadows in "GANGLANDIA" have an obligation to serve the constitution. And that obligation is to serve the liberties of the people and follow the constitution, not the onerous, taxing requirements of those greedy elites who rule from "GANGLANDIA".
No man or woman should be treated like cattle and sheep. Nor should animals be abused and mistreated. No one should be ridden into the ground from exhaustion, whippings and endless meaningless clicking. The freedoms we have fought and died for cannot be bought and sold or traded away. The constitution cannot be politicized or turned into a commodity. No man or woman can be turned into a mere commodity or statistic.
And feigned emotions must not be used to sway opinions. Such false emotion comes across as foreign to the hearts, minds and will of the people.
The people have gained in knowledge and understanding and say very clearly it is time for "GANGLANDIA" to go away!
Are you really listening? Then understand this! There will be no externally proctored MOC from the home or office - no matter if every year or once in two. There will be no "long-test" 10-years from a testing center for those who fail your bogus MOC online and there will be no failing those who cannot pass your onerous long-test.
ReplyDeleteIt is time for mandatory MOC to go away immediately or the ABMS will have to go away completely.
Ariel Benjamin Mannes. ABIM's Director of Investigations. 2008 - Present
ReplyDelete- Ariel the ABIM enforcer and Benjamin the board prep bouncer.
ABIM/ABMS goon squads made way for ACP to move in on New Jersey' lucrative test prep turf; to do so they hired one of the best "enforcers" to carry the bat for them . . . Ariel Benjamin Mannes and DUI attorney partner Marc J Weinstein (BS)
ABIM/ABMS' restraint of trade means the end of independent courses and study groups; ABIM's goon squad attacking the right to assemble and chilling free speech.
The end of the free market and the beginning of price manipulation and monopolistic control of trade; plus the political emasculation/power over physicians.
ACP moved into the lucrative New Jersey/New York/Pennsylvania ABIM certification market after muscling in on Dr. Arora's board prep territory and shutting him down.
(They set back and intimidated other prep courses and let them know big brother is watching, surveilling. Chilling effect on fair commerce.)
http://www.abim.org/news/abim-files-complaint-against-arora-board-review.aspx
Here's the egregious result and the proof for any doubters about the willful intent of the ABIM/ABMS/ACP/AMA/ACGME to retrain trade and exercise their power over others. This is a very raw and obvious example of classic racketeering.
ACP's live certification prep courses offered for a pretty fee
https://www.acponline.org/meetings-courses/courses-recordings/internal-medicine-board-review-imbr/new-jersey
ACP's streaming online/digital MOC courses marketed with an "offer you can't refuse" - if you fail the test
https://www.acponline.org/cme-moc/moc/learn-more/abim-exam-preparation/review-courses/philadelphia
Addendum ad nauseum
Here's is ABIM/ABMS' future plan. This plan involves further exposure to civil and criminal prosecution and the invasion of privacy. It involves further racketeering and conspiracy to defraud physicians and the public utilizing ABMS associates, goon squads and their affiliates, and so on.
http://transforming.abim.org/moc-assessment-update-answering-questions-and-planning-a-survey/
ABIM's impracticable value systems: how SDM (shared decision making)fits with the ABIM Foundation's non-practice of co-creation
ReplyDeleteIf only the ABIM actually understood and practiced what they preached.
For example, "SDM" (shared decision making): if ABIM executives followed their philosophical teachings and treated their client/physicians with the same respect as they 'intended' to treat patients, then MOC would have never been 'instituted'. Maintenance of certification would have never been recommended by Benson and Kimball without a real discussion and vote involving all the ABMS physicians.
MOC never would have been the distraction it is today if Cassel, Wachter and Baron had truly done their jobs and listened to the common reason of 750K physicians. Instead they were reckless in their ethical and fiduciary responsibilities.
Deviating from its path and articles of incorporation, just completing its 50-year plan, the ABIM and ABMS morally bankrupt leadership and ethically sterile committees invented a nightmarish culture of greed. Leadership invariably acted with wanton disregard for the healthcare system and the public.
Cassel, Wachter, Holmboe and Baron focused on inventing/spouting expensive political theories pushing partisan healthcare reform, staging ethically demoralizing political dramas, and commercialized the entire ABIM and ABIM Foundation. They centered their theoretical crosshairs on hard-working physicians, permeating the organizations with an empty pseudo-science and replaced the inward call to medical science with intimidation and sophistry.
Co-creation, from Wikipedia:
"Co-creation is a management initiative, or form of economic strategy, that brings different parties together (for instance, a company and a group of customers), in order to jointly produce a mutually valued outcome."[1]
"Co-created value arises in the form of personalized, unique experiences for the customer (value-in-use) and ongoing revenue, learning and enhanced market performance drivers for the firm (loyalty, relationships, customer word of mouth). Value is co-created with customers if and when a customer is able to personalize his or her experience using a firm's product-service proposition – in the lifetime of its use – to a level that is best suited to get his or her job(s) or tasks done and which allows the firm to derive greater value from its product-service investment in the form of new knowledge, higher revenues/profitability and/or superior brand value/loyalty."
"The Four Building Blocks of Co-creation
Prahalad and Ramaswamy [6] suggested that in order to apply co-creation, following fundamental requirements should be prepared in advance.
- Terms: Definition / Managerial Implication
- Dialogue : Interaction between customer / Two-way connection instead of one-way selling strategy
- Access: Allow customer to access the data / Create value with customer; beyond traditional value chain process
- Risk: To monitor risk and gaps between customer and firm / Share the risk of product development with guest through communication
- Transparency: Information among business is accessible / Information barriers should be eliminated to certain degree in order to gain trust from guest"
Wes tweeted: More news about ABMS medical board ethics
ReplyDeleteThis is about ABOS team physician and medical board scandal, which seemed to have been nicely buried. Over 220K spent on on Costa Rica luxury vacation in 2011 while Iowa football team "bled muscle" through their kidneys and the reporter focused on the money. Would not release the relevant emails to . Why? The answer is in the question why does a football team suddenly get a life threatening "muscle disorder"?
http://usatoday30.usatoday.com/sports/college/football/2011-02-20-1763104159_x.htm
The only question is what the heck were they taking/doing and why didn't the trainer and physician want to release the emails about the medical details?
Anabolic?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629047/
MDMA Ecstasy?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2439527/
Neuro-stimulants
http://www.ncaa.org/health-and-safety/policy/ncaa-doping-drug-education-and-drug-testing-task-force
External electronic devices?
https://www.researchgate.net/publication/8436904_Electronic_muscular_stimulators_A_novel_unsuspected_cause_of_rhabdomyolysis
page 35
http://www.doping-prevention.sp.tum.de/fileadmin/files/Doping_prevention/Biomedical_Side_Effects_of_Doping.pdf
ABOS and MOC
https://www.abos.org/
https://www.abos.org/moc.aspx
https://www.abos.org/media/12704/moc_update_to_diplomates__2015_02_.pdf
I'm not so concerned with what the ABIM says to our faces, or their carefully prepared press releases. We all know they will lie about anything or keep silent to maintain the status quo. I'm much more concerned with what they have done, are doing, and will continue to do behind our backs.
ReplyDeleteAmerican Board of Internal Medicine Foundation was established as a bank account to pad the income and retirement accounts of ABIM executives and give them green political fodder to toss around for greater influence and power in corporate and governmental affairs.
ReplyDeleteThey laundered tens of millions of dollars in single digit transfers not unlike Dennis Hastert who tried to keep his hush money below a magic alarm number for the bank, DOJ and IRS to get suspicious. To avoid suspicion they kept it all on the low down hoping they would not get called out on it.
Even the tax filings obscure the amounts of the transfers by intentionally leaving out commas and decimal points. Six million dollars was written for example 6000000 and not 6,000,000.00 like honest accountants with nothing to hide. Seven million dollars was written 7000000 and not 7,000,000.00!
I often wonder if John A Benson Jr., Henry Strozeski, Lynn Langdon, Harry Kimball, Bob Wachter, Richard Baron or Christine Cassel suffered any guilt in their heart fibers over this or had heart palpitations, or if their nerves felt ready to explode.
What they were also trying to hide from public view: the articles of incorporation forbid profit and the transfer of that great profit to another organization. There was only one legal way to transfer the assets. First the ABIM would have to be dissolved; and it was stated the treasurer must pay any and all debts first. The money could only go to a scientific organization involved in serving the public good. I am afraid that the ABIM Foundation would hardly be able to qualify for a scientific organization. It is clearly mostly associated with propaganda and engaged in cost-cutting controls for government and corporate need. One can see that it serves partisan political models and crony capitalist healthcare organizations such as the medical home, large accountable care organizations, and so on.
Professionalism is not a scientific idea, it is an idea associated with business. Co-creation is a business ideal or pragmatic model with a purported practical application. Likewise ABIM is a testing corporation involved more with lawsuits and trying to claim science as it own is not in the humanitarian spirit; nor is the ABIM's claim to medical science anything more than a for-profit enterprise.
The ABIM and the ABIM Foundation are two classic examples of continuous regulatory capture and propaganda paid for under duress of not being able to work with veiled and explicit threats. These are two examples of racketeering of the first order.
The ABIMF is an illegal entity.
ReplyDeleteDr Baron and his cronies should get real jobs and stop ripping the public off pretending they are useful or have any purpose. What waste.
ReplyDelete"Health raising" (whatever that is) with multi-colored uninterpretable charts (More gobbledegook)"
ReplyDeletethe man in that photo is the chief medical officer (CMO) of oregon health and science university in portland, or. same place where christine cassell was dean before going to the abim. the abim inserts itself into lofty positions to prevent any action against it.
If anyone is wondering why the standard playbook for every ostensible non-profit organization is to create a parallel "Foundation" group (and EVERY ABMS board has done this, INCLUDING the ABMS ITSELF with it's ABMS Research and Education "Foundation") I suspect it is a way to squirrel money away into potential profit-earning accounts that standard non-profits aren't allowed to.
ReplyDeleteAs outlined here: https://nonprofitquarterly.org/2006/06/21/should-your-nonprofit-build-an-endowment/
It sounds like the dream of big non-profits is to create an 'endowment'. As the article explains:
"An endowment is established when you and your donors consciously build a reserve for the purpose of creating a financial bedrock for the organization. You can’t spend the principal unless the donor or a court says so, but the income from that principal is usually fair game. This investment income is golden, because you don’t have to earn or solicit it. Some gift agreements specify how interest income should be spent, but it typically comes with no strings attached. There is no magic figure at which your pot is large enough to call it an endowment, but it isn’t a serious asset unless it is roughly twice as large as a typical year’s operating expenses. If you’re only earning enough interest each year to pay for a board luncheon, you aren’t yet in the endowment game.
Organizations that are in the endowment game, however, reap the benefits of solidity and unrestricted income."
The article goes on to explain the potential down-side to creating an endowment:
"Endowments are not good for all organizations, and not everyone loves them. The biggest argument against endowments—and the one that comes up in almost every deliberation about whether to start one—is that endowments shortchange today’s charity for an unknown future.
[...]
Current needs is the one that at least one of your board members will bring up, and is very possibly the reason why your board will vote not to have an endowment. “Why should we put a million dollars in a bank account when we can use that to serve a million more lunches?” Or buy a hundred thousand more books. Or facilitate a thousand more adoptions. Or renovate the façade of the theater. Many nonprofits are in dire need of more money, and most can at least think of an immediate way to use more. Therefore, it isn’t surprising that some people will value the use of contributions to meet current needs rather than build an endowment. And it isn’t just your board members who might feel this way—it might well also be your patrons, clients, elected officials, and local newspaper. Some people go so far as to say it’s not ethical to lock money in the bank when there are so many necessary ways to spend it now. Before you know it, you have bad press and declining donations—and you wish you’d never thought of raising an endowment."
[continued]
So how does this apply to ABIM and the ABIM Foundation?
ReplyDeleteI'd love to get a copy of the ABIM's original articles of incorporation from 1936 (you know, the one that said that they were to dissolve in 1986 but instead lead to this Maintenance of Certfication fiasco? That one). I would bet that somewhere in them they state that the fees collected for certification were only to be used to daily operations and outlined parameters for fiscal prudence-- perhaps capping the amount of money they were to allowed to have in reserve before that would trigger some reduction or elimination in certification fees. Remember that originally ABIM board members were true volunteers and were unpaid. That's no longer the case and these 'doctors' earn as much or more money from ABIM than they do in practice (probably because some time in the 1960's they noticed how much money was in reserve and needed to spend it somehow). And it's a hell of a lot cushier than actually being a doctor. As ABIM grew in influence and board members turned over, the mission of ABIM became perverted. A LOT of money was rolling in, so keeping the ABIM in business became the top priority. Dissolving it in 1986 would obviously stop the gravy train. I'm speculating that that big cash reserve they were sitting on (which was so big that they could pay their executives hundreds of thousands in salary and still have an excess left over) was actually going to soon be a hindrance, triggering a reduction in certification fees and thus revenue (at a time when any complaints of fee increases were either unheard or suppressed due to there being no internet and no means for individual physicians to voice their complaints).
Forming a parallel foundation would solve these problems:
1) The new foundation would be able to use any 'donations' they receive however they saw fit, be it investing in the TIFF Keystone Fund that Charles Kroll has uncovered or investing in the now infamous luxury Ayers condo at the peak of the real estate bubble (with a nice side benefit that the executives could 'rent' it for a night for less than a hotel room whenever they wanted/needed. I still haven't seen any receipts for how much they charged to rent it for a night or proof that anyone paid for using it at all) or opening an account in the Caymans to stash it away from prying eyes.
2) Transferring the $59 million cash reserve from ABIM to ABIM Foundation would clear the ABIM's books of excess reserves and recharactarize the money from 'fees for certification' in the care of the ABIM to 'donated funds' (by ABIM to ABIM Foundation) and in the care of separate corporate entity ABIM Foundation which would be free of any restrictions previously set by the ABIM's original articles of incorporation.
The revenue from the recertification scam had proven to be enough to keep ABIM operating year to year which is probably why they dumped that $59 million into ABIM Foundation all at once in 1999 as Dr. Wes exposed. With no obstacls to unfettered cash flow, ABIM wouldn't been needing it (so they thought, haha). Better use of the cash reserve was to launder it such that it could be invested into some high risk/high reward opportunities. If ABIM revenue fell short of expenses, certification fees could be raised without any pushback as they found in the preceding 10 years (doctors are such sheep, aren't we?). They could always go back to the Certification ATM funded by us for more as needed.
After transfer to ABIM Foundation, the $59 million was now technically 'donated money' that they could use in ABIM Foundation to create an endowment, which as the article described is meant to create a "financial bedrock" for the organization, without the limitations "ABIM fees" are likely subject to.
ReplyDeleteIn the past we did not understand sufficiently what their sharp sudden and shocking increase in taxing demands was all about and for. I hope we do now.
It is for controlling us for profit and political control.
They control through demand for time, obedience by creating conditions of fear, and money to pay them "voluntarily". Illicitly they claim the turf (pasture) on which we depend and they fleece us annually for nothing. It is a fleecing scam and nothing more. They are not good shepherds. They are vicarious wolves that have hypnotized physicians into being sheep.
I would hope that a non-partisan mind can now see through the MOC scam that drains, disrupts and destroys our personal and professional lives. They control us literally as state actors with regulatory capture. ABIM, ABIM Foundation, ABMS, NQF, ACGME, as represented by folks like POTUS ADVISOR Christine Cassel and other policy politicians like Richard Baron, Bob Wachter, Richard Battaglia, Susan Biemiller, Lynn Langdon, Eric Holmboe, are all individually and corporately state actors -- agents of government policy and policy-influenced corporate money.
They have even got advisors in the White House to protect and ensure that we stay under their control and none of them goes to jail for public fraud, conflicts of interest, federal misconduct, or the obvious racketeering and restraint of trade.
Christine Cassel is a partisan politician involved to the hilt with government and political party. Richard Baron is a partisan politician and professional bureaucrat. Lynn Langdon is a partisan politician and bureaucrat. All are ABMS and government advisors. No one elected them. That is the irony and yet they have controlled through a secret tyrannical political network comprised of cleverly placed and designed think-tanks, foundations, and regulatory NGO's. The courts protect them from the IRS. The IRS protects them from being judged by tax code and rulings that forbid corporate monopolization of a service industry such as the ABMS and ABIM with its goon squads to do its bidding, even to the point of destroying our bill of rights, privacy and constitution. And yet it is so much more than just gobbledeegoop. It is gobble up the competitor predatory practices, money laundering for political cronies and corporate special interests. It is all profiteering. It is racketeering. It is the politicization of NGO's. All of these things break the laws of our country. These actions break the backs of hard working physicians to the detriment of the patient. It is bogus hocus pocus and not legitimate science.
Science is dead at the ABMS and especially the ABIM and its Foundation.
They all illicitly keep touching our lives in ways that are deemed by members of our lawful society to be inappropriate. Acts of misconduct unbefitting for state actors or any corporate actor. They have their hands in our pockets, mess with our doctor-patient relationship, destroy professional choice and personal life.
They control us through surreptitious legislation bundling everything to destructive incentives and useless mandated busy-work. These professional ACP, AMA, ABIM and ABMS medical bureaucrats are plunderers all making use of their Choosing Wisely scheme and money transfers into the "Foundation". It has been their source for money laundering to create for themselves greater profit and income. The ABIM Foundation and MOC are all part of the ABIM/ABMS scam.
The ABIM Foundation should more appropriately be registered as the 1st NATIONAL BANK of INTERNAL MEDICINE. It was designed to take our MONEY and TIME and exploit us politically through nothing short of partisan propaganda and their dreaming schemers full of bureaucratic BS.
With IRS granting tax shelter to ABIM, taxpayers for years have been funding 'huge kickbacks' and 'deferred bribes' to executives under the shelter of loose Iowa laws governing nonprofits.
ReplyDeleteABIM bylaws clearly state its non-pecuniary nature and restricted political activities. Early articles make no mention of any compensation. Later they state "no inurement" or profit, but allowed "reasonable compensation for services rendered." First mention of compensation is found in article amendments of 1975. Also that year they added the terms "in perpetuity" to amend the "50 years" ("or sooner") dissolution of the ABIM.
ReplyDeleteThe ABIM was registered in 1936 under provision of Chapter 394 of the Code of Iowa 1935. (See ABIM 1936, Polk County, IA, Inst. No. 6741 articles of incorporation.)
The Polk County recorders office will photocopy and mail all they have on the early archival documents for the ABIM.
I understand they have a total of ten documents.
Articles of Incorporation, 1936, through the Statement of Change in 1982. The recorders office could find no documents filed after 1982 with her office in Polk County, Iowa. All subsequent filings can be found at the Iowa Secretary of State's offices for free online. Pennsylvania registrations (Scant due to loose PA regulations and requirements.)
Contact: Julie M Haggerty, Polk County Recorder, 111 Court Ave Ste 250
Des Moines, Iowa 50309-2251
You can request by telephone: 515-286-3160
Highlights of documents: 1936 original articles. Then nothing until the 1965 certificate of amendments. Later amendments filed 1967, 1968, 1970, and 1973.
In 1974 ABIM elected to adopt provisions of Section 100 of the Iowa Nonprofit Corporation Act. Two brief filings 1976 and 1982 are for change of address within Des Moines, Iowa.
After that the all documents are found at the Iowa Secretary of States offices. They were administratively dissolved due to ABIM negligence in 2009.
As I recall, when I looked online, ABIM was very sloppy on their trademarks and copyrights with US patent office. They were lapsed expired even at time of trial for a couple months during the cheating scandal. ABIM applied for in the last couple years a new trademark--"ABIM International!" I believe it has currently lapsed for showing no proof of international activity.
The principle place of business changed to Philadelphia, PA when they registered as a foreign corporation. Prior to that I believe Des Moines was considered the principal place of business, but it is not clear where and how the testing was done and by whom and the cost over the years. Perhaps Wes or someone could fill us in.
It was loose in the beginning with board and officers meeting at AMA and ACP meetings as they were also members of those organizations. Information of actual testing would be interesting. First test was 8 essay-style questions. 27 participants only. Depression era. Even the AMA had to defer collection of money for members, so it may have been free or a very modest fee for certification.
The ABIM retained a local Iowa attorney to be the registered agent after the PA registration. There have been only two registered agents. With the retirement of the first attorney, the registrations was transferred to his nephew bearing the same last name. The nephew attorney was not aware of the existence of the ABIM personally, but said his job was only to pass on correspondence such as lawsuits, etc.
The AMA and ACP founded this non-pecuniary organization. Membership or election to the board was exclusive to ACP and AMA physicians. However, the amendments of 1965 and later state that "the members shall constitute the governing body of the corporation and there shall be no board of directors. Member shall exercise all powers..." ACP leveraged the upper hand over the AMA by giving its members the majority of representatives to the ABIM as stated in the articles.
Bribery, public fraud, pay to play, bribery, hush money, money parking, misconduct in investment practices and activities, financial obfuscation, destruction of documents vital to adversarial parties, lying to clients and public concerning finances and compensation, obstruction, stonewalling, witness tampering, eliciting judicial misconduct, improper ex-parte contact, influencing the white house, pedaling policy in congress.
ReplyDeleteThey have engaged in giving and receiving improper favors, illegal ex-parte seizure of property, misconduct involving custodial rights to seized property, hiring discrimination, firing discrimination, violating disabilities act, ignoring ABIM vetting policies, misconduct in following conflict of interest standards, government ethics violations, extravagant spendthrift with client's money buying luxury condo, expensive retreats, paying PR firms for useless propaganda to mask fiduciary misconduct and operational problems, inability to focus on core mission, harassment, bullying, due process, privacy violation, misuse of public media to harm clients, fear mongering, political propaganda, explicit politicization of the ABIM, and on and on it goes!
One could write for months and never run out of horrific tales of their power and greed. In fact there is an amazing surfeit of criminal and immoral activity the ABIM and ABIM Foundation engages/engaged in and covers up. The restructuring of the past year should tell us volumes, but they are silent and not speaking actively using former executives and current legal teams to obfuscate, stonewall, defend, protect, and advise them.
To paint a bloody mess on the wall white or to throw a sheet over the gruesome truth is wrong. To silence a rape victim from getting the justice and compensation that they deserve is wrong. Look at CW. Look at their corruption. Look at the malicious intent to harm. Look at the actual harm they do. It is far from humorous. It is a tragedy. The ABIM is a reckless organization that is misleading and endangering the lives of millions of people.
I am not curious about their damn articles of incorporation in the slightest. I see directly the hell they have unleashed on physicians and the public and don't need any paperwork or documentation for their scandals and messy affairs. The ABIM has been aiding and abetting of criminals that the ABIM helped create and pass around through the revolving politico-corporate doors. The ABIM has been engaged in such vile misconduct for decades.
MOC is monopoly rent
ReplyDeleteHow much terror is manufactured by our authorities trying to protect us?
ReplyDeletehttp://www.globalresearch.ca/canadian-police-manufactured-terror-plot-to-ensnare-couple/5540465
Question: How could the ABIM and ABMS keep Ariel Benjamin Mannes and not make a public statement about the ongoing scandal concerning the investigatory value of a felon and his testimony to a court when credibility and security of knowledge are the core values of the ABIM. Otherwise they are without any trust. They have overreached and are guilty of a great deal of abusive harmful action and legal misjudgments. All the lawsuits against physicians are a prime example.
So, why is Mannes not gone?
How well do we really know the ABIM and what they are capable of and who they work for? (Certainly not physicians or the public.) Can we say with any degree of certainty that they would not manufacture testing incidents or fabricate evidence?
I believe the ABIM has crossed the red line of decency many times and conducted them in the most depraved manner.
So, what about that double felon they hired to be head of testing security and investigations - I mean A B Mannes.
We know he was compromised goods when they (whoever) found him. And it is evident from his bad police record, being fired from TSA and the aggravated assault charges and felonies, he could he not get a job in law enforcement or critical public security work again. He would have to go underground almost to work. So, how did he find the ABIM. Who set that up? I believe some powerful people must have moved him into position within the ABIM. Pulled strings to get him into InfraGard.
How much has he been willing to do for them? How far would a man like that go? And in his position. What do we know of Ariel Benjamin Mannes and his background? I understand he has been involved in "Homeland Security" or so he state, but much on his CV is a lie with beg gaps unaccounted for. Who has he lied to in the past? So, what did he reveal to the ABIM on his job application? Did the human resources people have a correct file on Mannes? Strangely the head of HR at ABIM was replaced after Mannes was hired. Cover up? It may be. The ABIM went to a lot of pain to bring in a firm to set up to be fired two hard working high-ranking 'tenured' managers in HR. The discrimination cases, which ABIM have never been brought before the media as they were settled out of court. What was ABIM, Christine Cassel, Eric Holmboe, Richard Baron, and Robert Wachter, Benjamin Mannes, Rebecca Baranowski doing or planning in 2008 and 2009? What was it all for? Who has the power to push a bad cop through system and place him in such a powerful position? We might come to believe the ABIM's financial and political pursuits are alarmingly Machiavellian.
I would not put it beyond the test publishers associations and the testing/security cartels, politically connected people to have pulled some strings to get Mannes on the inside. This could explain a lot about why an organization cannot just let Mannes go or fire him. He really is a liability and security risk for every physician and patient in America. You just cannot have a man like that in charge of so many files and even the executive’s lives.
ReplyDeleteWe also don't know what they did at the condo or what it was used for. There are innuendos to the condo, and serious questions unanswered. I have recently seen one ongoing lawsuit against the ABIM and others claiming ABIM has connections with a particular mob boss and also pedophilia. Why did someone want Mannes on the inside within the ABMS. Was it mutual tit for tat. ABIM gets something and their associates get something. Did Mannes infiltrate it and control/expand business there for the ABIM affiliates and Mannes testing security / publishers? It is very likely.
The obvious question comes to mind if one remembers all the hype that the ABIM and state attorney generals created over "fake" certifications that were being produced in large quantities according to court documents. This is how we first learned of Mannes and the ABIM. The ABMS/ABIM was about to launch the new hospitalist certification/MOC "track" for internist and Bob Wachter was very concerned about these "fake" medical certificates. I find this all very strange and to this day the ABIM has never caught the man responsible for these certificates. They have never given the Diplomates and Candidates they protect the real story behind the mystery man creating all those fake certifications for his various "churches". Perhaps the ABIM would like to explain this to us as well as why they pursued prep courses and physicians and still pursue physicians.
I just wonder how much of the testing security business has been created or manufactured by Mr. Mannes, his partners and the ABIM/ABMS. We understand a great deal about their testing security business being generated artificially by sting operations like the horrific things that our less scrupulous police have done. Often these involve unwitting accomplices, who will take the blame and given a promise that they will get away.
Mannes moonlights with Caveon and so on. What do we really know about that organization Caveon, which has actually helped to put teachers in jail on racketeering charges. Why has the ABIM not been put away long ago. Many physicians just still don't know who and what the ABIM is, and what they are capable of. Yet they still remain incapable of telling the truth.
And why is Lynn Langdon not gone?
ReplyDeleteWhen will justice be served?
ReplyDelete