On Wednesday, the American Board of Internal Medicine (ABIM) quietly announced their much-anticipated "modifications" to their Maintenance of Certification program on their blog. As expected, rather than ending the MOC program, ABIM has decided to double down and justify their unproven process using an edited video of Skype sessions from their most fervent (paid) supporters.
The ABIM reportedly conducted invitation-only "listening sessions" accross the nation. On the basis of those sessions and months of focus groups and navel gazing, the ABIM unilaterally decided that an "open-book" examination that physicians must participate in every two years could serve as an "alternate pathway" to "maintain" a physician's (previously lifetime) Board certification. They then had the gall to say these were the changes we requested. They weren't.
In actuality, those "listening sessions"were invitation-only. (Yes, I applied to attend the one here in Chicago but was never granted an "invitation.") Selection bias of diplomates was the order of the day. And as their legal fees mount, ABIM has yet to mention what they plan to charge recertifying physicians for their new "pathway." Rest assured it will be plenty.
By now, practicing physicians understand what MOC is really about. It is NOT about making money, physician ongoing education, assuring physician competency, care quality, or patient safety.
MOC is about the control of physicians.
Control doctors and you control health care delivery. Control doctors and you can shape them to corporate ways. Don't like it, dear doctor? Then leave. We'll find someone else to take your place and your patients.
But replacing experienced physicians is not so easy. It takes years to gain credible experience in medicine. MOC is not about experience, it is about rote memorization and data entry. And what the ABIM doesn't get is referrals are still not always guided by who your employer is, as much as corporations and the government try to make it so with their consolidation attempts. They can "innovate" all the new ideas they want, but doctors are not fooled. Tie MOC to credentials or to insurance company payments if you want, but extortion is extortion, no matter how you color it. Because ABIM has not taken accountability for their serious financial transgressions and strongman tactics used to protect their monopoly, they will remain a pitiful example of corporate greed to practicing physicians (the people they claim to "help") and little else.
The Accreditation Council of Graduate Medical Education (ACCME) and their powerful member groups (The American Board of Medical Specialties, American Medical Association, American Hospital Association, the Council on Medical Subspecialty Societies and American Osteopathic Association) know billions of other reasons MOC is important, too. MOC generates about $2 billion in revenue annually for these organizations when one considers the endless board review classes and registration fees for their members. Condos, limo rides, first class airfare, gym memberships, and multimillion dollar golden parachutes are dependent on this program. All done without proof of value to doctors OR their patients. All done without any assessments of MOC's potential harms. The fact that our bureaucratic academic leadership in medicine will not address the many problems uncovered on this blog's pages and what this means to patient care in America is more even concerning than the ABIM's missteps in my opinion.
Doctors have had it with the outright dishonesty and scandal that has plagued MOC from the beginning, especially when they're dealing with much more important life-and-death issues every day. The only realistic and honorable revision for MOC is to end it, or for every practicing physician to refuse to participate and allow MOC to wallow in it's own avarice and greed.
-Wes
23 comments:
Yes, I too received an unsolicited email from Dr. Richard Baron this week. Hollow words backed up with commentary from his sycophantic cult followers. Have you ever noticed that Dick's emails never have an 'unsubscribe' option? A small but telling example of ABIM hubris. Thank goodness for spam filters. A fund transfer request from a Nigerian prince would have more street cred.
Welcome to another episode of the ABIM's "brand-new" Punch and Judi Show.
It only took them how long to write the script?
I resent Punch and the Grand Puppeteer for turning physicians into puppets (Judies) that can be so easily manipulated and controlled.
http://transforming.abim.org/spring-2017-update-tentative-timeline-for-open-book-and-options-you-requested/
I have a dream that we can climb the mountain together and be free.
Mandatory MOC must end.
The American Board of Medical Specialties, through MOC decrees, exorbitant fees, ever-changing policies and execution of those policies creates slavery for physicians. These policies are transformed into mandates by affiliate organizations and those mandates are then easily imposed by each of the 24 medical specialty boards, with an emphasis coming from its right arm the ABIM. Through cunning and manipulation of physicians the ABMS in collusion with the rest of the quality assurance cartel creates power through systematically disseminating a feigned solidarity with physicians. There is built in to the system an underlying primary existential fear allowing ABMS to achieves and maintains an unnatural maintenance of control over the medical industry. The existential stick is, to put it bluntly, the fear of whether a physician will be able to work or not.
The ABIM (ABMS) can produce and sell all the CME it wants, as any business can, but participation should be voluntary with their company. Certification should be as it always was - for life. Other certifying boards should and must be encouraged. All unfair business practice and trade restraints must cease.
The voluntary nature of certification was agreed to from the beginning, but now the entire ABMS has breached its contracts with physicians. In fact the ABIM has failed to follow its own bylaws about the duration of the contract it had with itself. (1936 bylaws, "fifty years or less.")
ABIM was originally intended to be only five decades or less in duration. Its purpose was for establishing order not creating a secondary system of education for "keeping up". Certification was never about a qualifying factor for employment or reimbursement. The test was testament to one's own "rite of passage" as a scientist physician in modern medicine with standardized training and not a "snake charmer" or "charlatan". The "snake charmers" have been eradicated or put into their compartments long ago, that's why the founding physicians put a disclaimer on it stating that there was a time-limit to the necessity for a physician's voluntary participation with the medical boards. The order they were seeking was established back in the 1940's, well before the 50's and 60's, but then something happened.
The ABIM and ABMS sabotaged their bylaws and broke their contracts with physicians and the public. Instead of being "of the physicians for the public", they were transformed into entities secretly engaging in activities 'of the government and for the corporation'. The medical boards became politico-corporate mechanisms supporting healthcare reforms, social security controls, and engaging in corporate and Wall Street manipulations.
A private testing company should never be allowed to be transformed into a body that wields unelected, and unregulated power. Especially so, in a free democratic society.
ABIM (and ABMS) in the beginning made a pledge to all physicians who chose to take their "test" and register with them, that certification would be lifelong. They broke that pledge. This needs to be corrected for it shows deceit.
End MANDATORY MOC. End the slavery. Make certification for life again.
MOC is wrong, unconstitutional, and overreaching. MOC is a blatant abuse of power that with the advent of MOC, certification was imposed against one's will and "legislated" into a ruthless mandate.
Physicians are being controlled and made to pay extraordinary sums, and manipulated into an unholy conformity by being unduly tested to death.
Viceroy Baron of the ABIM and the Her Majesty of the ABMS still do not get it. They continue to cheat and exploit us. They threaten us, and even bribe the local governors to maintain strict control.
The ABMS' Viceroy Baron and the Empire's Queen Nora continue to forbid us (physicians) from twining our own yarn (medical knowledge) and making something of our own out of it.
Of course the Crown says we are free to follow our own pathways. But in fact, we cannot, because if we do seek knowledge solely outside the Crown, we will be told we are not 'keeping up' with their exacting bureaucratic mandates. We will be decertified and not allowed to be paid unless we pay the obligated work tax they annually extract from us.
If we don't do their MOC busywork every two years, and keep up in between, we will be fired from our positions. The passion for learning is quelled by them. Trust has become a bruised piece of fruit. And for all these years of indignity, distraction and suffering we are obligated to pay them?
Viceroy Baron and Queen Nora have us by the spools of their own fabricated yarns. Yet the irony is everyone understands the ruse and sees through them; nobody believes their spin.
And equally as troubling, they deny us something as basic as salt. (The goodness of the earth; the right to wholly care for a patient.) We are not allowed to use heat of fire or dehydrating power of the sun to make our own salt from the bounteous sea.
What they are doing is wrong. Please just say no to them. Come walk to the sea and make salt with me.
Signing up for ABMS certification and MOC can be even worse than some of the worst scams involving reverse home mortgages. Read the fine print of any contract before you sign. You and your family may lose your home and pay property taxes and other hefty fees down the road. They might foreclose on a vulnerable senior (and their family) leaving them without a home. It happens more and more often that some senior is scammed.
Now its physicians who have been in the ABMS reverse-certification markets
With the ABMS medical boards you already lost your lifetime certification, and you may lose your (once-upon-a-time) lifetime certificate if you are grandfathered and play the ABMS game. Watch out for pledges and sanctions coming at you from nowhere. Even years later as in the case of Dr. Salas Rushford of Puerto Rico. The ABIM has already stolen five years of his career and life. And if you lose your certification, you will lose the right to make a living.
When you lose your right to work, you can even lose your home. (Worse than a reverse mortgage because of the onerous legally binding pledge of honesty opening you up for an anyime attack. There are no statutes of limitations when the ABIM's lawyers have sway with the federal court.)
And now with an ABIM proctored test on the testing menu, and hence a pledge every two years, (more if you fail) you will have to sign a legally binding contract many more times. Biannually.
That translates into even more chances for Mr. Ariel Benjamin Mannes of the ABIM, or some other thuggish ABMS "Director of Investigations" to persecute you. The ABMS is not saying anything about how it works - the online "proctored" test. Not even the slightest detail to the insouciants who think they are getting a break from Rich by having to test five times instead of once in 10 years. That means you sit in a testing center (or your office/home if your computer and room happens to qualify) with 15 hours of nervous breakdowns spread out for you conveniently. NO mention of the nervous cost to you and family or patients. Think about the ludicrousness of an open book test using up to date or whatever they restrict you to (fees go to the ABIM for whatever sources they work with).
Read every word of what Baron says and what he does not say carefully, because everything they say is actually confused/confusing and is a way of more non-disclosure and concealment of what is really going on.
They ABMS hires Caveon and more of their undisclosed testing security friends to try to catch you engaging in what these Utah-based forensic experts might interpret as irregular behavior. That kind of regular scrutiny (every two years or more) might land you in civil or criminal court. The ABMS contractor Caveon has helped throw teachers in Atlanta, Georgia in jail. They spied on kids in New Jersey. The testing security industry is very incestuous and you are prejudiced as a cheater from the beginning.
They have already been spying on you. Fight the ABMS and fight for your right to privacy and civil liberties. The right to not be extorted.
The Strange Case of an ABMS Medical Board Running on Empty, Spinning Its Wheels in Reverse
In case anybody missed the fact-checking article Wes previously published on ABIM's "director of investigations" Ariel Benjamin Mannes in response to ABIM's friend/counsel Sidney Baumgarten's letter to the editor, it is very informative and insightful. Esquire Baumgarten in the past was disbarred for engaging in fraud and severe conflicts of interest in his capacity as an attorney for clients.
It looks like Sidney Baumgarten may be in the unpopular business of scamming very old women out of their homes with some of his other interesting business partners. Even if he did nothing legally wrong the appearance of it online is troubling. Where does the ABIM find such felons and frauds as Mannes and Baumgarten? How does a medical board even vet a convicted felon with such a horrifically bad record as Mr. Ben Mannes? aka Ariel B.
How about Baumgarten who appears to have hidden behind a mocked-up military record after he was caught defrauding clients as an attorney! He appears to have made a cottage industry for himself out of the horrible disasters involving New York City terrorism events - a disgraced lawyer wearing a retired reservist's military uniform around the CITY to garner respect?
I mention this because Baumgarten gets himself involved financially and personally with convicted felons a lot. Colonel Sidney Baumgarten had some association with a 911 fake responder who defrauded FEMA and Homeland Security for fake reports and money scams. Baumgarten's associate was convicted for taking money that he was not entitled to and inventing fantastic stories of his involvement in the 911 aftermath and in Hurricane Katrina.
No wonder Baumgarten got heated and sensitive to Dr. Fisher's accurate reporting about Mannes, the ABIM's director of investigations. There is more to their community crime watch stories and why they hide behind these images.
What other friends does Baron and his "testing company" have in their pockets to threaten and persecute physicians with? Dr. Fisher, in his rebuttal to a letter submitted by Sidney Baumgarten to a Philly medical journal, responded extraordinarily well and even stood his ground against the ABIM/Mannes/Baumgarten's threat and personal attacks. Almost anyone else would have been crushed by such an obvious but awkwardly placed personal threat.
Has Sidney Baumgarten may have been directly involved in taking advantage of very old seniors in reverse mortgage loan scams? It needs investigation, but it appears so, from publicly available documents. Maybe Dr. Baron could address the issues of ABIM's undisclosed director of investigations, his disputed felony convictions and what on earth he was doing working at the ABIM and ABMS? What kind of relationship did Baumgarten have with Richard Baron. Richard Baron was actively involved in 2007 onward in investigating/persecuting competing board courses and physicians who attended them. Dr Baron for his service outside his job description as a board member and officer was given the top job at the ABIM.
So did A Benjamin Mannes also make an industry for himself out of persecuting physicians, hiding his police record and felonies, while flaunting his highly misleading security intelligence background around at parties and conferences to the disgust of many who have actually looked at the facts involved in Mannes and Colonel Baumgarten's "careers".
Baron is distancing the ABIM from this whole thing with counter-measures and propaganda/PR/disinformation campaigns that have only seemed t backfire on him. The more Baron tries to prop himself and the ABIM up on the "high dive" the bigger his belly-flop in the water. Everything the ABIM is doing appears like Dr. Baron is putting an expensive-to-run vehicle in reverse. Lots of wet mud flying and they are still going nowhere.
What other friends does Baron and his "testing company" have in their pockets to threaten and persecute physicians with? Dr. Fisher, in a rebuttal to a letter submitted by Sidney Baumgarten to a Philly medical journal, responded well and even stood his ground against the ABIM/Mannes/Baumgarten's threat and personal attacks. Almost anyone else would have been crushed by such a threat. There are still many questions remaining unanswered.
Online proctored open-book testing? No research data has been provided that it will not just burden physicians more. No data has been provided on how well it works even as a beta-test. Diplomates will have to cram anyway. Open book is meaningless and absurd in a timed/recorded test session lasting three hours.
Where are the research results and who will the vendors be going forward partnering with the ABIM/ABMS? And how long can they legally keep the recording of your test and forensic data registered during the test? Will they suddenly discover years later that you got up to go to bathroom and nullify your test, sanction you and sue you. Or that your keystrokes appeared nervous or the pattern changed after fifteen minutes into the test. How long will their forensic experts take to go through all the recorded sessions? Will they say, just like the traffic camera folks that one year ago we just discovered that you went through a forbidden zone and the statute of limitations began on the day of discovery. You will have forgotten that you went to the bathroom (the forbidden zone) and now your open book test has drawn suspicion and they have suspended your ABIM certification. You will have no way to defend yourself from them, because you wrote down ABIM's copyrighted questions when you went to the bathroom they will say.
The two-year tests will only be available on certain days to prevent copyrighted material form being stolen and redistributed. The ABIM has created a nightmarish scenario of endless cramming for tests rather than improving anything. Open-book won't work. They have no proof or evidence that YOU can get through the test and answer all the questions without cramming the knowledge in. The test becomes a prison sentence and not a pardon from the 10-year test. The first test will be a total guess for them. No data is in at all for these PSYCHO-Metrics odd birds who believe in their own hocus pocus to evauluate. Who evaluates the esoteric world of PSYCHO-"M's" involved in statistical uncertainties.
ABIM in 2016 conducted online open-book ABIM test research using live test subjects? Ok, now where are the research data Dr. Baron promised to publish in April, 2016 that would be coming "by year's end"?
Also, where are completed feedback reports from the invitation-only randomly-selected two control groups?
At the end of this posting there is an excerpt from a Medscape article discussing ABIM's spring 2016 plans for testing their new online open book testing concept with Diplomates, Pearson Vue and UpToDate. One year later and now without warning the ABIM's Dr. Baron announces the new testing plan and not the results of his study. Absurd and Dr. Baron uses nice ABIM shills to Skype their confidence in the new pathways. Who is their targeted audience? This whole thing shows how inept, utterly incompetent and out of touch the ABIM really is. They cannot keep up with their own nebulous plans, because they are winging it every day. How can anything be scientific coming from a primarily political action group anyway?
The only efforts ABIM made to communicate anything of substance about their new pathway is to set up a totally new account for directing their questions to low-level staff members highlighting the word "MD" after RBaronMD@ABIM.org. Did the ABIM chief of staff really think that physicians who have years of experience with little to zero access to the ABIM executives would suddenly be able to just get Rich Baron on the phone?
Instead of ending mandatory MOC the ABIM has sloppily stitched together vague plans and a head-fake email account making it appear that you have direct access to the ABIM CEO/President for answers. Unbelievable. Candidates and Diplomates have no direct access to anyone of high rank at the ABIM or any of the ABMS medical boards' executives and never will. Rich Baron has been "working from home" most of the time during his 35 hour-per-week cushy political career there. In case anyone doubts this the ABIM's Walnut Street elevator is designed to stop on the executive Suites on the luxuriously remodeled 17th floor. They have added so many new executives over the past several years that they have no room for the elites to work there.
"The ABIM has invited a select group of internal medicine diplomates to complete a 5-hour pilot exam at Pearson VUE testing centers across the country between April 17 and September 1. It is not an actual MOC exam that will affect their certification status, and it covers only about 75% of the real thing anyway, Dr Baron told Medscape Medical News. However, because the pilot exam represents a bona fide learning experience, participants will receive 20 MOC points in addition to a $250 honorarium.
One group of randomly assigned physicians will take the pilot exam with access to UpToDate, an online information resource for clinicians. A second group will not have access to any online material. The ABIM will compare the test scores of the two groups, survey them about their experience, and solicit recommendations to improve the test. Dr Baron said his group hopes to publish the results by year's end.
If and when open-book testing becomes a reality, the ABIM probably would consider a variety of online information resources, and not just UpToDate."
Will ABIM and the ABMS let us see the contract they have and when they were signed with all their third-party vendors and contractors?
Is it fair to say that EU-based Wolters Kluwer, the parent company of Uptodate, is now an official ABMS testing partner?
Control the physician and control the medical industry. Globalist monopoly and medical industry hegemony are next unless physicians wake up and resist.
In 1965 the ABIM ceased to exist as a certification company.
The ABIM has been completely exposed for what it is: - a Ponzi-style hedge fund maintained to be at the disposal of elite professional medical politicians in order to manipulate medical professionals and influence the healthcare industry for the benefit of public and private special interests. This scheme is mirrored throughout the 24 medical boards and emanates from central ABMS policy and mandates.
Furthermore, the ABIM is now clearly a fake certification company engaged in propaganda and bogus testing science. The pattern repeats itself throughout the ABMS.
Recent investigations into conflicts of interest at the ABIM and other medical boards reveal that key executives have tremendous appetite for cash and political power. Some boards like the ABIM have covered over tax anomalies. Clear obfuscations and obstruction in in non-existent financial transparency and legal proceedings demonstrate an unwillingness to open the books and let forensic sunshine clarify the organization(s) accounting and operations.
This insistence on opaqueness (while claiming transparency) speaks volumes and points to political and financial abuses of the organization for personal and political gain. Medical politicians and the quality assurance industry have colluded to snare physicians into a constant state of being extorted for fees and coerced into doing useless activities that feed the quality assurance industry and the powerful corporations and special interests they serve.
A series of connected organizations in the quality assurance markets have been using the organization (ABIM and ABMS boards) to self inure themselves beyond belief. The executives of these organization, and in particular the ABIM, have been pillaging not only the client but the taxpayer through falsely claiming non-profit status. The avoidance of paying taxes, when it is clearly warranted is reprehensible for the key executives. They can no longer keep carrying on in the way they have. Such uncooperative and ignorant behavior warrants sanction and further investigation by federal authorities.
The ABIM has been despoiling constitutional guarantees of all Americans by setting dangerous precedents. They have engaged in atrocious abuses of their clients, including privacy violations, militant invasions of civil liberties, due process, and defamation. The ABIM in collusion with the ABMS has been involved in the plundering of huge sums of money by means of secret transfers (money parking, laundering of cash and high risk investment instruments) and the creation of illicit foundations with money acquired by means of for-profit activities such as one would find in any unfair business engaged in such crooked practices.
The entire ABMS has been engaged in price fixing - setting prices in excess of market value.
Such price gouging has been achieved by extortionist policies set by all the medical boards. Extortionist policies became mandates through collusion of quality assurance industry unfair business practices and trade market manipulation. Mandates and "voluntarily accepted" political arm-twisting and financial headlocks has led to steady "take it of leave it" mandates and price increases - with price-fixing clearly manufactured in tandem among all the 24 medical boards. It is a gross lie to claim that prices/fees/activities are "set by the ABMS umbrella organization in Chicago."
Key operatives/executives/directors from each member board share critical positions of decision-making and conspire benefits that are both politically and financially advantageous to the desired purpose(s) and increasingly burdensome fees associated with the monetary reimbursement of executives for such.
Such price gouging and fixing is inexcusable and needs to be remedied by court and legislative action. The ABIM in collusion with the ABMS umbrella leadership had a major part in creating the arm-twisting and extortionist mandates resulting in 'head-lock' conditions of employment and reimbursement.
It is injurious for physicians to have any further relationship with the ABIM, ABMS, or the extortionist practices of the Chicago/International umbrella.
The ABIM and its executives have been engaged in illegal activities. The operations and activities over the past fifty-one years needs to be investigated and prosecuted to the fullest extent of the law. There needs to be oversight from somewhere. The executives of the ABIM and ABMS need severe punishments meted out. We can start with reprimands from the US congress, Senate and their mirrored legislative bodies in the states.
Those executives, officers and directors who fall under the statute of limitations need to be held to account for their actions. They need to be investigated and prosecuted for their political manipulations and white collar criminal shenanigans and they need t be prosecuted. The ABIM as an organization is broken beyond repair and needs to be shut down in order to protect the public and physicians from further political, financial and criminal abuse.
Opinion:
There is probably no greater investigative journalist alive today than Kurt Eichenwald. Kurt's series of stories on the ABIM ring even truer today as the ABIM scrambles to hide their ineptness, negligence, greed, egregious conflicts of interest, and corruption while the reel from scandal. "It is in a fight for its very existence."
With the new ABIM re-certification pathways being rolled out and willy-nilly ramping up for a 2018 launch, Dr Baron is doing what the ABIM (and ABMS) intended to do all along. They culled physician opinion just as they culled participants in their "feedback sessions". The outcome of the session was a foregone conclusion. A Soviet-style vote with only one candidate, an online bi-annual test and a punitive runner up, and a continuance of the ten-year test.
This 'duopolistic' "new pathway" maximizes potential revenues from the built-in failures - with a two-year option and a ten-year alternative for those who can't take tests very well. Consider being under the pressure and stress of having to prepare for a two-year test with the dread of possibly being forced to do the ten-year exam anyway. Many physicians will quit or move to a state that has enacted or plans to enact anti-MOC legislation.
This new ABIM BS pathway was never anyone's choice other than the CFO and CEO of the ABIM and their corporate cronies who need them to survive in order to control physicians and lobby in Washington DC for them. No thinking physician wants MOC shoved down their throats. Hardly any physicians find MOC useful. In fact most find it harmful. What all this means is the ABIM is pushing a scam with another kind of scam - a ruse consisting of lies and propaganda.
The ABIM conceived and created this "new" bi-annual online testing scam several years ago and it has had nothing whatsoever to do with "physician professionalism" or "patient quality assurance". Think, "we were listening to you" and "the public is increasingly insisting on certification and MOC."
But you can be sure that ABIM's "new" scheme - and all the advertising/subliminal messages authored by conflicted physicians whose "honest thoughts" were strategically planted in prestigious equally conflicted medical journals - had everything to do with the alarming fact that the ABIM has been bleeding cash out the gills for years while the revenue streams have been increasingly drying up.
Kudos to Kurt Eichenwald for ferreting out the facts and having the guts to write the truth about the ABIM.
The ACP is one of two founding parent organizations of the ABIM (1936). The AMA is the other parent. The AMA House of Delegates voted to end mandatory MOC. The state medical societies and legislatures are listening to their electorates and doing what is right.
Patients want quality of time with their physicians back. Physicians want their professional freedom back. There is no turning back.
Everyone except conflicted parties with corrupt vested interests are moving to end mandatory MOC.
There is only one right course of action for the ABIM, ACP and AMA to take. The ABMS, ACP, AMA, and especially the ABIM must stand shoulder to shoulder with their one million certified physicians and resolve to end mandatory MOC.
The spirit of resistance to the greed and corruption is insurmountable. The disgust with the ABMS medical boards and their associates has reached a hiatus that there is no going back to the old status quo of business as usual with the American Board of Medical Specialties. The violations of human dignities, civil liberties and privacy must end . Physicians and patients are fed up with the ABMS. The usury, racketeering and profiteering is over.
The momentum of the anti-MOC anti-corruption movement is unstoppable as it moves from state to state.
"Meeting Coverage - ACP, ABIM in Talks to Lessen MOC Burden
ACP's self-assessment tool MKSAP could become exam alternative
by Cheryl Clark - Senior Staff Writer inewsource/MedPage, April 03, 2017
SAN DIEGO -- If they get their way, internists seeking to maintain their board certification may soon have a third option beyond the often-dreaded 10-year American Board of Internal Medicine exam or the board's two-year Knowledge Check-In that starts next year."
Every physician in the United States of America and around the globe have no interest in having a ABMS trademarked fist shoved down their throats anymore. Physicians don't want a first, second, or third ABMS MOC pathway. It is a bad relationship that ended badly. Physicians want to move on. Physicians want their freedom and right to choose again and patients want their physicians back. The ABMS has broken the sacred trust of physicians and patients by doing great harm with their greed and corruption. There is no going back.
The ABIM announcement that MOC is part of campaign to combat the lack of physician trust in the USA is the most delusional, bizarre, misguided science fiction ever written. The ABIM is the self-declared beacon of "trust" and "faith" for the American Public. Rich, have you totally gone insane? The ABIM is precisely why NOBODY TRUSTS the ABMS and the mechanism through which physicians are re-certified ad nauseum. BTW, that 2014 NEJM crap article about how the US ranks at the bottom tier for public trust of its society's physicians. Look at the top ranked countries- Most of Scandanavia, Turkey etc. Ask yourself this question. Of those countries do any of them have an equivalent ABIM that harasses and rips off their physicians? That hounds their Diplomates with nasty lawsuits while living in a $2.3M condo in Istanbul or Stockholm? Do the Norwegian physicians have to deal with their ABMS stealing money from them so they can drink vodka and eat herring while the rank/file physician in Oslo is saddled with trial attorneys, MACRA and ABIM corruption? Did the Istanbul Board of Internal Medicine, sue their young doctors while tooling around in a Mercedes?
The fact is NOBODY TRUSTS THE ABIM. NOBODY TRUSTS RICH BARON. Nearly everyone trusts their personal physician according to the NEJM survey.
This ACP announcement was a real disappointment. It cements the notion the ABIM will fail catastrophically in short order.
Continue to defund the ABIM folks. Once the lawsuits loses start to pile up, Rich Baron will be chased out of Walnut Street. Maybe when he gets fired he will have to go back to taking care of patients and dealing with what we all deal with on a daily basis.
Payback is a bitch.
1) ABIM publically promises to cut their expenses and salaries 30-40% just like the rest of us.
2) ABIM leaders no longer work for a salary and are volunteers with a modest stipend. No 401K. No perks, spreadsheet pass-throughs, benefits. No spousal travel benefits. No $2.3M pied a tierre pleasure palace.
3) ABIM move its headquarters to a City that does not accept corruption as the norm: ie Boston, San Francisco, Kansas City, Salt Lake City, Denver.
4) ABIM cuts the fees to graduating residents and fellows.
5) ABIM moves the money from the Cayman Island back to the US in a highly liquid asset vehicle.
6) ABIM invokes an oversight committee composed of volunteers who for a small stipend will have the power to block, vet and balance the opaque ABIM Board of Trustees.
7) The ABIM BOT and the managing physicians are put in office by popular vote of the Diplomates and subject to a limited 3 year term, capped at 2 terms.
MOC®, the Broken Arrow of Trust
For physicians MOC® implies broken trust. A physicians Lifetime Certification was replaced by an impostor - a cheater named MOC®.
For ABMS and Richard Baron, MD, MOC® is all about insisting on the Maintenance of Control® over physicians.
For the ABIM CFO, Mr. Mandes, MOC means concealing the ABIM's Misappropriation of Cash® from the DoJ® and IRS®.
How could a word denoting something as fake as MOC®, have anything to do with trust?
"Linking MOC and trust - Richard Baron, MD, ACP Annual Meeting
Speaking at the annual meeting of the American College of Physicians, Dr. Richard Baron said that false and misleading information circulated widely on Facebook and other social media channels runs the gamut of health issues, from falsified studies about purported links between vaccines and autism and public health scares on impostor websites, to stories of miracle cures for any number of ailments.
'It’s not just vaccines people are questioning,' said Dr. Baron, ABIM’s president and CEO. 'There are erosions of trust in government, and there’s the tenacity and power of wildly inaccurate information. You will be dealing with patients who tenaciously believe things that you know not to be true. You will need to find ways to build trust, credibility, and relationships based on their trusting that what you’re saying is really in their interest.'
U.S. physicians aren’t secure in the shaky trust landscape. In fact, globally, the United States ranks 24th in public trust level of physicians by country (N. Eng. J. Med. 2014 Oct 23;371[17]:1570-2).
'The confidence in the medical system today is lower than the confidence in police or in small business,' Dr. Baron said. 'That’s [the view] people are bringing into your offices every day. I don’t think we can assume that deference and trust are given to doctors, that the privileged role that society affords us is something that we’re going to have forever. We all have to think how trust is built in the new world.'"
The last sentence is worth repeating, "We all have to think how trust is built in the new world."
The ACP and the ACC are clearly in cahoots with the ABIM. All jockeying for more money via MKSAP, ACC SAP, meetings etc etc. Hugely shocking because both the ACP and the ACC have multiple streams of income independent of fee generation from its members. So why act subordinate to the ABIM? Lack of courage or a political backroom deal to divide the empire. What is utterly true is the ABIM's gas tank is us. The Diplomates. MOC is almost half of their annual income. For arguments sake let propose 40% of MOC income evaporates. They will have to either borrow money or cut salaries or fire people or do all three. Or maybe they screw the fellows and residents by hiking their entrance fee into this politico-economic zoo.
Hey Rich- are you going to soak the graduating housestaff by sucking their wallets empty even more?
Dr Yul Ejnes- how much money is Rich Baron giving you for your loyalty? Are you going to allow him to further burden the residents and fellows in Rhode Island? Was part of your career path after Chief Residency inclusive empowering such a corrupt organization like the ABIM?
Shame on Weinberger, Baron, Ejnes.
Shame on Rhode Island Quality Institute for allowing Ejnes to dictate how to steal more money from the housestaff and Diplomates.
It's ACP's Super "DynaMed Plus" (ACP's products are light years ahead of the competition)
And, if you are lucky, ACP's super "DynaMed Plus" will come flying to your home, office, or Pearson Vue Testing Center to rescue you just in time for your 2018 MOC open-book testing needs. As a matter of fact you'll be begging for it when you learn that "independent studies" have learned that your "evidence based medicine guidelines/summaries" at UpToDate and other competitors are much older - already 299 days older than ACP's KRIPTON-FED "DynaMed". And ACP's products will be primed to "keep up" as you "keep up" with your mandated Two-Year ABMS MOC EXAM. And here is the promotion the ACP is offering to get you interested. You can get it free for the rest of the year. All you have to do is join ACP or renew your ACP annual membership. DynaMed Plus is free through Dec. 31, 2017, but just this year, after that it will cost you.
I am sick of the racketeering of the many organization that make up the quality assurance/certification cartel. The timeliness of the ABIMF-funded MOC modules and ACP's latest product lineup for MOC test preparation is a shameful testament to the egregious conflicts of interest that exist at the ABMS and their partners in crime. They ignore the will of the people. They ignore the AMA HOD resolution to end MOC. It is clearly the will of physicians and the public that mandatory MOC should end. The complexity of the process of measuring quality is now a corporate mania that is killing medicine. MOC is corrupt to the core. It exists for control of physicians. It is for padding executives pockets while they jump in bed with special interests. They ones in charge have lost all credibility and integrity. Not one true word ever comes out of their mouths. When tyranny rules and lies are more common than honest direct words, it is time for revolt.
It is time for change. It is time for MOC to end now.
I concur fully with Wes!
"Doctors have had it with the outright dishonesty and scandal that has plagued MOC from the beginning, especially when they're dealing with much more important life-and-death issues every day. The only realistic and honorable revision for MOC is to end it, or for every practicing physician to refuse to participate and allow MOC to wallow in it's own avarice and greed."
Dynamed weekly update
http://www.dynamed.com/home/about/ebm-journal/archives/article/dynamed-weekly-update-volume-6-issue-38
"Why DynaMed Plus?
https://www.acponline.org/clinical-information/clinical-resources-products/dynamed-plus
Finding the heart for advocacy again
ACP and the AMA founded the ABIM in 1936. There was a lifetime certificate then. The ACP and AMA have a moral obligation to restore that lifetime certification and make the process voluntary again. Not tied to employment or reimbursement. Not a mandate bundled with onerous costly pathways which demands recertification.
The ACP and AMA initiated the certification process. They broke the original contract with physicians and they must fix it. It is not the ABMS or the ABIM who are the sole parties to blame for the greed that set in and creating the clever mechanisms of control. To say that the ABIM and ABMS are independent is to forget the past and the integral nature of the relationship.
Just as a parent can never turn their back on their offspring, the ACP and AMA have an obligation to restore the original order. As we all know things have gotten away from the ABIM and ABMS.
Anything less than total advocacy for the physician and restoring lifetime certification as stated above is disingenuous on the part of the ACP and AMA.
In washing their hands of their moral duty to act and restore the integrity of the ABMS certification to its original contract, they have destroyed their honor. They have destroyed trust.
But moreover, in creating an external surrogate called MOC as a demoralizing and onerous "policeman", they have demeaned the inherent goodness of humanity by impugning the passion for lifelong learning that comes only from within. Not without.
The founding physicians knew this. There was no need to write it in the bylaws as it is the essence of life. Life decays without this passion for learning. Everyone in the past knew this. We must get this back more than anything.
The ABMS/ABIM cop mentality killed our capacity, because it killed our goodness, humanity and trust. Physicians are too damned burdened with all that is detrimentally imposed.
If we demote our trust in the basic goodness of humanity, we demote our goodness. As a result, we lose the bigger share of our humanity. That humanity is our true inheritance, not money or rank.
If we dampen the passion for learning, we only lose the passion for learning. In doing so, we lose another aspect of our basic birthright of the humanity we all share.
And maybe the most important point as it pertains to the MOC debate. We can be sure we have diminished our sense of humanity and value in our own self worth, when we let others eviscerate or interfere with our individual innate capacity for knowledge.
This happens most frequently when we allow petty, greedy, ignorant minds to lead us. People with such a herd mentality debase the spirit of truth itself.
Without humanity and truth living inside us it is really a lonely road.
And if we don't restore that original contract with ourselves and each other, we will most likely never know or understand that which initiates the desire and capacity for higher knowledge within us, how it arises, and the passion which sustains it.
As a physican who has now taken and passed 5 ABIM exams and just taken another, and in full consideration of my 20 + years in successful private practice, I can, without question, state that the latest ABIM exam has NOTHING to do with the real world of medical practice. I found the questions to be the same old immature,goofy academic-derived trickery jargon that belong in the grave under the ABIM tombstone. I curtsy to all the obsequious sycophantic academic ABIM jesters with indifference; while the rest of us will be actually taking care of patients.
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