It was the perfect setting to deliver the Practicing Physicians of America's debut message to Congress regarding the ABMS Maintenance of Certification program (pdf of slides) last Thursday:
-Wes
Additional information:
My earlier rebuttal to Richard Baron, MD, President and CEO of the American Board of Internal Medicine's, defense of MOC previously published in Medical Economics.
Anyone interested in downloading the Powerpoint of my presentation to use for educational or advocacy efforts can download the presentation here.
Practicing Physicians of America website.
31 comments:
Excellent Wes!
Please let us know about membership and donations. We ALL want to support your organization. "dr." Baron may not admit that we ALL do, but hey - let him play Ostrich.
Just donated!
ABMS MOC questions to present to Congressional members, the media, and IRS.
Is MOC racketeering? Is MOC restraint of trade? Is MOC public fraud? Is MOC self-dealing? Is MOC tax evasion?
If one sees objectively the facts as they relate to the above allegations, MOC becomes to those who possess the umbrella of facts one of the most outrageous and deviously designed educational programs perpetrated on patients and physicians. Consequently, then, is it not ethically, professionally, morally and legally wrong to participate in such a scam?
What is one's moral obligation to resist mandatory MOC and end it. The more we know, the more we feel the moral imperative to end mandatory MOC. The present head of the ABIM understands this, but for inexplicable reasons cannot do anything to remedy the situation by lobbying with his partner organizations to end mandatory MOC immediately as the AMA House of Delegates so resolved in the summer of 2016. Why the feet dragging on healing medicines growing divide by dealing with this important vital issue. It starts with stating a position of opposition in solidarity with his colleagues at the AMA and so many state medical organizations.
In order to understand the issues involving MOC one needs to ask only one fundamental question to answer the serious allegations listed above - allegations which have been leveled against the ABMS and their crony organizations, colluding orders such as the ACGME, AHA, NCQA, and NQF. The feet dragging becomes even more heavily heard with increasing alarm the more we learn about the innards of MOC.
The facts are straight. The central question is: "Who benefits from MOC." The physician? No, there is no evidence that physicians benefit, in fact it only distracts and drains docs of time and money. The patient, then? No, it limits patient contact with physicians harming the fundamental tenants and core oaths associated with care.
The egregious conflicts of interest are staggering and glaring.
Then who does MOC serve?
MOC serves mainly the top earning executives - the profiteers of the ABMS cartels. And it serves the special interests. Who are they? Do we need to name them. We need only look at the "not-for-profit" tax filings, personal bank accounts, decades of hedge fund activities, real estate investments, and offshore investment accounts to see the truth about the total reversal of the meaning of "non-profit organization" and "charitable contribution to society." This reversal and visible amorality turns the stomach inside out.
Not only have these professional medical politicians milked physicians with their bogus MOC program, they have betrayed the public trust as they sucked and suck still the organizations they represent dry, hoarding the lions share of revenues for themselves. But that's not all, they made sure through their CFO's and HR Directors they also secretly skimmed the cream off the top in the form of tax-deferred compensation, lucrative retirement packages, outrageous personal perks like the purchase of personal luxury condos w/chauffeur-driven town cars, and not to forget the setting up of personal health care benefits that the rest of us would die for.
The ABIM Foundation should transfer those millions of $$$ back to a practicing physician-led organization like the Practicing Physicians of American (PPA) and not secretively fund the likes of people like George Soros in order for him to further his political agendas and social engineering projects.
"Judi Cassel named Chief of Staff at ABIM"
Why does ABIM have two professional politicians (DEMOCRAT PARTY) from Philadelphia, Pennsylvania, and DC politics working at the same position at the same time? I thought the ABIM claimed to be a physician-led organization. Why is it populated from the top down with egregiously conflicted politicians. Very obvious it is not a physician-led society and has nothing whatsoever to do with helping physicians, but rather harming and intimidating physicians.
ABIM named a new chief of staff without mentioning the departure of Suzanne Biemiller (strong GSK connections)who also claims the leadership role on her LinkedIn account. What gives?
http://www.abim.org/news/judi-cassel-named-chief-of-staff-at-abim.aspx
https://www.linkedin.com/in/suzanne-biemiller-5836803b
ABIM has never acknowledged or denied the highly controversial employment of the double-felon Ariel Benjamin Mannes as "Director of Investigations". They have never mentioned him in a press release or on their 990 tax filings. (June 2008 to present. He must still be working for them (on the payroll in some capacity) as he is a witness in ABIM v. Salas Rushrod v ABIM). We understand from court documents that he was the Director of Investigations hired under Donna Campbell's tenure as Director of Human Resources.
According to sealed court documents, which we have no access to obviously, Mannes gave a deposition regarding the ABIM's legal persecution of Dr. Salas Rushford. Mannes is mentioned in a dispute over legal representation. A brief transcript is provided of part of the deposition, so we know of the existence of Mannes.
There are alarming questions surrounding the personnel and company that ABIM keeps. Also creating a great deal of suspicion was the unannounced departure of the ABIM Director of Human Resources Donna Campbell in December of 2016.
A city of Philadelphia politician/bureaucrat was going to replace Donna Campbell, but the ABIM give no announcement about this changing of the guard other than one phrase saying that the new Chief of Staff, Judi Cassel will also be Human Resource Director (as well as Chief of Staff and "Ethics Chief").
With every passing day the ABIM creates more confusion and obfuscation of their operations and the lucrative payout to non-physicians leading the ABIM program. Is it legal or ethical what they do?! Does it conform to the bylaws and their requirements? Does it conform to or resemble the ABIM's original mission at all?!
More questions than answers from the ABIM!
There are references to ABIM's Ariel Benjamin Mannes on this site DoctorsJustice. I believe there is a link to the partial deposition there in provided documents. What a sad organization the ABIM is to sue so many doctors and sanction thousands to keep their empire of control going. They do much of it through operating in the dark in secret. They get discrimination cases to go away by settling. They make no announcements about these horrors they put employees and clients through. But when they "win" a few thousand dollars against a mother of ten over copyright infringement they put out thousands of announcements and the lead attorney takes a lonely victory lap. No mention is made that they spent millions to do so. No mention of the settlement with Arora yet by the Dr. Baron either. We believe it holds some key elements. It should be a public document as there may be illegalities or improper abuses of ABIM clients involved.
http://www.doctorsjustice.com/
More questions than answers from the ABIM!
There are references to ABIM's Ariel Benjamin Mannes on this site DoctorsJustice. I believe there is a link to the partial deposition there in provided documents.
What a sad organization the ABIM is to sue so many doctors and sanction thousands to keep their empire of control going. They do much of it through operating in the dark in secret. They get discrimination cases to go away by settling. They make no announcements about these horrors they put employees and clients through.
But when they "win" a few thousand dollars against a mother of ten over copyright infringement they put out thousands of announcements and the lead attorney takes a lonely victory lap. No mention is made that they spent millions to do so.
Also very disturbing. No mention of the settlement with Arora yet by Dr. Baron either. He was a key player doing the dirty work with attorneys and their hired guns of 27 crisis response team which A. Benjamin Mannes claims to have led. We believe the sealed settlement holds some key elements. It should be a public document as there may be illegalities or improper abuses of ABIM clients involved. Some of the so-called cheaters may have been invented by the two-time felon as he was allegedly in charge of the ABIM "HOTLINE" reporting incidents. (Really Lynn Langdon and Dr. Baron did much of this. With the highly egregious offender of common sense science and financial conflicts of interest, Christine K. Cassel.)
http://www.doctorsjustice.com/
"Things got away from us." Just look at all that is being imposed on us from all sides. From MOC to MACRA. The unconscionable body of useless busywork, the never ceasing stream of bureaucratic distractions and financial requirements.
What's it all for?
Just to keep the madness going with the endless testing to death and collection of data, the control and abuse of power. In essence "what has gotten away from us," has resulted in the abusive control of patients and physicians rights. It has been imposed on us by a few run amok ngo's like the ABMS member boards that are making ill-gotten money from it all.
It's up to all of us working together and with our own individual efforts to become aware of what is going on and give a strong intelligent response which will generate real solutions.
The Practicing Physicians of America is a good grassroots response and good faith effort which must be supported. PPA will work if we want freedom to practice medicine and live our lives more than serfdom. It will succeed if we all want freedom more than the status quo of dreaming of change but doing nothing about it.
We are paying into the "ABMS elite investment fund" with our own money just have the right to be indentured slaves and sharecroppers with few rights until we the very end while the elites get rich and the patient gets ever diminishing health coverage created by bureaucratic bottlenecks thrown at physicians at every turn.
To legislate the end of mandatory MOC in each state would be a good goal in which to end slavery to the outdated ABMS. And getting rid of the MACRA requirements at the federal level would be another solid aim.
What are the powerful member societies AMA and ACP actually doing for physicians?
One would not need the PPA if the AMA and ACP actually did what they were created to do. They were created to serve their clients and do what is in the patient's best interest. Now they are only political powder for government and special interests with a little lip service tossed in. Physicians and patients are their financial fodder.
I would much rather put my money investing in an organization that will serve me and not just elite executives and their special interests. That's a lot of reasons why it is better to give our money to the PPA. Practicing Physicians of America is serving patients by working for practicing physicians to get some autonomy back.
Wes - Practicing physicians in every corner of the country are indebted to you.
What I found interesting in the slide show, beyond the $59M in assets in 1999, is that the year started with $46,247,684, on income of $11,150,353. Expenses were $948,933 (Program Service $664,099/Management $284,834. Profit: 1075% !!!! In 2014, revenue was $54.5M, expenses $59.2M. Loss: 8% !!!! Revenue up 5x, Expenses up 65x !!!!!!
great news
I suggest the next ABIM board meeting starts with a motion to end mandatory MOC. Make certification truly voluntary again. It's very difficult to take a broken organization such as the ABIM and put its shattered pieces back together again. Absolutely embarrassing to read hard to stomach commercials parroted by medical scientists and serious academicians. Any mathematician knows the value of a negative number.
ABIM has become just another bad sandwich shop slopping tasteless cheese on meat.
The organization is literally dead and seemingly "nice people" like Rich Baron with his rehearsed talking points will not bring back the heart of the ABIM. Cassel and Baron killed it completely by unwisely harming physicians, engaging in public fraud, and stuffing their greedy pockets with millions of dollars just for carrying out their ignoble acts of infamy. We just can't forget the treachery.
All that is left of the original founding-physician's organization--which they breathed their life force (voluntarily for free) into--are not medicine's sacred obligation to serve--but only faint autonomic pulses in a jar.
http://transforming.abim.org/why-i-serve-marianne-m-green-md-facp/
Anon 05:24, those are noble thoughts that any ABIM insider with a shred of principle or self-respect left would proactively move to self-discontinue #MOC, but the best anyone outside the organization can reasonably expect would be resignation in protest. Like the Confederate commissioners who met with President Lincoln shortly before the end of the Civil War, the ABIM insiders know their once-prestigious organization is surely doomed, but they have no power to negotiate their own demise. That, like the death of the Confederate States of America, will be imposed on ABIM by forces entirely beyond the insiders' control.
Nevertheless, Dr. Rico, we are given the chance in life to make a difference in society for our colleagues, family and friends. Why not take the opportunity to unify the profession by clearing the lump in one's throat and allowing the heart and mind to take the first steps of beginning to begin.
Life is much too short and we live with far too many regrets by taking the trodden road of security for oneself and not the one that will make all the difference. It is a choiceless voluntary act to address the important issues involved in ending mandatory MOC.
It is the obligation of the boards to end mandatory MOC because it is not voluntary at all as they proclaim in public statements, contracts and written materials. This is a glaring contradiction that any federal judge involved in interstate trade and restraint of such trade would find apparent. Racketeering is also a no-brainer for any general adjudicate to see.
Consider this: the ABMS medical boards claim to be voluntary and non-pecuniary, but at the same time they make huge profits that go into the pockets of executives, employees and board members. They make such huge profits by colluding with many non-pecuniary partner organizations--equally as profitable--who help them to make maintenance of certification (MOC) mandatory.
The NCQA, JC, ACGME, XYZ insurers, and AHA are a few of their colluding partners. It is racketeering on an unprecedented commercial and governmental scale. One cannot sidestep the fact that these organizations are all for-profit regulatory bodies acting for the state and corporate special interests. The intertwining of state and corporate actor is disturbing to say the least.
It is obvious that it is the obligation of all the ABMS boards and their members to end mandatory MOC, thereby righting many wrongs and undoing the steady stream of harms that flow out of mandatory "MOC".
HB 723: Maintenance of Certification. Florida filed a bill to ban MOC
https://www.flsenate.gov/Session/Bill/2017/0723
https://www.flsenate.gov/Session/Bill/2017/0723/BillText/Filed/PDF
There are far too many unintended consequences for healthcare, which vociferously stem from the personal inaction of the boards and board members to abolish MOC. But we must also include the financial shenanigans of the ABIM Foundation's "wealth management programs" and its misplaced fascination with "professionalism", which none of the ABMS execs embrace themselves, and we must not overlook the unwise preoccupation with Choosing Wisely.
The dissemination of mandated medical policy and cost-cutting recommendations do not have any proper place at a 'simple' not-for-profit testing corporation established during the great depression to be in the business of offering certifications.
It must be clearly understood and the ABMS boards should follow their own acknowledgement of getting it wrong. But their broad expertise of getting it wrong goes far and wide into the arena of legal wrongs also.
The ABMS lead organization in Chicago and its member boards are not a regulatory umbrella designed to create mandates and measures; they are a completely voluntary bodies (rites of passage type), certification testing entities and nothing more. To pretend otherwise or overlord MOC is wrong, illegal and the surrounding hubbub it creates should be indictable and punishable by law.
Let's be clear, MOC imposed on a physician anywhere in the United States and its territories is conscious manipulative public fraud perpetrated on the public for the purposes of dealing out personal financial entitlements and forging political powers to the executive elites and "non-practicing" board members.
For the ABIM/ABMS to conduct their businesses otherwise than as wholesome non-profit enterprises--sticking to business of certifying physicians--the medical boards and their umbrella organization have consciously entered into the world of profit and politics. It thus moves the ABMS outside their non-profit charitable foundations as a simple certification testing enterprise. They clearly deviate away from themselves as individuals
The executive, employee and board symbiotically transgress together into the realms of being actual paid state and corporate proxy actors, colluding with government and the corporate medical industry. The tripartite relationship of exec, employee, board/council all become liable under the law--even their contractors like Caveon/Kryterion who collude with the ABMS by intending to test with third-party proctors online and then through legally binding (criminal) contracts/pledges spy on physicians. Any "irregular behavior" noticed during testing is open to civil and criminal prosecution with actual prison time a possibility for these amoral entities.
We must also beware of the undisclosed financial relationship between Wolters Kluwer (UPTODATE), the ABMS and Kryterion to deliver open-book online proctored testing. Caveon is now a "standards setting" organization with ANSI and can impose new legal exposures to physicians who "volunteer" to become certified, and participate in "voluntary" online MOC testing from home or ABMS' sponsored testing venues.
We need a kill mandatory MOC bill in every state!
Great presentation Wes!
What is wrong with this picture? Physician fees become lucrative goads; government taxation that opens the door to endless lawsuits which physicians can initiate from the harm it does to them.
And we cannot overlook the restraint on interstate trade which the ABMS has instituted by 'hook and crook' with its myriad of profitable partnerships. If this additive measure of corruption infused into the ABMS' foundational premises in the form of "anything goes policy" does not get corrected, the war against the ABMS executives and proxy armies will be waged by the HHS' OIG, the DOJ, the IRS in conjunction with the FBI's reinvigorated elite crimes unit.
Who has tried on the board to end the industrial-strength war that literally is destroying lives and maims so many. Every action has consequences, just as inaction does. Every board member is responsible for the tax filings whether they are on the financial committee or not.
Who will ease the tremendous physician burdens and free up time for patients? Who will offer up the cup that will make the water flow once more?
I have a good feeling about the PPA. Thanks so much to all! Can't wait for the congressional hearings. Which committees? Oversight committee headed by Jason Chavetz would be a good one as there are certain improprieties/misconduct that involved Christine Cassel while working for/at the ABIM/NQF/Kaiser/Premier and her PCAST role at the White House. Cassel, Baron, ABIM used their positions in government to empower themselves to solicit and push for legislation that enhanced their financial and political hold over physicians and the patient. The interstate commerce committee would be a good one for the ABMS' obvious acts involving restraint of trade. Judiciary committee would be good for violations of non-profit organizations involved in profiteering/racketeering/self-dealing/tax evasion.
What Kelly Ann Conway did to endorse products of Ivanka Trump using her government office was politically dumb/sanctionable but nothing compared to Christine Cassel et al. (See attached oversight committee ethics letter.)
But what the ABIM/ABMS has done utilizing their corporate influence and use of state actors like Cassel, Wachter, Baron and associated political entities to push partisan agendas/financial boons is almost in a league of its own. MOC and Choosing Wisely beg to be investigated by the DOJ with indictments handed out. It is that serious and the corruption is widespread, not just local at the ABIM. It involves an archipelago of revolving door NGO's. The implications of using a testing company as a front for political action/financial gain to have the freedom to do politic around in high style is more than reprehensible. Consider Cassel/Clinton and their decades-long relationship forging healthcare policy and legislation.
Through back channels made possible by physician fees, the ABIM and ABIM Foundation have been utilized to create intervention/restrictions/rationing via Choosing Wisely campaign and its domestic/global dissemination in healthcare arenas. CW was specifically designed through congressional back channels/professional medical politicians to complement the costly PP ACA created with much opposition by the Obama administration. These are obvious to anyone close to the ABIM/ABIMF/ABMS what they have improperly done in concert with many NGO's behind closed doors. Proof of the collusion is in MOC being included in the ACA. Therefore the misuse of non-profit NGO's needs to be investigated thoroughly. Otherwise there will be more lobbying and political appointments such as the spate of Democrat fundraisers/political chiefs that ABIM has attracted to itself. Suzanne Biemiller and Judi Cassel are two of the recent to come onboard in the post Cassel regime under Rich Baron.
What's more it has become an accepted norm among hundreds of medical ngo's cheat. This illegal and fraudulent misuse of tax advantaged organizations for personal and political gains needs thorough investigation and judicial action where some heads roll--we don't mean the guillotine--but serious prison time.
The sting operation led by Cassel, Langdon, Baron, Holmboe, Weinstein, Mannes, and so on, must be looked at seriously as well for its political implications and abuse of federal power by Christine Cassel, et al concurrent to her high ranking position in the White House and close relationships with Pennsylvania's powerful elite in the legal arena such as former governor Ed Rendell (Ballard Spahr) and his wife at the time a key federal judge in Philadelphia.
Anon 12:59, you're absolutely correct in that all of us are responsible as individuals for the results, both intended and unintended, of our actions on others. History teaches us the lesson of the Nuremberg trials, that there is no collective guilt ("it's all the fault of the crazy guy in charge who killed himself, I was just following orders"). So I will second your encouragement to Dr Baron and the rest of the ABIM principals to look outside their sheltered Philadelphia bubble and do what they know is right while they still have the ability to do so. Before long, it won't matter.
American Board of Radiology: more ABMS financial and testing security embarrassment
(990's and ABR testing cop jumps ship for Caveon)
More obfuscation on tax forms; this time regarding former ABR executive director Dr. Gary J. Becker who got $821,500 for 2014 as a former employee! Wow, Becker got more in "other compensation" (over half as much again) than in his base pay. And what is that "tax free" money all about, plus the "retirement and deferred" payout.
What undisclosed "Lynn Langdon-like" enterprises were he and the others involved in at ABR. (See schedule J, part II) In 2013 Becker made over $703,000 claiming to work 80 hours of work. That is nearly three times the hours of work than the ABIM head.
ABR, which does not make audits available to the public, failed to report Gary J. Becker on their tax schedule where it is required in the front sections. But in the back of the 990 tax filing form they slip it in where one has to turn ones head sideways to see it. There it is near the end tucked away hoping folks would not see it. The other executives also get tax free money and deferred retirement as well. Companion travel. And they should have explained what all those non-taxable compensatory benefits were about on schedule J, part III. But it is all left blank.
The former associate executive director, Jennifer Bosma, PhD, who probably did the previous years actual work, got 186,000. Bosma is currently with the ACGME radiology committee as a public member. In 2013 filings she made $283,000.
This is a sweet deal for the ABMS and its executives who created their own testing centers for initial certification and MOC. More money for the executives. What's that testing property and equipment worth (as a real estate investment) in Chicago and Tucson. And they mostly cut Pearson Vue out of the deal except for some incidental MOC and medical physics testing.
One sees that ABR also has ABR International and ABR Foundation as financial and political pontoons and a lot of investments in securities overall.
ABR tax filings (990's)
http://www.guidestar.org/FinDocuments/2015/410/773/2015-410773787-0c021161-9O.pdf
http://www.guidestar.org/FinDocuments/2015/363/481/2015-363481016-0ca7029e-9.pdf
http://www.guidestar.org/FinDocuments/2014/363/481/2014-363481016-0b2a28c2-9.pdf
http://www.acgme.org/Specialties/Review-Committee-Members-and-Staff/pfcatid/23/Radiology
http://opa.ahsc.arizona.edu/newsroom/news/2006/radiologist-gary-j-becker-md-named-chairman-rsna
Big money going to testing centers and "big brother" testing security spies
ABR's former associate executive director Jennifer Bosma, who appears to have a solid resume in the "quality assurance" field, previously worked for the National Council of State Boards of Nursing which gave their lead testing contractor NCS Pearson/Pearson Vue nearly $56 million dollars in 2014 and $45 million in 2013. That is a lot of money. How much does the ABIM and other ABMS member boards give to their testing centers? And are they planning something similar as the ABR to cut out Pearson, Prometrics, or Kryterion.
Will they start their own testing centers like ABR did? This is one very lucrative business. Add in the testing security spies at Caveon and online proctored testing platforms. and it becomes quite a party/competition/money fest.
The American Board of Pediatrics has been a client of Caveon for many years. ABIM's Rebecca Lipner is presenting with Caveon this year. ABR's test security expert Joe Kamell has joined Caveon recently. ABIM's director of investigations/contractor ex-cop/felon Ariel Benjamin Mannes worked/works for ABIM and Caveon/Kryterion and others. Ballard Spahr's former "ABIM v Arora attorney" Marc J Weinstein has had an undisclosed long term relationship with Caveon where he presently works as investigative manager and privacy attorney. It is quite a "who's who" of ABMS conflicts of interest!
This suddenly appeared on the internet as other documents disappear.
https://abpedsfoundation.org/conflict-of-interest-declarations/
http://www.innovationsintesting.org/media/ATP2017_ProgramBook.pdf
Of interest: ABR's Gary Becker in 2012 discussed Radiology candidates'(widespread)use of non-sanctioned residency study materials. CNN and pdf statement follow. This scandal appeared just in time to get on "60 minutes" (MSM) and served to launch ABR's new proprietary testing platforms and "healthcare reform" MOC incentives sponsored/fostered by the ABMS/Cassel/Baron/Wachter/Weiss/CMS courtesy of the framers of the ACA. The ABIM/ABR/ABMS insiders involved in creating the cheating scandal have now been identified. There is a great deal to be suspicious about the timing and the key players as though it was all orchestrated for the media and to once more demonize physicians and not the corrupt money-grubbing/highly conflicted quality assurance system that is in place in Chicago, Philadelphia and DC.
CNN interview w/ Dr. Becker ABR: "Questions and answers have been memorized, sometimes verbatim, and contributed to extensive archives of old ABR test material that become the prize possessions of many residency programs," Becker said in the video, which appears on the board's website.
He said "accumulating and studying from lists of questions on prior examinations constitutes unauthorized access, is inappropriate, unnecessary, intolerable and illegal."
About half of the questions on the radiology test are the same each year.
"The half of the exam that is not new comprises questions from a variety of previous exams, not from the prior year," Becker told CNN.
"As always, the assembly of the exam is governed by the blueprint created by the ABR for that particular examination. All questions are reviewed for currency before being reused."
http://i2.cdn.turner.com/cnn/2012/images/01/11/abr.exam.security.statement-01-07-2012.pdf
http://www.cnn.com/2012/01/13/health/prescription-for-cheating/
Is ABR, ABIM, ABP, ABMS cunningly securing the MOC money pipeline through the launch of new technology and testing security measures? ("We are listening to the dissent."). Are physicians going to sleep falling in a trap with cleverly constructed ABMS promises rife with empty words of "change"? Or is it all just a well-documented show for the DOJ and IRS to keep the ABMS executives, helpers and boards out of jail?
2012 ABR statement (about the precarious situation) for CNN viewers.
"EXAM SECURITY
5
6 The American Board of Radiology (ABR) serves the public.
7
8 CNN viewers should know that the ABR plays an important role in protecting patients and the public by
9 ensuring that radiologists are able to safely and accurately interpret and perform imaging studies and
10 image‐guided procedures. After a long and arduous path of education and training (Attachment 1), the
11 certifying process demonstrates that doctors are competent to safely and effectively interpret imaging
12 studies and perform image‐guided procedures. Once in practice, they must participate in a program of
13 continuous professional development known as Maintenance of Certification (MOC).
14
15 ABR is replacing its proven and time‐tested exam format, which includes an oral exam, with new,
16 highly‐standardized, computer‐based exams that will be more objective and better able to assess the
17 abilities of the physician examinees, without measuring extraneous factors not uncommon when
18 candidates take the orals, such as nervousness. As we proceed, we leave behind a proven test of
19 clinical reasoning. Not surprisingly, ABR is determined to safeguard the integrity of its certification
20 decisions by ensuring the security of its new examinations.
21
22 Today we live in a world of instant information sharing and are aware that recalled test
23 questions(“recalls”) have been passed around and used not only to guide study, but at least by some to
24 memorize exact questions and answer options, so as to increase chances of passing when these
25 questions were encountered again on future examinations. The latter is a violation of ABR rules and
26 constitutes cheating on the examination. Still, that was the past, and it involved the “written” Qualifying
27 Examinations that are taken in residency, not the ABR’s highest‐stakes Certifying Examinations which
28 serve as the final assessment in the certification process, at the completion of residency training.
29
30 We cannot change the past. But we CAN prepare well for the future. Since December of 2007, ABR
31 staff, volunteers, and the ABR Board of Trustees have been working tirelessly to produce our computer32
based Core and Certifying exams that ABR will begin to use next year. These new tests will assess the
33 doctors’ abilities to actually interpret imaging studies and perform image‐guided procedures rather than
34 just memorize facts. In March of 2011, we began to put in place a critical foundation block of this effort:
35 an exam security culture change. In our outreach to residency training program directors, faculty,
36 program coordinators, department chairs, and residents, we are doing everything in our power to
37 ensure that the exams are a fair and accurate reflection of a doctor’s abilities and not just a test of
38 memorization. Today the definition of cheating is both crystal clear to all involved and rigorously
39 enforced. As a very important addition, we are attacking the root cause—the motivation for use of
40 recalls—by increasingly providing useful study and preparation aids, such as study guides and practice
41 exams, and emphasizing the critical importance of candidates’ professionalism and ensuring the public
42 trust."
On ABIM's website Rebecca S. Lipner's longstanding relationship with the test security/test spy company "Caveon" has never been disclosed. Why? It is one of the most significant possible conflicts of interest at the ABIM and ABMS and we believe this very important conflict of interest and many others should be included on the ABIM's website for anyone to see. I have requested "further information" from ABIM about many subjects and the answer is always e-mail us about that with the answer always being "no response". Why? We have learned of the extensive cozy relationship of the ABMS and Caveon. We have even seen one brief disclosure referenced above. Isn't it time that the ABIM and ABMS medical boards disclose everything about their violations of privacy and civil liberties, but especially the lucrative conflicted financial relationships that propel and protect the "quality assurance industrial complex". I find all this more than troubling. It shatters my faith to the core and destroys all possible future trust in the ABIM, its "umbrella" and all the other medical boards. What's worse Caveon does not disclose anything about itself. They are not even listed with the state of Utah where most of the principals reside and work "from their homes". Their videos of the principals on their website has them standing outside some glass office building, which is totally unrelated to their business. Many of the Caveon "senior members" are testing industry insiders with long histories with Pearson, ATP, Prometrics, etc. Read Rebecca Lipner's profile well. Look online for yourself for her continued relationship with Caveon and the ATP. Look at Lipner's "ABIM sponsored research" (113 listed articles on ABIM's site) and so on and ask your own questions about whether physicians are being played and scammed by some of the best schemers and unfortuneately lowest elements of our society. I am disgusted!
"Rebecca S. Lipner, Senior Vice President, Assessment and Research
Dr. Lipner is Senior Vice President of Assessment and Research at the American Board of Internal Medicine, where she oversees a team of measurement and research design and analysis experts who employ measurement principles and both qualitative and quantitative methods to ensure and enhance the high quality of assessment programs across the ABIM enterprise while disseminating evidence-based research findings to the public. In this role she ensures that ABIM assessment products remain relevant to the practice of internal medicine and identifies new possibilities and innovations in assessment and technology that guide research and development initiatives.
Dr. Lipner is also responsible for the exam development, scoring, statistical analysis, standard-setting, equating, security and evaluation of measurement properties for ABIM assessment products including innovative items types such as procedural and case-based computer simulations. She also oversees research analysis including survey research, internal medicine workforce trends, and health outcomes research. Prior to joining ABIM, Dr. Lipner held a variety of teaching and faculty positions at Drexel University, St. Joseph's University and the University of Pittsburgh, where she taught undergraduate and graduate courses in statistics, tests and measurement, experimental design, systems analysis and design, and expert systems. Dr. Lipner received the Research in Medical Education T. Hale Ham Award for New Investigators in 2003.
Her research interests include computer-adaptive testing, high-stakes testing and assessment, statistical modeling, experimental design and the use of simulators in testing. Dr. Lipner is a frequent speaker on these subjects and is widely published in professional journals, including the Journal of the American Medical Association, Annals of Internal Medicine, Academic Medicine, Applied Measurement in Education, and the Journal of Educational Measurement.
Dr. Lipner received a doctorate from Drexel University and a master's degree from the University of Pittsburgh. She graduated summa cum laude from City College of New York, where she received a bachelor's degree in Mathematics and Psychology. She is a member of the American Educational Research Association, the Association of American Medical Colleges, Generalists in Medical Education, National Council on Measurement in Education, AcademyHealth, and the Association of Test Publishing, where she served as Program Committee Chair and Vice-Chair from 2006-2008. She currently chairs the American Board of Medical Specialties' Psychometric Advisory Group and serves on the Medical Council of Canada's Technical Advisory Task Force.
Disclosure of External Relationships
As of January 2017, Dr. Lipner reported the following ongoing relationships with other healthcare-related companies:
Other compensation from other not-for-profit healthcare-related organizations:
Dr. Lipner serves as a consultant on a National Institute on Aging grant through Dartmouth/VA Researchers to study the efficiency of healthcare for physicians who have gone through Certification or Maintenance of Certification, receiving consulting fees, paid to the American Board of Internal Medicine.
She also serves as a consultant on a Patient-Centered Outcomes Research Institute grant through Dr. James Tulsky of Harvard University to study ways to improve doctor-patient communication, receiving consulting fees, paid to the American Board of Internal Medicine.
ABIM collects—and members share—information in much more detail than is reported here. We welcome questions about our Conflict of Interest (COI) policies and processes. Please contact us at ABIM Governance Services if you have any questions."
Lipner et al 113 listings of ABIM "research".
http://www.abim.org/search.aspx?q=lipner&o=0
What about ABIM's frozen assets?
And then there is the defunct ABIMF-generated Institute for Clinical Evaluation (ICE) - paid for with secretively transferred physician fees. (After the second registration of the ABIMF with PA and IRS was told ABIMF was in IOWA. Where was ICE registered and claimed on ICE's 990's?)
Rebecca Lipner was involved in this failed ICE project costing millions of dollars in "frozen" physician fees. Read the study sample below of ICE-related "dry air" and understand for yourself why it was pulled. (More ABMS pseudo-science and obfuscated financial shenanigans.) But in all their endeavors at the ABIM they never addressed why their psychometricians/executives at the ABMS were failing so many physicians. (evaluation problems? incorrectly/randomly failing? or consciously failing them?). As Wes pointed out ABIM employees don't care about patients or physicians and how they are affected. I believe they live in their cunning heads without heart anymore, burned-out and sold-out psychometricians, looking only to the bottom line and how to protect their lucrative paychecks. This needs to be investigated.
http://iacat.org/sites/default/files/biblio/gu02-01.pdf
What about the American Board of Pediatrics and their rich assets?
http://www.credentialingexcellence.org/ncca
http://www.credentialingexcellence.org/p/cm/ld/fid=34
Imagine this...a formerly disgraced/disbarred attorney effusively renders praise upon a strong-arm thug who happens to be a convicted felon. While simultaneously engaged in an inept character assassination attempt against a well respected cardiac electrophysiologist- cum- investigative reporter, who has tenaciously picked up the sword against Goliath. Truth stranger than fiction. If Hippocrates is blushing, then Draco must surely be in severe gastrointestinal distress.
An ad hominum attack in defense of a felon? How pathetic. Referring to Mr. Mannes's lawbreaking antics as a 'blip' is a whitewash. A cheap euphemism to distort the realities of the crime. So transparent as to call into question the veracity of any argument that follows. There is no landfill large enough to hold the Counselor's verbage.
On the other hand, Mr. Mannes's association with the ABIM is quite natural and fitting. A...let me repeat...a convicted felon working with an organization that has evolved into a core-corrupted entity. Run by a cohort that should be held accountable for actions that rise far above the the level of a mere 'blip'.
So now, the ABIM and its henchmen have set their sights directly on Wes Fisher. They should know of the groundswell of support that exists for him. Mr. Baumgarten appears to be leading the charge of a contentious new PR campaign designed to confound and intimidate one of the ABIM's most articulate and outspoken critics.
One can only speculate as to the ongoings of the ABIM strategy sessions led by Herr Doktor Richard Baron in his besieged bunker. I do not take the present proxy actions as originating from a position of strength. Rather, I smell the blood of a wounded predator.
Wes, keep up the good fight. And know that there are tens of thousands of us who stand behind you.
Post a Comment