Friday, November 11, 2016

More Insights to ABIM Board Certification Tests and Scoring

From a recent early-career physician who failed their certification board examination and is trying to understand why:*

Dr. Fisher,

I contacted ABIM today asking many questions about the initial certification exam and the scoring. 

As I've seen you mention, they claim to use the (modified) Angoff Method to set the cut score for passing. It involves a bunch of "experts" reading questions and estimating what percentage of "minimally competent" test-takers would answer correctly. They then average all experts' percentages for each question, and average the percentage for all questions, to achieve the minimum passing score. Apparently. No info on who the experts are. Also no definition of what a "minimally competent" test taker is.

That's a weird system, but it wasn't what I found most egregious. Without going into too much detail, there are 240 questions on test. By my answer report, based on number of missed questions, I got 74% correct. They have interviews with their president and examples online stating you need to get about 65% correct to pass. I blew that away and still failed. So, I called them. To start, they told me that at least 35 questions are "test questions" that end up being thrown out and neither count for or against you. So we are paying to be research subjects. And paying handsomely. Even if you throw out 35 questions, I still got 70% correct, so I asked how I could've failed if I was still well above the 65% threshold. They told me that not all tests are equivalent and essentially I may have had an easier version and needed to get more correct. So apparently someone could've missed more than I did but still passed if their test was arbitrarily deemed more difficult? 

I asked many questions about how this could even be considered an equitable way to grade a high stakes test, but got little response. They did offer to have a psychometric statistician call me. In 7-14 days.

Thanks for your time and for reading. What an arbitrary process. Also, they will not let me see my test or answers, nor can they show me what questions were thrown out. This being clouded in such secrecy just adds to the mistrust from physicians. How can we trust a test that's so arbitrary? Also, if I continue to fail (or am failed, depending on how you look at it), is the ABIM going to pay off my student loans? I've proven competence in residency and now fellowship training. I would argue I've proven competence on this very test too.
A few notes about this physician's observations.

ABIM has published several "abstracts" on their webpage about methods of psychometric testing. The first abstract, published in February 2011 an co-authored with a representative from the computerized testing firm PearsonVue, discusses "transitioning the board from linear computer-based test to an adaptive, multistage testlet-based examination" and their "experience 'selling' this change to leadership." In other words, it appears the method of scoring ABIM examinations made a change before February 2011 to IRT scoring. Secondly, it appears a member of PearsonVue and an ABIM non-physician helped "convince" the ABIM leadership why they should change methods. (On a side note for those interested, here's a not-so-"simple guide" to Item Response Theory.) The second abstract, published in April 2011, discusses a "transition from classical test theory (CTT) to item response theory (IRT) scoring." What prompted the change in scoring technique is uncertain, but it appears the method for scoring examinations for ABIM board examinations changed before early 2011. Importantly with this new technique, the pass rate cut-off appears to be determined AFTER the test is taken and may vary from individual to individual, as the doctor suggests in the email above.

For those interested, the 2005-2015 pass rates for initial ABIM board certification were as follows: 92% (2005), 91% (2006), 94% (2007), 91% (2008), 88% (2009), 87% (2010), 84% (2011), 85% (2012), 86% (2013), 87% (2014), 89% (2015). (source: the Internet archive and ABIM websites).

Was this change in examination methods responsible for the declining pass rates of physicians taking the ABIM certification examination noticed by program directors across the country in 2013? Or was this the way PearsonVue required the test be scored if PearsonVue's computerized test centers from  were used for scoring (making it a "win-win" for both organizations)? We are left to wonder. The  falling pass rate hypotheses considered even included the possibility that study methods of millennial physicians were less rigorous.  The New England Journal of Medicine's summary of the controversy tried to quell the outcry from millennials who were quick to respond. Even the American Board of Family Medicine's leadership felt compelled to explain their falling pass rates about the same time.

Isn't it interesting that no one ever entertained the possibility that a change in scoring method at the ABIM had occurred that might have caused the drop in pass rates? If true, the process of passing a physician's initial board certification is inconsistent between test takers since tests contain questions that are "weighted" differently for each diplomat and the process of determining pass rate cut-offs remain shrouded in secrecy.

It's time for the ABIM to stop hiding their "secret sauce" of test development, changes in test scoring, and test "security" processes and address this young physician's questions directly and honestly. Test scoring and the setting of pass rate cut-offs should be transparent and reproducible for any high stakes examination administered to US physicians, especially when this self-proclaimed "voluntary" testing and re-testing now affects all US physicians' ability to gain (and retain) employment.

Or is that too much to ask of folks that use physicians as research subjects without their consent, engage in illegal lobbying of Congress and "stakeholders" for their benefit, and delight in moving our testing fees offshore to the Caymans for their own benefit?

-Wes

* Portions of the letter were edited to protect the physician's anonymity.

30 comments:

Brite said...

In my opinion it would be better to close the ABMS down. It has become a corrupt redundant corporate enterprise comprised of career DINO profiteers, cunning goon-cops, dirty copyright attorneys, and their manipulative money changers.

Anonymous said...

What a scam. Need to "Trump" this one!

Kallil said...

OUR de-conflicted Medical specialty societies and our great universities with strict conflicts of interest bylaws can join forces and put together an annual certification test for all the specialties.

Such tests can get a 'test run' during residency and fellowship. This should not be done in secret but open to practicing physicians, faculty, physicians, medical students, residents and fellows.

There is no reason for anyone to fail because of a "dirty tricks test mafia" and a corrupt "politically active" quality assurance system. This system appears to be more syndicate than anything else. Our next AG/DOJ should appoint a special prosecutor assigned to investigate politics and money in the quality assurance industry and their affiliates, such as the ACGME, NQF, RWJF, JC, AHRQ, CMS, NCQA, URAC and others.

http://www.abms.org/about-abms/associate-members/
http://www.abms.org/verify-certification/official-abms-display-agent-partners/

I agree with previous poster: "What a scam. Need to 'Trump' this one!"

Anonymous said...

Ha Ha! Some test takers are more equal than others.
Right out ot fhe Clinton mafia playbookd.

RIAM said...

ABIM's variable ratio scheduling

What is troubling is that physicians have funded their own demise. By being kept in the dark we have been stimulated to believe in the course. Just like B F Skinner's pigeons we follow a maze of blind testing. It is outrageous what Baron and Nora do. I call out the ABIM for colluding with Pearson. That is reprehensible.

Wes Fisher did not mention here, except by link, all the testing police and copyright surveillance that goes along with these modern day testing cartels. I believe what they have done is public fraud. It is in essence another blind study conducted on physicians without informing the client/subjects. These unethical CEO's and Chiefs are legally required to disclose.

But more irritating and frightening is the fact that the ABIM thinks it can just screw with physicians’ lives. Playing the pass/fail game is another form of pay-to-play; it means physicians are being gamed by Pearson/ABIM/ABMS.

Hard working clients are tossed in a roulette wheel where in the past there were mostly random, unscientific results to contend with, but one passed. The only requirement was only just required that physicians believed in their master Skinner.

And now Pearson/ABMS has introduced chaos theory into the mix. There are no data to even inform physicians whether the costly lengthy certification process is anything but a feel good placebo. It cures nothing and prevents nothing in terms of the quality of healthcare.

Now we have 'MOC-dollar-mania' another game that chews up a lot of time on the rat-maze; it is meant for keeping physicians on track. And we have the 'policing-of-the-rats' game with shock therapy applied. You get held up by the 'panel-of-three' and kept out of the game if they suspect some genetic irregularities or social defects. They cull out the most vulnerable in the populations. And your colleagues see you being bled dry and eaten alive if you resist them.

OSSIA said...

The Big ABMS Piggy Bank

The ABIM/ABMS has become nothing more than a big piggy bank for the ABMS' big cheeses. These big wigs lobby, lunch together, and play golf while participating in their 'work-from-home' 'thirty hour-per-week' payday. We are the ATM for professional medial bureaucrats.

I ask myself what bank that I deposit thousands of dollars into far-too-often does not have to disclose any and all changes in terms that occur. The ABMS does not do this. And we know why.

The federal government mandates that bank clients receive updates from banks mailed out to clients. But with the ABIM secrecy is everything; the modus operandi. You give and give but you get zip. Yet they know everything about you, even your zip code. It is incongruent we get no disclosures, even though they have files on us all.

The only disclosure I have gotten was to tell me that I can now have the option of paying every year several hundred dollars; or I can make a big damn balloon payment, which locks in my price. I was not such a nice pigeon when they "disclosed" this mandatory annual fee to me.

The ABIM should come clean and do the right thing for physicians. They should end mandatory MOC. If they don't do it, I recommend shutting the doors forever of this evil org. Nora, before she retires should do it or she will forever hang her head in shame.

Maybe Dr. Nora is moving up the corporate ladder to another position in the revolving door scheme, so her lack of independent thinking and will is baked into the cake in the ABMS/ACGME/NQF game of musical chairs.


Joyce said...

Keeping physicians in a dark testing tunnel

The changes discussed in Wes' article are not minor changes. They are dramatic changes to the testing protocols. And the changes came at a time when they were lobbying to get MOC into the ACA and tucking money away in the Cayman Islands and Ireland.

The testing protocol changes came at a time when they were suing and sanctioning the hell out of thousands of physicians for attending non-ACP affiliated board prep courses. These were courses with materials that residency program directors found to actually be effective. ABR and Frontrunners were among two that the ABIM targeted. With these non-ACP programs made defunct or subdued the ABIM and ABMS would have a free hand in the keeping the action all for themselves.

Vulnerable young physicians were demonized as a result of bad policies. Also ABIM's goon-squad felonious cop may have presented false evidence/impressions to a federal judge. He and ABIM executives presented sworn testimony to the court. They were seeking to be granted a very rare sealed writ in order to seize physicians' personal data files.

We are talking about civil liberties violations and possible judicial tampering. They are well connected politically and judicially at the ABIM, so it is highly likely they were granted a favor that an ordinary person would not receive. One rule for the elites and another rule for the commoners.

Everyone must understand this organization called the American Board of Internal Medicine; the executives and their handlers do not do anything randomly. It is all by design. And they have designs on you. Their design right now is to hold on to their big piggy bank and money machines. They can only do this if they keep everyone uninformed.

Payback and Politics. said...

In all the media hype of the election results, one of the most clarity filled statements came from the UK. Nigel Farage stated the anger of the populace was a direct result of the unholy alliance between Big Business, Big Government and Special Interest Groups. The corollaries from that statement to the ABMS/ABIM/ABIMF mess could not dovetail more with our Nation's political mood and especially with how Medicine and Surgery are governed in the USA. In the 8+ years of ObamaCare, physicians were promised a smooth transition into a Socialist Health Care system. It was sold as cost efficient, choice filled, and respectful of the rank and file physician whose sole duty was to the patient. Nothing could be further from the truth. What transpired was a misguided, poorly planned political gambit that lead to annual double digit increases in health care premiums, less choice and less freedom for the patient and the doctor. It lead to the evaporation of thousands of private practices as hospitals hungrily soaked up the masses who panicked. The Trial Attorneys were sacred cows and Tort Reform was the most obvious lip service to the physicians who pleaded for it. We watched our patients saddled with "donut hole" prescription burdens make a choice between paying for their heating bills vs paying for their pharmacy deductibles.

All lies. Every single one of ObamaCare. Lies. Lies. Lies.

Who swooped in to stand in the power vacuum? The NQF. The ABIM and ABIMF. The ABMS. All the sister organizations and half sister organizations eager to stick their flag in the ObamaCare paradigm. That desire to act as a broker and to exact a transfer tax on clinical care is what galvanized their access to billions of dollars and hubris lead to condos, Mercedes Limo Service, offshore tax havens and pension funds for themselves.

The fatal flaw in that strategy is turning their backs on their constituency. We all noticed these thieves were taking our money and then making all of our lives very difficult.

Well on Election Day that blunder will come back to haunt the ABIM and the NQF. Slavitt at CMS? Gone. Goodby.
ObamaCare? At the very least will be utterly overhauled and the hot white light from Mr. Trump will expose the phony leaders of the ABIM. Scurry away if you can Dr. Baron. When you are a cockroach scampering away on a ultra white wall, everyone can see your maneuvers.

It's a different world and the ABIM will pay dearly for its treachery.
So for the doubters on Walnut Street, the Mayo Clinic Proceedings manuscript stated that 88/100 physicians want your MOC to disappear. Very similar statistics to Dr. Wachter's E-survey.
Be prepared to lose your jobs. Maybe next time you will remember that when you enter a political environment with the good mean and women of the ABIM Diplomates who actually actively take care of patients...
WHAT COMES AROUND, GOES AROUND.

Anonymous said...

Payback and Politics wrote: "All lies. Every single one of ObamaCare. Lies. Lies. Lies. Who swooped in to stand in the power vacuum? The NQF. The ABIM and ABIMF. The ABMS. All the sister organizations and half sister organizations eager to stick their flag in the ObamaCare paradigm. That desire to act as a broker and to exact a transfer tax on clinical care is what galvanized their access to billions of dollars and hubris lead to condos, Mercedes Limo Service, offshore tax havens and pension funds for themselves."

Very true! What the American taxpayer may not realize is that all these NGO's like the ABIM were infiltrated and populated with Clinton's health care cronies like Christine Cassel and her mentors like Harry Kimball and John Benson, Jr. forty years in advance in advance of Obama Care. We have to look back to Hillary Care twenty-five years ago and understand that these NGO's and "Foundations" served to pay King's Ransoms to the political allies and protégés of Benson and Kimball. They just passed the torch to Cassel and her many "self-appointed" executives. B and K got lucrative "do-nothing high-paid advisory jobs" at Universities after they retired on physicians fees and lucrative investment schemes way before the Cayman Island Hedge Fund scheme. Keep hidden and keep you mouth shut. Benson and Kimball by policy would not do any interviews other than to accept accolades/honors. The NQF was created by the Clintons. If ever there was a handsome Clintonesque pay-to-play org with its hands all over private and government money! It got caught meting out hospital recommendations, lobbying, and policy, but the DOJ failed the taxpayer and only settled the case rather than investigating thoroughly as it should have. Not one indictment. Cassel sent her public relations officer from the ABIM over to the NQF. Then as PCAST advisor to Obama (White House advisor)the Clinton's precious NQF was let off with a slap on the wrist even though they had clearly been caught with bloody chicken feathers in their mouths. NQF CEO appointment to the egregiously conflicted Dr. Cassel to the rescue to help shut the government's case down. NQF is another ABIM/ABMS-type revolving door and pay-to-play enterprise. I would say that Hillary Care exploded back on the scene with Secretary of State/Healthcare Tzar Clinton's appointment to the Obama administration. There are so many organizations that need to be purged of political power brokering and graft. We need a very good AG to lead the DOJ and FBI.

Anonymous said...

The NQF and ABIM connection to the Clintons is apparent and should be to every physician. The have a far reaching global political syndicate that strangely resembles a crime family. This is also apparent to many Americans as polls asking about Hillary Clintons guilty/criminality were 50-60%. The Clintons' connection to George Soros and the ABIM Foundation is more than curious. Money was funneled from the ABIM Foundation into Soros "societies". Now protests are being orchestrated across the country sponsored by BLM, Move-on and many others with money ties to the oligarch George Soros. Has American become the new Ukraine ready for a Soros-sponsored coup here in American that leads to states annexing themselves. Some are calling these riots, where there has already been property damage and bloodshed a purple revolution. The Clintons appear to be sore losers. Follow the money and the patterns of corruption and criminality are clear. I also am in favor of a strong AG in the new administration that says it will drain the swamp.

http://www.washingtontimes.com/news/2016/mar/13/moveonorg-raising-funds-from-trump-protests-warns-/

http://thefreethoughtproject.com/soros-trump-protests-revolution/

http://www.zerohedge.com/news/2016-11-12/anti-trump-us-color-revolution-includes-soros-and-clinton-%E2%80%98purple%E2%80%99-takeover-0

Lisa said...

Next time you berate an IT worker consider that they have to go through PearsonVue testing much more often than any physician does. This is the model being rolled out to medicine. They normally have some questions that end up being thrown out. One reason is that if the question is stupid and ambiguous or just has wrong choices, you can write down that question number and inform the proctor. If you are getting a question wrong because the question is just wrong, then you should not be penalized. Explain why it is idiotic or unclear to the proctor. PearsonVue test are also adaptive so they start easy and if you are acing it right from the start then it might get harder faster than anticipated. There are some tests that will end quickly if you are doing very well. But it may feel like your head will explode.

Consider also the testing that actuaries go through. This literally depends on how smart the other people taking the test are. If you walk into a room full of Asians then the odds are you just blew the exam. Statistically, they are smarter than white people. And if they're at an actuary exam, they are most likely near the top of the curve for their group. There is a set number of passes. There is a curve. If you are average then you must leave and take an exam with a stupid group of people to pass. This is the world of testing. These are the people who dictate to insurance companies how doctors are to treat patients because they got the best test scores in math and know nothing of medicine.

It is what it is. People are going to fail when they were trained well enough to be good physicians. Some people will pass when they don't seem to know very much. More than once I've had to explain things that I would expect to be rudimentary to someone whose in a white coat and being called a doctor. Everyone has learning gaps but come on people.

Anonymous said...

Excellent investigative reporting!

Anonymous said...

Trump protests proof of professional activist involvement
http://www.zerohedge.com/news/2016-11-13/anti-trump-protests-proof-professional-activist-involvement

Arthur Fougner MD said...

If MOC were set up as a Clinical Trial, it would have already have been stopped for overwhelming lack of efficacy.

A strange unfolding of co-incidents said...

"When stuff hits the fan, stuff flies" - anonymous Philadelphia mobster circa 1970's

I would like to see an audit before the end of this year of the ABIM and ABIM Foundation as was recently recommended by one of the highest ranking medical societies in the US.

In light of the fact that ABIM accountants/auditors advised Henry Strozeski CFO (1974-2004)personally to retain all tax records indefinitely, we should also audit the ABIM, American Board of Internal Medicine Foundation*** and ABIM Foundation to as far back as possible.

The auditor's letter (with tax copies retention advisement)is available for view online as part of the ABIMF's 2002 tax year filings. It is dated October, 23, 2003 signed by J. Brian Carden of Mantas, Ohliger, McGary and Quinn, PC. located in King of Prussia, PA 19406. 610 337-8811. (2003 phone number)

Strangely, Mantas, Ohliger, McGary and Quinn, PC. was acquired in 2005 by RSM McGladrey, which also acquired American Express Tax and Business Services for $220 million just prior to the acquisition of ABIM's auditors/accountants.
http://www.accountingtoday.com/news/18424-1.html

Also of note and curiously, around the same time in 2005 ABIM and ABIM Foundation's hedge fund brokers 1838 Investment Advisors went defunct.
http://www.pionline.com/article/20050808/PRINT/508080730/1838-closes-quietly-after-returns-and-assets-drop

Hank Strozeski left ABIM/ABIMF in 2004 after his associate Christine Cassel came on board in 2003. Cassel signed the "official ABIM Foundation registration" in 1999 while she was ABIM Foundation Chair. A purview of Strozeski retirement consideration would be in order since Strozeski is the only signatory on the American Board of Internal Medicine Foundation registration in 1989.)

I would like to see an audit of ABIM Foundation and American Board of Internal Medicine Foundation all the way back to 1986. There was no foundation in 1986, but surplus moneys earmarked for what would become the "Hank Strozeski, John Benson, Harry Kimball, Lynn Langdon, Christine Cassel, Richard Baron, et al retirement fund."

Physicians fees in the form of gross profits were being transferred from the ABIM to the ABIM Foundation from its inception until 2007. The money was invested and traded heavily by Wall Street insiders at the time.

Many of these insiders worked along side of some of the most notorious felons of Wall Street at Drexel, Burnham and Lambert. It also became defunct from illegal insider trading practices.

When a new attorney general is appointed I would highly recommend the appointment of a special prosecutor to look into the ABIM/ABMS' situation.

***Name later cleverly changed to ABIM Foundation to avoid tax scrutiny.

The Wolters Kluer/Uptodate/McGladrey/CCH Connection said...

It is perhaps not so coincidental that RSM McGladrey Network Adds
Wolters Kluwer/CCH Learning Center as Member Benefit in August of 2004.

(RIVERWOODS, ILL., August 9, 2004) – CCH Tax and Accounting (CCH) and the RSM McGladrey Network today announced that access to the CCH Learning Center at a preferred price has been added by the Network as one of their member benefits.

"The RSM McGladrey Network is showing real leadership in offering this outstanding benefit to its members," said Mike Sabbatis, Vice President of Sales and Marketing for CCH Tax and Accounting. "We’re pleased to welcome Network members to the CCH Learning Center and we’re confident they’ll find our courses engaging, easy-to-access and relevant to their needs."

"For one low annual fee, the CCH Learning Center gives our members access to 100 practice-oriented courses over the Internet, with more courses being added all the time," said Dan Brooks, Executive Director of the RSM McGladrey Network. "With CCH’s reputation for authoritative, up-to-date content, members will be assured that they can meet their continuing education requirements while increasing their ability to meet the real-world challenges they face in their practices."
CCH Learning Center as Member Benefit

https://www.cch.com/press/news/2004/20040809t.asp

Investors/Wolters Kluwer
http://wolterskluwer.com/investors

Tax Accounting/Wolters Kluwer
http://wolterskluwer.com/products-services/our-portfolio/tax-accounting.html

Uptodate/Wolters Kluwer
http://www.uptodate.com/home

CCH/Wolters Kluwer
https://www.cchgroup.com/

Christine Cassel. Kaiser Permanente associate from 2002-present. ABIMF Chair 1999. ABIM CEO 2003-2013. NQF head 2013-2016 Kaiser Medical School 2016-present.
https://en.wikipedia.org/wiki/Christine_K._Cassel

Anonymous said...

OHSU Dean Cassel to step down. Announced just a couple of days before the board was to vote. It was a done deal well in advance of the vote. Nice salary she got just for parking herself at OHSU. "The board sets the compensation." She was the board before leaving OHSSU. Cassel's first order of business at OHSU was to hire two women to do the work for her. Created the assistant dean position and installed another woman to be the liaison between the Dean's office and academic affairs. Did Cassel purchase a house in Portland? Where did she live? I bet you already know. "They" operated in secrecy and with silent running. They torpedoed healthcare with deliberate and precise targeting of physicians. They took out the infrastructure, went after physicians political power and then terrorized the populations with indiscriminate . . . call it what you will!
http://www.ohsu.edu/xd/about/news_events/news/2003/02-19-christine-cassel-to-step.cfm

Anonymous said...

How McGladrey and MOMQ merged.
http://www.bizjournals.com/philadelphia/stories/2006/01/02/story3.html

Bad audits brought Horwath and Lavanthol down. 1990. And "tough times" for auditors.
http://www.deseretnews.com/article/133652/LAVENTHOL--HORWATH-FILES-FOR-BANKRUPTCY.html?pg=all

Tough times for accountants auditors 1990.
http://www.nytimes.com/1990/11/05/business/auditors-adjust-to-desperate-times.html?pagewanted=all

Bill said...

This is outrageous what the ABIM and their cronies have done. The pieces are starting to come together. The puzzle is clear. It is an even uglier conniving org than I thought!

Anonymous said...

Anonymous Tue Nov 15, 06:08:00 PM CST posted: http://www.ohsu.edu/xd/about/news_events/news/2003/02-19-christine-cassel-to-step.cfm

What a setup! Christine Cassel comes off the ACP as the first woman president. Then Dr. Cassel goes off to be first woman Dean at OHSU, but not really doing anything except political activities--what a pretense. From there she gets a cushy job with the ABIM as first woman CEO/President, but never lived in Philadelphia. What a scam.

Then Bob Wachter bought her a nice overpriced mansion for $2.3 million with a discrete chauffeur overlooking Washington Square. It must have been partly for flying into town with hubby in tow for the "sting operations" and "special party events" i.e., the lobbying they never admitted to or disclosed yet.

It is unbelievable! And given the corruption in Cassel’s political affiliates, who knows what kinds of money changers and traffickers in human flesh they discretely brought in for their guests. Ask the former Ayers staff! Money and power always begets more money and power. In case people don't know, Philadelphia is one of the most corrupt towns in America. And that is after the major crime bosses were put away in the seventies and eighties. It is a different kind of corrupt--into politics and corporate control. And there is that double felon at the ABIM in charge of ABIM/ABMS investigations who Dr. Baron, Wachter and Cassel hired. They still will not admit to or disclose that they hired a dirty tricks scoundrel and keep a tight lid on any verbal discourse. What a total scandal.

Even the ABIM admitted Dr. Cassel did not show up for work just as we always thought; they just paid her 10 million dollars to "fill the position". She was mostly a political appointee, not a quality assurance bureaucrat.

Looks like the previous ABIM head Harry Kimball needed a good alibi for his MOC scam and his financial "crimes"! After he he "retired" with all the money he stole from physicians got a do-nothing high paid position in the University of Washington Office of the Dean. Who would want to prosecute a new person and especially the first female CEO? It is historic after all. This politically correct person Cassel discriminated against high ranking African American women at the ABIM and purged them from the ranks. Cassel with her egregious conflicts of interest has been such a hypocrites all of her professional life.

Then Cassel moves up the ladder again through the revolving door back into the White House, while "working" for the ABIM and NQF. At the same time she was owned by special interests. She served Kaiser Permanente and Premier, Inc.

Cassel turned the ABIM into a fascist regime with secret police recruited straight out of prison--Ariel Benjamin Mannes, alias Ben Mannes just finished his probation and was accepted into the American Board of Internal Medicine with no questions asked it seems. Why do physicians have to account for every month of their education and careers and Mannes gets to lie about everything?

The ABIM is comprised of self-enriching bureaucrats with their own self interests and political agendas in the forefront of their minds always. It is not about medicine, it is all about the money and what money can buy.

The ABIM board gets paid to do nothing except keep the status quo and keep them hushed. The undisclosed "Director of Investigations" has his felonious hands in keeping everybody quiet. The conflicts of interest at the ABIM are unfathomable. And with all the dark money involved in politics and the ABMS every physician has been "politically hushed" through regulatory capture.

Cassel as Chair of the ABIM Foundation was groomed from long ago to be brought into ABIM's crime central and conduct dirty work for her bosses. It would be good to expose who they are and the whole ABMS racketeering scam.

Anonymous said...

Have you looked into all the mergers and acquisitions of Wolters Kluwer?

What about Wolters Kluwer's acquisition sprees? From Lippincott to HarperCollins to Little, Brown and Company; to Ovid, to Uptodate, MedKnow and beyond.

Look at the concerning rise of Wolters Kluwer as an investment vehicle for gobbling up all the medical publishers like Uptodate in 2008. What happened after that? They launched the product in the UK in 2014 and in continental EU one month after. 47% of the shareholders are in the UK with 24% in the US. France, Germany, Spain, Switzerland, Netherlands, the rest of Europe and other hold the rest of the issued shares.

Who are the power brokers in healthcare driving them; and what is the likelihood that corporate and government medicine incentivizes Uptodate to propagandize medicine such as "Choosing Wisely" or just infiltrates the organization to the point that we see a potential retail corruption of medical science. I only say this because I am seeing it in Uptodate already - slowly over the past few years.

Also bear in mind that the ABIM is in the process of conducting a pilot project with Uptodate as THE medical source for open book testing to see if this kind of format could be incorporated into the recertification process; but only as PART of the MOC requirements.

The CEO of Wolters Kluwer is an American (since 2003)although the company is registered in the "Nederland." Ga cijfer!

Interesting points from a "Global Research" article pointing out WK's conflicts of interest with big pharma.

"Most medical journals receive half or more of their income from pharmaceutical company advertising and reprint orders, and dozens of others [journals] are owned by companies like Wolters Kluwer, a medical publisher that also provides marketing services to the pharmaceutical industry.” — Helen Epstein, author of “Flu Warning: Beware the Drug Companies” (http://aaci-india.org/COI/Flu_web_final.pdf) (Dr. Gary G. Kohls, Beware the Drug Companies, How they Deceive Us: “Criticizing Big Pharma” Global Research, February 16, 2015) - See more at: http://realitieswatch.com/25-facts-about-the-pharmaceutical-industry-vaccines-and-anti-vaxers/#sthash.s5IQ7znN.dpuf

Wikipedia
https://en.wikipedia.org/wiki/Wolters_Kluwer

WK bought MedKnow in 2011, India's OA publishers site
http://www.medknow.com/aboutus.asp

Sample job at Wolter Kluwer's Uptodate posted at glass door looking for an ABMS certified (preferred) physician.
https://www.glassdoor.com/job-listing/clinical-informaticist-uptodate-JV_IC1154703_KO0,22_KE23,31.htm?jl=1842687141
http://www.medknow.com/aboutus.asp

Double Irony of ABIM's Affiliation with Wolters-Kluwer/Uptodate said...

Wes, you wrote about ABIM and Wolters-Kluwer's UpToDate relationship:

"Despite physicians calling for an end to MOC, the ABIM wants to maintain it. Without it, you see, they'll be bankrupt. Note also that the ABIM wants to offer physicians who participate in their "research" for less than $50/hour. (No compensation is given from travel to and from the testing center). Ironically, UpToDate already makes the need to participate in the ABIM/ABMS MOC program obsolete. Third, most physicians at large hospital settings have access to UpToDate already. Fourth, 20 MOC points seems like bribery when your program is increasingly required for hospital credentialing and insurance company panel participation."

Given the ABIM/ABMS' cozy relationship with Wolters-Kluwer/UpToDate and McGladrey(ABIM's accountant/auditor for years) don't we have a smelly situation which draws attention to ALL of the tax filings of the ABIM and ABIM Foundation.

It is an obvious very old cozy triangular affair and very fishy. ABIM/McGladrey/Wolters Kluwer

Todd said...

ABIM 990 tax filing link bad: There seems to be an error when I try to read tax forms 990 from their site. I can only view the first page. Anybody else get this read error?
http://www.abim.org/~/media/ABIM%20Public/Files/pdf/revenue-expenses/abim-990-form.pdf

What I see is not very transparent and it is not even accessible. I see a 2016 filing from 2014? Weird. Are they always filing so late, Wes. Prepared by Christopher Pekula. It does not name the firm Pekula is with. I understood he was McGladrey.
https://www.linkedin.com/in/christopher-pekula-196ba116

McGladrey has just rebranded with a global initiative. Now they call themselves RSM.

Todd said...

McGladrey Changes Its Name to RSM in Global Branding Initiative

Global economic publication, national brand campaign reinforce middle market commitment


NEWS RELEASE

CHICAGO, October 26, 2015

RSM US LLP (“RSM”), formerly McGladrey LLP, is celebrating the launch of its new brand, which unites fellow firms from more than 110 countries in the RSM International network under a common brand, by issuing the first global edition of The Real Economy and launching a national advertising campaign. The unified brand is part of an initiative to further RSM’s vision to be the first-choice advisor to middle market leaders globally.

“Since we helped found the RSM International network more than 50 years ago, our firm has been dedicated to taking the middle market to the global market,” said RSM US LLP Managing Partner and CEO Joe Adams. “As middle market companies increase their participation in the global economy, they are challenged by the ever-changing regulatory and business landscape. For decades our firm has combined an understanding of our clients’ unique challenges and aspirations with our knowledge of the global business environment to help leaders move forward with confidence. The RSM brand brings this enduring commitment to life in a real and tangible way.”

As a centerpiece of the rebrand, RSM is launching The Global Real Economy, a semi-annual global edition of its flagship publication, The Real Economy. Led by RSM US LLP Chief Economist, Joe Brusuelas, and other RSM leaders from around the world, these reports address a range of international issues relevant to middle market firms around the globe. This global thought leadership initiative is part of a larger effort by RSM to provide actionable insights and analysis to middle market companies about the issues most relevant to their businesses.

RSM is also launching an advertising campaign in the U.S. as part of the rebrand entitled, “The Gauntlet,” with national television spots airing on Headline News, CNN, Bloomberg TV and The Golf Channel. Developed by Charlotte-based Luquire George Andrews, the campaign also features extensive online, digital and traditional media components in leading publications read by middle market business leaders. The creative premise for the ads centers around a middle market leader running a real-life gauntlet, meant to symbolize the challenges RSM can help clients overcome as they grow and expand globally.

“It is extremely important that our thought leadership and creative assets represent the global issues our clients face every day and underscore our commitment to help them experience the power of being understood,” said Andy Bosman, principal and chief marketing officer of RSM US LLP. “Our unified brand gives us a broader range of global expertise and perspectives to provide even more relevant insights to middle market businesses on a daily basis.”

To download the inaugural issue of The Global Real Economy, visit our website. Subscribe to The Real Economy here.

“Over the years, our firm has evolved with our clients, developing a strong suite of services to support their expansion into the global market,” said Adams. “Unifying under the RSM brand will better enable current and potential clients of RSM International firms around the world to more clearly see the strength and broad reach of global services offered.”

To learn more about RSM’s global capabilities, visit our website and watch “The Gauntlet.”


http://rsmus.com/newsroom/news-releases/2015/mcgladrey-changes-its-name-to-rsm-in-global-branding-initiative.html

RSM International, Wikipedia said...

McGladrey is now RSM

"RSM International, branded RSM, is a multi-national network of accounting firms forming the sixth largest accountancy professional services network in the world. The member firms of RSM are independent accounting and advisory firms each of which practices in its own right, and is unified as part of the network. The network is not a separate legal entity of any description in any jurisdiction, and does not provide services.

The largest member firms are RSM US, formerly known as McGladrey, the fifth largest accounting firm in the United States; RSM UK, formerly Baker Tilly LLP, the seventh largest accounting firm in the United Kingdom; and RSM China, formerly Ruihua Certified Public Accountants, the third largest accounting firm in China. Together, the North American, European, and Asia Pacific regions accounted for $4.64 billion of revenues in 2015.

On October 26, 2015, all member firms of the network were rebranded as RSM.

History

RSM International has been in continuous existence since 1964, when it began as a small network that was originally called DRM. In 1993, the organisation restructured and changed its name to RSM International.

Historically, RSM was derived from the initials of 3 of the original founding member firms of the organization:
Robson Rhodes (UK)
Salustro Reydel (France)
McGladrey (USA)

Founding member Robson Rhodes was acquired by Grant Thornton and absorbed within their network,[2] while Salustro Reydel merged with KPMG. McGladrey, or known as the RSM US member firm, is still part of the network today.

In January 2006, Ms. Jean Stephens became the first female Chief Executive Officer of a top 10 international accounting network."

Robson Rhodes was acquired by Grant Thornton which was under investigation for:

"Accusations of negligence and incompetence

Grant Thornton Moldova has been accused of incompetence after being the auditor for three of Moldova’s banks involved in the Moldovan bank fraud scandal. The theft was discovered in November 2014 at Unibank, Banca de Economii and Banca Sociala, which Grant Thornton Moldova audited in 2011 and 2013 along with KPMG. Stephane Bride, one of the managing partners of Grant Thornton in Moldova, was appointed as the Moldovan Minister of Economy after the scandal broke out. Allegedly, the money was embezzled and spirited out of the country in complex financial transactions, some through UK companies. The authorities had to rescue the three banks with a bailout equivalent to half the annual budget. None of these allegations have been proven and Grant Thornton Moldova did qualify the audit reports for these banks."

https://en.wikipedia.org/wiki/Grant_Thornton_International


When Big Four Audit Companies Need An Audit said...

All the Big Four Accounting Firms Have Deficiencies (2014 investigation)

"Registered broker-dealers, and their auditors, are under intense scrutiny. Just last week the Securities and Exchange Commission (SEC)issued an alert warning broker-dealers they would be held responsible for customers selling unregistered securities. The SEC said 80% of the 22 firms it recently inspected had deficiencies in this area and many were referred to the Enforcement Division for further action."

"The Public Company Accounting Oversight Board (PCAOB), the independent audit firm regulator established by the Sarbanes-Oxley Act of 2002, is having even worse luck getting the auditors of broker-dealers to shape up over the last three years. In its third report under an interim broker-dealer auditor inspection program, published August 18, 2014, the PCAOB identified audit deficiencies or auditor independence findings in 56 of the 60 audit firms inspected and in 71 of the 90 audits inspected.

“Many of the observations noted during 2013 have not changed from prior inspections and relate to fundamental auditing principles,” said Robert Maday, Deputy Director of the Division of Registration and Inspections and Program Leader of the Broker-Dealer Firm Inspections Program."

Hope said...

The new attorney general nominee Jeff Sessions has some harsh things to say about the ABIM crime syndicate cronies and the obstruction of justice. It is about to get interesting. I all depends on what the meaning of swamp is and how far and wide those underground river systems and pools of corruption extend.

The DoJ will not need to settle for tax evasion to get ABIM/ABMS "quality assurance" fraudsters and their associates; they are guilty of public fraud and blatant racketeering plain as day. And their patsies who do their books and secret investigations will all squeal when poked for answers.

I suspect the stuff they are hiding is all backed up elsewhere in several places and can't be so easily destroyed.

The ABIM was founded by the AMA and ACP. Any tax audit they want before the "end of the year" is just a pretty attempt at whitewashing the fraud before the DoJ is purged and we might get serious about white collar crime again with real indictment and hard time served. FBI will be purged of the Deputy Director and maybe the Director will be fired, I would suspect.

In case folks don't know the AMA is corrupt. The core of power does not lie with the elected delegates, but elsewhere and those elites with the power are running scared. Physicians should push for some real justice and not settle for a white-washed audit of the ABIM. It is just a game. Will they submit to an audit. It is a charade to deflect from the criminality across the entire ABMS and their affiliates.

A full investigation is warranted as Newsweek's Kurt Eichenwald as he adamantly called for in his investigative reports. Physicians have to demand it for real justice to be served. "Grow a damn spine!"

http://www.breitbart.com/2016-presidential-race/2016/10/06/sen-jeff-sessions-blasts-fbi-destroying-evidence-granting-mills-immunity-its-breathtaking/

Anonymous said...

We need a thorough investigation with all the investigative tools available to the DOJ.

ABIM: VIOLATORY POLICE STATE AND PARTISAN POLITICAL ACTION COMMITTEE said...

ABIM V SALSAS RUSHFORD V ABIM ET AL
STILL NO DEPOSITION OF A. BENJAMIN MANNES AS ABIM CONTINUES TO COVER UP WRONGDOING

A call for unity from Doctors_Justice website:

"ABIM and what it does with Physicians Money !!! November 11, 2016

David is Alive and Battling

ABIM continues its tactics to delay, coerce, to not divulge, to keep things under the stamp of CONFIDENTIAL, to have depositions redacted so the truth is hidden. Why is a nonprofit so keen on SECRECY !?

David has continued his battle in silence but onward with the truth and the veracity of triumph.

Malcom Gladwell has said:

“There is a set of advantages that have to do with material resources, and there is a set that have to do with the absence of material resources – and the reason underdogs win as often as they do is that the latter is sometimes every bit the equal of the former.”

ABIM continues to spend thousands of physician’s money to coerce, to pressure, to demand obedience, to control and we need to combat this… David is energized and strong.

Physicians need to show their strength and support.

Let's hold ABIM accountable. ABIM's attitude only works on hurting physicians. TOGETHER WE ARE STRONGER !!!

If you have been wronged by ABIM contact us !!!!"

http://www.doctorsjustice.com/single-post/2016/11/11/ABIM-and-what-it-does-with-Physicians-Money-

ABMS Testing, Choosing Wisely and Physician Response said...

The irrationality of healthcare rationing by consciously designing systemic failure

There is a website that bears the heading "change board certification." Nearly all the responses in comments say MOC is a scam, fraud, self-serving, waste of time, waste of money, onerous, bureaucratic nonsense, an on and on. Only a few people thought MOC had any redeeming features.

But we could assert that such comments miss the real mark. MOC is worse than a scam or public fraud. It is a conscious design to limit access to healthcare by taking qualified physicians randomly out of the system. What Wes has discovered my give clear evidence of this when we summon up in our minds the accumulated body of evidence.

Choosing Wisely is a prime example of the conscious design of placing limitations on access to the full range of healthcare tools and services by creating confusing recommendations. The gamut and range of unforeseen harms and unintended consequences were considered to be acceptable collateral damage in their war against a normal state of affairs in healthcare. This latter tendency shows how cobbled together was the health reform plans of the neo-Clintonian bureaucrats calling the shots at the ABMS, ACP and AMA in concert with Casselian cronies with their influence over the Robert Wood Johnson Foundation, AARP, Consumer Reports and so on all the way to the White House.

To view actions of the ABMS and its associates as isolated responses to healthcare reform does not see the whole body of actions and evidence leading up to the enactment of the ACA.

In light of all ongoing reality checks that Wes keeps presenting, I would recommend, rather than keep reasoning with ABIM's unreasonable, secretive, destructive, self-serving, scamming, fraudulent medical bureaucrats, it would be much more in line with reality and pragmatic to push for ending MOC altogether. That should be the only response at this point if one is standing in the light.

The ABMS/ABIM darkness sponsors darkness in physicians' hearts and minds

An upset physician called me today and asked this question: "Why do a few out-of- touch self-serving bureaucrats get to spoil the whole of medicine. I am sick of it. I just want to be free of it all."

I listened attentively as the physician told me they were "ready to quit altogether and do something else."

The ABIM and its ABMS affiliates are literally failing physicians. ABIM/ABMS are failing physicians with bogus testing expertise, which they do not possess. Of course they do this consciously with malice. All the documents are online to prove their hubris and self-serving lie of being indispensable.

They are pushing physicians out of the profession with their pseudo-science - which is nothing more than pricey propaganda. This costly propaganda, paid for by physicians (and ABIM's profligacy born by taxpayers), was designed consciously to limit access to professional skilled healthcare.

I would take my case not to the ABIM but to the Inspector General and the DOJ.

http://www.changeboardrecert.com/all-comments.html