A previously ABMS Board-certified physician with 10 years experience fails her Maintenance of Certification examination. Does she have the right to work in the hospital where she has tirelessly and compassionately cared for critically ill patients for years, earned the trust of her colleagues and nursing staff, and taken call every fourth night?
According to the American Board of Medical Specialties, the American Hospital Association, and the AMA, she does not.
She must lose her privileges to admit to that hospital, be ridiculed publicly, and watch her career fold. According to these unaccountable organizations that don't directly care for patients, she does not demonstrate the "exceptional expertise" required to have a piece of paper hung on her wall that tells the world she's a great test-taker. According to the ABIM Foundation, she does not demonstrate "medical professionalism."
This is the crux of the debate about Maintenance of Certification now. For reasons that only our most jaded bureaucratic elite medical leadership can fathom, they have allowed a pay-to-play scheme to invade our medical education system so they can fund their Cayman Island retirement funds, car collections and health club memberships.
Today, the American Board of Medical Specialties fraudulently claims to US physicians that their version of time-limited board certification is a "voluntary process."
It is not.
It's Mafia-style pay-to-play scheme in medicine.
Let that sink in.
It's a world of false words/labels and the people responsible (all of us) keep shrugging it off as though nothing mattered - good/evil, action/inaction, love/hate.
But the words voluntary/mandatory, pass/fail and the existence of that painfully-thin veneer that masks the profound truth behind it all, matters deeply for a physician and a patient.
It matters for us all.
Action/inaction and our relationship with one another is the ultimate tell of a society in the the twentieth century, twenty-first or any century to come.
We really must look at things as they are and call things (rhea) by their right names.
The high numbers of failed docs, those who leave medicine to pursue other opportunities, or those who retire early or never enter practice at all appear to be indicative of an engulfing problem with the same concerning pattern across all medical specialties. On the part of the ABMS/ABIM, it seems willful, malicious, and by design. If it was not intentional on their part they would fix it immediately at the very least, by calling a moratorium on MOC and restore lifetime certification for all. If the ABMS and member boards can't fix the problem, show reluctance, or don't offer at least a meaningful temporary solution to those immediately affected - pending some real studies of MOC's effect on patients and docs, then it proves that they are the problem. MOC, every sensible person knows, does real harm and the ABMS does not want to have that data to be forced to deal with. It appears they have put out a great deal of capital investment in personnel and the new programs and versions of MOC to beta test.
MOC has a profound effect on the reduction in physician numbers and docs granted hospital privileges. That translates to fewer docs and fewer hospital beds.
Who designed this? CMS? ABMS? Wall Street? Big Insurance? NCQA? Kaiser Plans? United Health Group?
Irregardless, it is supply-side economics. Just think of it. A "voluntary" test and a "voluntary" test taker somehow mandated through the test company colluding with other quality assurance organizations. A group of non-profit certification corporations reducing the numbers of docs and hospital beds. And other resultant services and supplies.
When calculating the significant cost reductions from the down time and those patients and physicians who are tossed under the bus, I would say it needs to be investigated by the DoJ and OIG of the HHS.
When you add the Choosing Wisely Campaign to cost-reduction strategies it is a cunning way of reducing demand for physicians, hospital admissions, medications, supplies and services.
One might suggest that the ABIM and its shadow organization, the ABIMF, for example, are not
about professionalism at all, but really about behavioral and functional forms of healthcare rationing serving up various algorithms involving numbers and levels of patient encounters and behavioral modifications leading to significant cost reductions.
See McKinsey global healthcare cost reduction study
[PDF]Supply and demand strategies for lowering spending on hospitals
Lowering the demand for hospital services is not, on its own, sufficient to reduce hospital costs. The supply of ... necessity, given that health care budgets around the world ... services through capacity closure or facility .... patients to talk directly with a doctor or nurse. 2 For a ..... a health system should have, and bed numbers.
Non physicians at the ABMS/ABIM regulating physicians right to work and the numbers of physicians in the workforce?
Yes, absolutely, physicians have the right to practice without participating in MOC!
Moreover, patients have a right to see their physician. Patients are losing their physicians left and right. ABMS MOC is a significant part of the makeup and landscape for the decline and lack of physicians in America today. This must be openly admitted by the ABMS CEO and various executives in charge of their specialty boards.
Making matters worse, in rural America critical access hospitals have been shut down in many locations and doctors/group practices are not available anymore - moved out - or have gotten absorbed by corporate buyouts. MOC is not an insignificant part in causing physicians practices to fail also.
Every struggling physician who leaves to become part of the bloated bureaucracy of growing numbers of administrators or wants less stressful employment in non-clinical academia or pharma or who retires early has MOC/re-certification on their minds. Look through the ranks of clinical MD's, it is dwindling in count. And the number of MD's participating in MOC is contracting. Nobody willingly wants to wast time and precious resources on MOC.
Show me an MD who practices in clinic and works for the ABIM. There are none. In fact, out of twelve key executives there today listed on their website, there are only four with MD degrees. None of them practice. There is only one who claims to supervise residents at a small clinic, but this is once in a blue moon or not at all AFFAIR for looks at an institution five minutes walk from ABIM's offices.
And this is alleged to be a physician-led organization? What a jocular bit of Saturday Night Live is that. How ludicrous to spit out such a brown tongue-in-cheek wad of chew in front of practicing physicians' feet. Who believes it. It shows how out of touch these antiquated clubs of profligate politicos really are.
The ABMS is a nefarious organization run off the hard-working backs of rank-and-file physicians who must eat ABIM/ABMS's Chicago-style bull and forced to take their syndicated flack.
You do MOC or you don't work, which means you go along you can't pay your rent, and your children don't eat. It is that simple. Whatever nonsensical words we hear such as, "we are listening", if means they are doing more creative word-work. It is just "trying to stay out of jail" propaganda that their risk managers and communications officers put out to read back in court to the DoJ and OIG attorneys - none of it will be believable to seasoned prosecutors. The Rich Barons of the world are just trying to stay in power and keep their legion of damn financial scams and political agendas alive.
Today's heroes are the ones who openly oppose such tyranny.
ABMS and their cronies in the quality assurance/testing cartel are not physician-led, but a corporate-led industry with professional politicians and revolving door government bureaucrats in charge draining the bank accounts of physicians and taxpayers every month.
ABIM (a physicians-led org in name only) has no real physician presence, only a few Wall Street and K Street physicians with an MD. The present CMO is a PriceWaterHouseCoopers/NCQA numbers man. Rich Baron is a CMS/NQF/Commonwealth Fund man. A quasi-"G-man" and professional politician serving special interests in the tradition of Thomas Brem to Christine Cassel.
The last ABIM CMO was involved in - how did the defendant's lawyer put it - "going beyond his job description along with the past two CEO's and other executives and some board members/officers. It's all in the court records. These thugs - that's what they have devolved into - were involved not in protecting the public but their financial monopoly.
Court documents prove the ABMS and ABIM are part of a protection racket. Censored materials in court proceedings substantiate it as well. ABIM has served as the strong-man for the ABMS. All the talk about the umbrella organization not being accountable is a patent lie. In fact, the ABMS in Chicago exists for the sole purpose of advising and counseling the member boards on most important matters, except whether Rich Baron is allowed to work from Mt. Airy at home or must he fight Philly traffic show up at the offices. But it is their responsibility to not allow a politician like Christine Cassel to make politico/corporate hay lobbying/twisting arms in DC, while under full employment with the ABIM. That violates policy and ethics.
Court documents and media accounts track that these non-physicians executive MD's were involved heavily in political and financial strong arming, thuggery and covering up facts that they and their "director of investigations", MR MANNES, was a double felon hired to crush and destroy physicians' professional and personal lives. MANNES was and is a man with a checkered history of civil liberties violations, impersonation, violent rages, and gun violation(s). Nobody has requested his public service records in New York and DC as far as I know.
ABIM and ABMS supporting a game plan involving a bad cop thrown off the DC Metro police force (and they knew it) now sicced on thousands of physicians in America and ordered to take down ACP's board review course competition. They did this through means of the thuggery of corporate spying and mud-slinging. Wild, unsubstantiated to this day, accusations and the plans to illicitly seize physicians private data and personal information in order to persecute and control the entire body of ABMS physicians. Their cases so outrageous that even those with pro-se representations could not win a penny from their victims. Sound far-fetched?
That's what many thought until they started looking at the, court records, depositions, personal accounts, financial returns and monopolistic gangland power structure. That power structure included access the courts and influence at the highest levels of government and bureaucracy along with the quasi-regultory agencies, NGO's and corporate special interests.
The CEO's COO's and CMO's, and director of investigations carried out their Machiavellian schemes of power and tyranny through tactics of intimidation, public demonization, and violations of due process for thousands of physicians. They were sanctioning, suing, threatening with criminal innuendo. There were harsh accusations, forced confessions under duress, victimizing the victims into pointing fingers. Everything the ABIM/ABMS did amounted to wholesale bullying. A fireworks display where the whole arsenal of powder and power was put to use.
And the bullying continues today. Look at the case of Dr. Salas Rushford. They ruined for the sake of ruin without a case. And they knew it. A bluff. Now ABIM stands on a financial precipice.
Physician-led with physicians and patients in mind? Not in the least! Let me add to this.
The ABIM's current Chief of Staff and Chief Medical Ethicist is not even an MD, but a lifelong Philly-city politico and bureaucrat.
The Chief of Staff before that had no medical degree either and the closest they ever got to healthcare was through their spouse. He has a big pharma public policy executive position and counsel on bribery. The spouse, who was an undisclosed party on the Chief of Staff's application to ABIM. Stock is a significant part of compensation in large pharmaceutical companies such as GlaxoSmithKline.
Important information concerning ethics and policy violations were totally missing in the former chiefs disclosure list. Try explaining that on the next job application. It is an ethics violation and offends even ABIM's lax conflicts of interest policies and enforcement.
We can cite many examples. Think Christine Cassel and her egregious conflicts of interest. A fiasco that grew into a very significant scandal. ABIM does not even want to address any of this. A CEO kneeling in the sand with his head buried in a vast and intrepid history of lies.
No public announcements of that "political advisor/chief of staff/government affairs contact" leaving with tail behind their legs in shame. No mention of severance payouts either. No press release. And the C. Cassel story was ten million times worse.
Out of the 12 key executives at the ABIM, I challenge those scant four ABIM executive MD's to produce their rare if any clinical hours over the past thirty years. I challenge them to produce their MOC/10-year exams and provide us with proof of where they took those tests and perhaps even video proof of them entering and leaving the Pearson Vue testing center.
We all understand they require video monitoring for everyone. That makes it hard for some to focus. This video monitoring should have included the elites. Let's see the footage of those testing this year for proof of Pearson participation and not a cheating scheme for the elites.
For example, where did Dr. Baron take his 2008 re-certification test in geriatric medicine and show us the proof that he was not given an elitist executive privileged pass by the ABIM and ABMS. A free ride? Call Pearson yourself regarding your favorite ABMS bureaucrat/politician. In most cases they will tell you they have no record of ABMS elite Dr. X taking a test their testing center. Why is that? They are required to keep up.
We'd like to have the question of MOC participation and proof of it addressed by all the hundreds of privileged executives/board directors and officers past and present at the ABMS as well. Let them show us their Pearson Vue record of test and receipt! If the ABIM has taught us anything it is this: you cannot trust them in the slightest. It is unfortunate, but that is where it stands.
On trust and violence against others
I'm wishing I had never heard of the ABIM or ABMS. They have turned the practice of medicine into a pure hell. If I had the power to change things I would close this entire sour organization down and suggest that residencies and fellowship programs provide in conjunction with competent societies provide a nationally recognized free certification test that goes along with specialty diploma. Make it a paper test ( the computer was slow and froze on me ) and make the test and the test results available immediately afterwards.
Heck with copyrights and criminalization of sharing medical knowledge. It should flow freely. I want a darn break from the computer and all the stupid clicking. Give me back paper records. Healthcare flowed much better. One can only see half the number of patients rounding or in the clinic.
General Sherman said war is hell. General Lee did not have to say it out loud. I say MOC and modern medicine is hell too. The ABMS fired the first shots and took thousands of hostages already. I declare my complete opposition with the ABMS position on MOC and their monopoly on giving a certification test to anyone. They have violated their professionalism standards, the common trust and their ethics pledges.
But here is the clincher for me. They have used what is essentially plundered money unwisely for purposes that are inconsistent with a charitable testing/certification company and inured themselves beyond my scale of comprehension.
Their ethics and professionalism has been degrading every year. It is now down to nil. The ABMS's privileges granted by unwitting patients and the greater medical society to test physicians for anything has been abused serially and to the point of criminality. These rights to test anyone should be stripped from them and give to responsible neutral parties or institutions.
Most importantly, the ABIM cannot be trusted with my files and personal information due to the documented and proven felonious intrusion into everyone's civil liberties and privacy rights.
Most importantly for me, I do not feel safe. I do not trust them one bit.
Wes, the more I think about it, the more I feel that this must be by design. We are only beginning to see the DREXIT that is to come, and all of the exiting physicians are going to be replaced by less qualified and less expensive NPs and PAs who have absolutely no requirements for MOC or any of the other onerous regulations that have forced and continue to force physicians from practice. The benefits of NPs/PAs to the corporate-industrial medical system is not only that they are less expensive but also that they do not have the scientific background and/or intellectual curiosity to question cookbook medicine including care guidelines, formularies, etc. Healthcare in the U.S. will continue to suffer. The question that plagues me now...where can I go to finish my career that allow me to practice medicine the way I learned it and loved it, and also where can I go to retire and be cared for in my old age the way I had hoped for. The way things are going, I certainly don't want to be an M.D. in America, and I'm not really looking forward to being a patient here either!
Suzanne Biemiller, ABIM Chief of Staff (2014-2016) departs to start her own company
Executive Leader at American Board of Internal Medicine, a $56 million nonprofit organization
*Led strategic organizational change - work designed to better engage customers and break down departmental silos
*Implemented new ways in which the organization communicated internally and externally
*Changed budget process in order to better reflect[ed] program priorities
Thank you for your public service, Suzanne! We wish you the best of luck with your new business.
Do we have to repeat their names and speak of ABMS corruption and treachery over and over again until we all get what is going on right under our trusting noses.
Do we have to keep shouting about the public fraud at the core of the MOC enterprise until we all recognize what infamy has occurred and what fresh violatory deeds are brewing in their out-of-touch bureaucratic brains?
Do we want to keep paying into their self-enrichment programs, continuing to fund our own demise?
ACGME fees $6200 initial
<5 residents $4300 annual accreditation fee
>5 residents $5200 " "
9000+ programs =
MOC fees hundreds of dollars per physician ???
900,000 physicians =
By not focusing on lifetime certification and keeping it simple and honest, the ABMS/ABIM/ABP/ABFM etc., have invited conflicts of interest and corruption in the door.
Nothing epitomizes that corruption of the organization and conflicts of interest that have entered more than the invention and implementation of mandatory MOC.
Nothing mirrors and illustrates a lie and the destructive power of a lie more aptly than the ABMS' insistence that MOC (or certification) is still voluntary. This is as far from truth as the moon is from the sun. All 24 satellites and their umbra have darkened the earth and eclipsed what was perhaps once an accomplished standing in the light on proud ground with a lifetime certification - a certification that most certainly once meant something. A pledge of lifetime learning was inherent in that lifetime of meaning.
Now lifetime learning has been reduced to ABMS's lowest denominator. Coercion for the sake of an executive's financial enrichment. Their learning means fragmented, choiceless, learning that has been thrust on physicians with a "devil's hammer".
Physicians' rights are patients' rights and patients' rights are physicians' rights.
We all need to stand together to protect and preserve our rights.
This buffering oneself off from a negative reality concerning oneslef is also true of the ABMS. This psychological process is true of the ABMS/ABIM because the ABIM has not yet issued any apology or offered to recompense any injured parties that were steamrolled by ABIM/ABMS' unlawful injurious actions against their customers/clients.
In fact, they have, along with their goonish expelled officer of the law, Mr Mannes, they have also buried the events and unfortunate experiences violating others. They have put their head in the sand about the accompanying episodic pictures of themselves doing harm. Pictures/impressions that bubble to the surface of their busy minds. No it can't be, but it is.
It must be like a part of their lives has been placed in a wax museum where actors are seen as though from the outside looking in on quality assessment/certification leaders seen as external waxy strangers playing their roles - seen reluctantly as characters "other than who they pretend or feign to be".
Knowing these psychological details are hard to swallow of the mind seeing itself caught in incongruous acts of seeking personal financial enrichment, which stands in contradistinction to one's projected self-image as a good guy or woman protecting the public. But it is nothing of the kind. And add on top of that in the case of Mr. Mannes, and the other "directors of crime" at ABIM, the self-enrichment schemes and undisclosed partnerships.
Mr. Mannes and his ilk had personal conflicts of interest with the ABMS, Caveon, Kryterion, ATC, privacy attorneys, lecture partners, and others in the testing/security industries and many other quality and standards assessment companies involved with them.
Who should believe them and who should fear them? No one.
In short all this corruption of the organization and the individual, in this case the chief investigator in charge, means the courts and judges involved should have made ABIM's director of investigations, Mr. Mannes, a disqualified witness in signing/presenting himself and evidence to the court.
Fib after fib just to get a sealed rarely-given ex-parte writ to seize Arora's company's property and thousands of needlessly victimized physicians' and their personal files.
Mr. Mannes and the ABIM, along with their attorneys, abused their good faith custodial boon and obligation to not exceed what was granted to them with the seized files and other personal data on physicians.
They went after thousands of physicians in violation of their civil liberties and privacy rights. Their court document clearly was a limited one. Arora's computers, boxes of documents and other electronic devices became Christine Cassel's political stomp party to have her way with the entire body of fearful physicians. Afraid to stand up the the ABIM's fraudulent actions.
The judge granted an inch and the ABIM took a mile.
ABIM executives and officers misrepresented to the judge and court zealous plans associated wtih their chilling intent to harm and fear monger many more physicians than they requested from the court in order to solidify their monopoly and control physicians - control through the power of fear and strength of money. Lots of it. And MOC was their illicit partner, a fast track cash horse in the race to bail them out of their financial crises.
MOC generates hundreds of millions of dollars annually for the ABMS boards.
Mannes' past history and two/three felony convictions and charges would have made any
judge balk at granting/giving an unfair advantage to the ABIM over Arora in their copyright dispute with Dr. Arora. Dr. Arora, as a result of ABIM's deceitful abuse of the judicial process, was violated by the ABIM, their attorneys and the unwitting courts.
Globalization of Medical Education - Accreditation and Assessment Without Borders
Association of American Medical Colleges AAMC Conference San Francisco 2012:
Kamal F. Badr, MD, Associate Dean for Medical Education, Professor of Medicine,
#American University of Beirut AUB
Emmanuel G. Cassimatis, MD, President and CEO,
#Education Commission for Foreign Medical Graduates ECFMG
Robert K. Crone, MD, President & CEO,
#Strategy Implemented, Inc.
Lewis R. First, MD MS, #University of Vermont Professor and Chair of
Pediatrics; Editor-in-Chief #American Academy of Pediatrics Journal Pediatrics; Chair,
#National Board of Medical Examiners
Dan Hunt, MD MBA,
#Liason Committee for Medical Eduation LCME
Co-Secretary; Senior Director, Accreditation Services,
#Association of American Medical Colleges AAMC
Robert K. Kamei, MD, Vice Dean, Medical Education,
#Duke-National University of Singapore Graduate Medical School DUKE-NUS
Donald E. Melnick, MD, President,
#National Board of Medical Examiners NBME
Thomas J. Nasca, MD MACP, CEO,
#Accreditation Council for Graduate Medical Education ACGME
Lois Margaret Nora, MD JD MBA, President and CEO,
#American Board of Medical Specialties ABMS
Janette Samaan, PhD, Director, Global Health Learning Opportunities,
#Association of American Medical Colleges AAMC
Javaid Sheikh, MD MBA, Dean, Professor of Psychiatry,
#Weill Cornell Medical College in Qatar WCMC-Q
Ironically the "quality" assurance organizations are focusing on quantitative efforts in the US and now abroad to increase revenues and expand their bases of power and influence.
The problem they are generating by this is clear. Less focus here in America means less quality. More money for them is all they understand. And the pretty words that aim to justify.
MOC is the quintessential canary in the coal mine that is telling us there is a toxic air and volatile brew in the work environment making it less safe. The out of touch self-dealing executives are the air and brew we should all fear and try to neutralize.
The ever increasing executive compensation tells us that we have to fix this toxic addiction of theirs. It is a deepening problem. MOC and all the greed and waste that it represents must go, or healthcare in America faces and explosive collapse.
Non-profit organizations led by head-in-the-sand CEOs with huge appetites for compensatory packages, deferred accounts, luxury condos, first class tastes and tendencies in everything except for thinking with clarity about the dire condition we are in. And the non-taxable lunches, dinners and entertainment. The country club memberships.
Now they are playing Marco Pollo seeking exotic trips to foreign lands just to play "big shot bureaucrat" on our dime. They want the Singapore dollars and Saudi gold. They play Polo for excitement of politics in despotic lands just to seek more dollars for themselves.
What is going on? The beautiful canary has been poisoned by their greed. They have been turning their backs on their real obligations, which are to be simple, honest and direct in their thinking and transparent in speech to all.
It is all mixture that spells disaster for the patient and physician.
Quality is being diluted and the safety of healthcare has been abandoned at home for executives seeking more sources of hard cash to support car collections, condos, country club living.
MOC is a blatant symptom of greed that needs to be treated. The disease has gotten into them like a bad bug driving them mad. Infatuated with global adventurism and domestic experimentalism - all thrust on helpless populations here at home who need attention. And they are abusing physicians riding hard on their backs when they really need a break.
All these onerous burdens in the name of old fashioned greed.
MOC is harmful. Stop it, ABMS! Stop it.
You are doing us all and yourselves great deal of harm.
Bottom line for ABIM
Not even the financially stable AAMC could bail out the ABIM, even with their strong cash/investment balance and stable debt rating (according to a recent Fitch report).
Not any of the ABMS associate members could put Humpty Dumpty back together again, either. The ABIM has fallen too far. The corporation is broken and they already have egg on their face.
Are physicians victims of corporate theft and unconscionable forms of workplace abuse?
There is absolutely no question that physicians are presently innocent victims involving financial extortion by the ABMS with their MOC money demands.
What makes matters worse the whole pattern of victimization is perpetuated by self-appointed unaccountable moguls serving special interests and getting away with it.
Self-enrichment programs put the glue on the envelope shutting the door to any reason or kind reciprocal light getting into the dark chambers of the ABMS umbrella or any of its member boards.
Docs are violated by literally being placed in a mental torture chamber from which their appears to be no escape. The daily drain of heart and brain is the hopeless result and aim of the ABMS' MOC machine.
The MOC system is as sophisticated in its torturous purpose and execution as it is in the extraordinary rendition of its devious design.
One could argue that no one wishes to do a fellow human being or animal harm, but it is an unfortunate fact that such disgusting acts and rapacious deeds exist. Is it that some folks were groomed to be callous? The ones willing to be involved in systematic conscious usury. We can be sure that such traditions of falsity, cruelty and abuse were not born overnight or invented in a day. Who invented the archetypal model for such a person? What mechanism in us creates the protective shell of images and contradictory feelings in order to live with oneself?
Just like any slave or worker that is meant to be subjugated, the physician has been psychologically broken down and conditioned for many years, trained to be servants to an elite class that claims "he knows best". Or "what we do to you, we do on behalf of the public who are wary of physicians harming them." "Just take your MOC medicine."
If one understands the mystery inherent in this puzzle of human psychology, one will perhaps see the meaning of life that eludes us.
And thus also sprach the ghoulish warden and torturous guards in the "Shawshank Redemption". "Just take your bullet in the back like a man." "There is no escape."
An objective study would show, however, just the opposite to be true. Physicians are trusted and that is what the powers which the ABMS serves are afraid of. The public is weary of the "one percent club". The public is wary of CEOs and wardens who abuse their employees and abuse the inmates who are tortured and murdered because they resist and insist on what is just.
The public is wary of buying the products and services of such CEOs and wardens. MOC is such a product. The public distrusts the CEO's painfully false words, promises and the deceitful deeds of MOC. All this just protracts the usury and abuse. It is the most uncanny thing that a product that is supposed to assure the public was given the trade name "MOC". MOC is MOCK. How can anyone associate with the word MOC as something true or good for you.
MOC (mock) is false and always will be.
We understand clearly from medical school to residency and beyond that the preponderance of students and physicians are conditioned to stoically accept and submit to various forms of "extraordinary rendition" that the AAMC, ACGME, ABMS, specialty boards, their associates and affiliates just for "love of power and money" inflicted upon them.
These organizations that slowly and painfully inflict their MOC renditions of health assurance on physicians and patients are detestable. This mock (MOC) untested unverified science is a torturous extraordinary rendition. MOC/recertification operates repetitiously on redundant principles, which only servers to perturb and leads to a dulling of the mind and feelings.
MOC operates as the acme of inefficiency because it is falsely prescribed and a wittingly redundant test seen as a scam and handful of useless sand at the same time. MOC is an unfit artifact of gratuitous methods and standards derived from an extraordinary interpretation of medieval philosophy. Just as Boethius misinterpreted many of the Greek systems, the ABMS misinterprets and misrepresented the humdrum of MOC as a modality that physicians would just accept. Boy were they wrong about that! And if one system is off, you can bet that the gamut of their psychometric values for their testing systems are off as well. If one actually looked at the numbers and harmonic theory they were prescribing with even there certification testing and measurements for such would all explode like a rotten walnut or the walls of Jericho under the force of a thousand trumpets out of tune, the instruments were hewn by greedy artisans that valued money over being in tune.
The ABMS and its MOC is a system of archaic and barbaric vassalage and taxation; it is a rule by those indulging in intellectual malpractice and profligacy placing themselves on top admonishing those beneath for wasting resources, while insist on the hoarding of finite resources for themselves. They place insistence on others, while ignoring their own hypocritical practice.
These barons and baronesses insist on secret propagation of a bloated elite bureaucratic culture that manifests only hubris, avarice and gross waste.
Coercion, fear, and flagella without carrot are the behaviorist postures and normative psychological underpinnings that keep their assurance rackets and payment systems operating smoothly.
Congressional investigations needs to be conducted to root out such bad actors in our society as the ABMS has repeatedly produced - the real baddies who are daily colluding with an enemy that we all created ourselves from our inattentiveness, passivity and ignorant trust.
This "enemy" is seen often today as it infiltrates and infects any governing quality assurance or testing body it pleases. They are mute about things that matter - perennially silent about their own wrongdoing - with decades of ingrained patterns of selfish deeds.
They wear a shield around their false personas, like a secondary mask, and their carefully crafted, protected words are born out of a unique culture that can only be described as "uncharitable hypocritical elitism".
But everyone has a master. They serve elitist partners with their own trademarked brand of arrogance and greed.
ABMS Uses the Ruse of "Meeting Physicians Halfway" on MOC to Play Them Like a Fiddle
More evidence of pay-to-play and collusion, and the feds are not doing a thing yet to prosecute these elites.
Where are the calls from Medscape or an investigate journal to look into the practices of the ABMS? I believe the media should cover this story and do their civic duty to the healthcare profession by calling out the ABMS for the potential crimes they are committing and getting away with? Where is Pro-publica?
The ABMS Stick and the Bloody Carrot
An ongoing investigation and study of white-collar crime and racketeering in the US as practiced by the ABMS quality assurance/testing cartels.
For a better look at the real mentality of the ABMS. See ABMS Singapore for a look at some of the offshore companies and despotic regimes ABMS collaborates with financially. It is frightening what forms of torture this medieval city-state uses on its subjects.
Physcian assisted caning in Singapore: brutal, bloody and sometimes lethal
The ABMS has not been indicted yet for racketeering, public fraud, financial irregularities and other crimes against the United States of America. MOC is clearly part of a widespread self-enrichment ponzi scheme. It is part of a highly orchestrated racketeering scheme to control physicians and the medical assessment and testing markets.D
Here is the latest version of ABMS proposed MOC "caning": instead of every ten years they plan on submitting physicians to MOC's humiliation and torture every two years. Under surveillance at home or in your office live online. Just think about the stress of that.
ABMS does not vet each other, so how can you expect them to vet their third-party vendors who will be proctoring, keeping files and videos, in short spying on you. They have been documented to have followed test takers on line to monitor them for any sharing of copyrighted "medical knowledge".
What is two-year online proctored testing? It is and even more insidious testing design than known to date. Two-year continuous testing even more onerous to your practice, injurious to patients' rights. What's more Two year MOC is five times more stressful, time consuming and humiliating as it is five tests instead of one.
What's more, any MOC testing whether five times in a decade or just once every ten years is considerable more dangerous to physicians personally in terms of the ABMS' penchant for fear mongering sanctioning and prosecution. Here's why?
2-year proctored on-line testing (or ten-year) is testing you to death more often with more chances for the ABMS medical boards to not just take your money, but is a clever trick to get you to sign an "updated contract" in order to have the chance to be submitted to a legal hell.
ABMS/ABIM ruins you life without credible proof or real cause, thus making a living purgatory out of your life as you become their political pawn. They truly might "beat you to death" in court like they have so many thousands of others with criminal/civil prosecution or sanctions.
Need proof? You don't have to look further than pacer.gov or: https://www.doctorsjustice.com/for the court records.
It is heavily documented in federal courts that the ABIM/ABMS have been prosecuting competing board review companies and suing and sanctioning physicians without due process. They have systematically violated their constitutional rights for well over the past ten years.
And they have secretly used dishonest felons and other dirty investigators to violate doctors' constitutional guarantees and privacy.
It's the classic stick in the one hand (that threatens) you, while the other hand offers to flagellate your sensibilities and decency telling you it is somehow good to have you under constant proctored surveillance and videotaping in your home or office.
A veneer of crumbling old brick swallowed by the the thin hollow glare of glass
AAMC perspectives in retrospect - an old facade crumbles as AAMC begins its move to 655 K Street causing a little setback for their plans
CVS has already moved in on the street level along with a middle eastern restaurant
The AAMC said they were moving (and taking on a lot of debt) so their 600+ AAMC employees could be in one building. Now they are leasing space out left and right to smaller educational/credentialing organizations that they are forming new alliances with in medicine, dentistry, nursing, veterinary medicine, phsysicans' assistants education.
The AAMC is investing overseas. Even the Colleges of Nursing is spending money exploring in other countries making contacts looking to expand.
Was the whole thing about a new AAMC building really more about what corporate American calls a merger. Taking on debt to buy out similar companies in the hope of controlling markets, prices and increasing demand for products and services. The AAMC will now be leasing space to these groups whereas before they had their independent office spaces.
I don't like the aesthetics of the new building and I don't like the feel of the new AAMC.
Something just seems wrong and pretentious about it all. Even the compensation seems unbalanced on the part of the AAMC in relation to the new organizations. The CEO of the AAMC makes $1.3 million, while the CEO of the Colleges of Nursing makes less than $200K.
The old buildings that used to be owned by the AAMC have been converted into condos and office space already. It's too late for them to turn back as others already begin to piggy back off their corporate ventures abroad and into the brave new world at home.
Are we all being swallowed up by the lure of money and thin hollow glass of a "new order" while the old world we try to preserve crumbles?
It makes the fight against MOC all that much more important to me as I try to preserve integrity, honesty and sanity for myself and those souls who are yet to come in the future.
Keep up the good fight, Wes!
- Foggy Bottom
I can't help but wonder, does any of the recent dash to dog/cat/bird/horse/cow MOC madness have anything to do with the fact that the powerful educational/lobbying group representing the Veterinary Colleges of America (and several overseas affiliates) just moved in with the Association of American Medical Colleges at 655 K Street in Washington DC. You know right next to Capitol Hill and the White House.
In DC AAMC's new digs at 655 K Street NW is known by the nickname the "Triangle". Is that like in Bermuda Triangle where everything gets swallowed up or comes up missing? Just the opposite from the data that we have so far. Everyone is well accounted for everyday as they are being put on a runner if they are not on a lead.
Just maybe, its just a hunch, but maybe we should call this new alien AAMC abode, where various unknown projects are coming together, by another euphemism as in Nevada's most famous top secret site - "area 51". How about calling the AAMC compound/facility just "Area 655". This way folks won't evocatively confuse AAMC's huge new site with the Bermuda Triangle.
But I really hope they are not conducting secret research and developing powerful new weapons systems to use against us. Ones like the ABMS invented called MOC just to boost falling revenues. Or new ones like the system/portal described here: the "bow-wow/meow man-eating ABVP VET MOC PORTAL.
According to a rumor going around the ABVP execs, board and regents have just recently diagnosed the portal's problem as a new leaked NSA virus, code-named "mad cow disease". Much more pernicious than WannaCry that attacked the British health system NHS recently.
In case you think this is all just a long fuzzy tale, here are some serious academic references from the federal government, not cunningly rated "platinum" like the ABIM though
American Board of Veterinary Practitioners ABVP (Domociled in Nashville, TN being "advised" by the AAVMC college accreditation folks in DC.
"No rebel flags and no rattlesnake cowboy boots if you come to DC please.")
American Association of Veterinary Medical Colleges AAVMC (previously domiciled at 1101 Vermont Ave NW now at AAMC 655 K. Street in Washington DC. "No blue jeans and no free trips to the Grand Ole Opry or lunch at the Museum of Art with this stiff regime.")
Buyer beware (intelligent vigilance will be necessary in the MOC fight)
For Veterinarians certifying with the ACVIM or its other specialties things have changed almost overnight. They have a mandated MOC system now, albeti much less onerous and painful than what ABMS physicians contend with.
But ABMS was not always as onerous. And the conditions at present must go from mandatory back to voluntary for everyone.
Currently for Veterinarians in the ACVIM MOC means now 'maintenance of credential' which involves doing enough CME every 10 years. Currently the number of MOC points is 75 for this board.
This particular board is different from the other major board in that it is broken up into "systems" (surgery and internal medicine for example), whereas specialties an the ABVP are divided by animal species.
The next phase in this veterinary MOC system is most likely a propaganda trick for their budding ministry of propaganda. The pet owners will be reported as saying that MOC points are not enough. The public demands a more rigorous system. "We need a testing regimen in order to feel secure entrusting our pets to these vets."
The ABVP requires a dues fee (gives you discounts and publication) every year, and that dues payment/fee of $305 maintains your credential and records the MOC points.
The ABMS, ACGME, AAMC, AAVMC, AANC, ect., will not let go of their multi-year plans to make MOC for everyone more onerous for monetary gain and political submission of clients.
We believe certification testing/reporting/evaluating/improvement are the next requirements as the gold standard which all "docs" will be required to meet. They will say it is in order for the public to feel safe even if their is no proof that testing/documenting/evaluation/QI regimes are effective. Vets do not know of the sting coming just around he corner and diplomates of the ABMS should not cease in fighting the ABMS otherwise these selfish bullies with their political agendas will have even more of their way with every physician.
It is not the reign of quality they seek it is the reign of quantity. Cashing in for themselves above even the slightest effort to improve quality. The ABIM and the rest still cannot produce a viable initial certification test. The are too distracted to even try.
MOC is all just impossibly inane busywork and revenue streams leading executives to newer vistas and thresholds on the meaning of "non-profit". It means cheating the client, the taxpayer and patient in order to line their pockets and increase their investment accounts
It is the reign of quantity for bloated bureaucrat CEOs and their executive hordes of 'militia academic'.
Warning to the Veterinarian Diplomate and Candidate:
The AAVMC Amerian Association of Veterinary Medical Colleges, now located at the AAMC office and conference site on K Street, is a double whammy that all veterinary board diplomates and candidates will have to monitor closely. Once a candidate volunteers, even if they are grandfathered with a certificate dated prior to the 2016 cut off, the candidate will relinquish their lifelong certification status and be a mere mortal set to expire at the date at the whim of the board and with whatever changing mark in the target they choose.
The American College of Veterinary Internal Medicine and many other veterinary certification boards have been run like real non-profits.
How will MOC money and political influence of the AAMC and its ilk change all of these charitable organizations?
We are perhaps looking at a window on the past of what the ABIM used to be like. There is an opportunity to study this for the sake of real science and humanity, which includes our beloved pets animals we depend on to sustain this nation and world.
When money and power starts coming in it attracts graft as we have seen with the ABMS.
These people are not stuffing their pockets with millions of dollars. On the contrary these people who care for animals are giving their time away. There is a story here I think.
That ACVIM Foundation 501(c)(3) IRS filings have some interesting recurring patterns over the years where the ACVIM - their 501(c)(6) related organization with most of the assets - keeps giving the Foundation a cash grant just under a hundred thousand dollars and then a cash loan of a few hundred thousand dollars. Not sure what that is for as they don't really seem to do anything much at all as a charity. They pay a couple of salaries and benefits, but that's about it. It's not clear why ACVIM even needs a Foundation.
ACVIM on the other hand looks like a "trade" organization that pays for a staff of 16 or more and a CEO's salary that doubled over the past few years. They have an annual conference that generates most of the revenue. The new CEO was a restaurant association manager and was brought over to improve their financial results. They have some investments and assets of nearly 8 million dollars.
Surprisingly they consistently leave the question of lobbying blank, while for the Foundation they check "NO" every year. Some years show a few weird 40 hour positions that are marked 0 for compensation. Hard to believe when they spend nearly a million on compensation. None of the staff are veterinarians, while the board and regents (from other ACVIM associated colleges) are vets.
It looks like the new CEO came in around 2011 (interesting time for QI initiatives, etc.) The MOC revenues if they come will not be substantial enough to do more than pad the CEO's salary. The ACVIM only has 2000 diplomates. Hardly worth starting the MOC enhancement harassment program and pissing off the diplomates about reduntant CME paying for approved meetings, and registering what they must do anyway for their license.
It looks to me that MOC at the ACVIM and affiliated colleges is just another political power trip to get conformity/uniformity to the MOC program where everyone suffers uselessly and everyone is tamed. They may not understand that they are selling out their diplomates for a fistful of dollars. Strong-armed or lured in themselves without real understanding.
No, Virginia, this does not look like a real non-profit charitable organization, it is just a friendly certification company and trade organization that is trying to improve its bottom line. And it appears to have a do-nothing drag of a Foundation that maybe they want to keep tossing money into for some reason. Or just because others are creating them.
But its not a hardball criminal organization like the ABIM, which we've seen run by clever political jockeys like Wachter and Baron and ruthless cunning cartel divas like Chris Cassel. Highly political individuals willing to sellout their broken souls. Frauds improperly using NGOs for scoring partisan political victories and inuring themselves beyond belief. Filling their bank accounts with bilked physicians' fees and the continuous harvesting of hedge funds and offshore investments.
They are not nice people, Virginia.
They travel back and forth between Wall Street and K. Street and spend most of their work time doing exactly what the IRS proscribes against.
Exactly what the DoJ frowns upon and indicts you for. Exactly what the OIG of the HHS calls public fraud and conspiracy to defraud the American people.
How long will such criminals be allowed to walk freely from quality assurance NGO to government/corporate committee/board and back to NGO again having their way with us controlling almost everything in our country.
These ones at the ABIM, Virginia, are miscreants perpetually high off themselves and their own dirty glow.
Association of American Medical Colleges Executive Compensation and Assumption of Debt
Buying a new AAMC headquarters in 2011 cost money - lots of it - so why did AAMC not tighten the executive belt instead of adding a couple of sizes to its waistline?
Did they feel too big to fail?
According to 2011 IRS tax filings executive compensation for AAMC stood at $5,099,965.00
By 2012 executive it compensation spiked to $6,177,117.00
In 2013 executive compensation jumped markedly to $7,947,330.00
In 2014 the executive compensation stood boldly at $8,555,962.00
The latest figure for executive pay on GuideStar was $9,233,840.00
With the assumption of debt of over $150,000,000 in DC bonds and a sizable bridge loan obtained until its real estate sold, the AAMC financial status was downgraded to unstable. But that did not stop them from padding their bank accounts.
One would think that the executive compensation committee would have shown some fiscal restraint by not doling out the debt to their elites as though it was profit sharing time. But spread the debt around like a dollop of "happy times are here again" they did. Just like whipped cream on pumpkin pie. The big bond issuance of over 100 million came in November.
To underscore the fiduciary irresponsibility of using the "extra cash" on the balance sheet for giving everyone a raise, it would have been much more prudent to use that cash to help pay down their massive debt and return to a more normal balance sheet sooner. Market conditions can always go south.
To make matters worse, the compensation committee approved a deferred non-qualified compensation plan for the big wigs. This boosted one's net significantly and reduced the tax burden.
The CEO Darrel G Kirsch, MD received a dramatic increase in salary the year the debt was issued. A special note emphasizes this fact in the tax filing. Kirsch received $57,115 as part of the newly instituted deferred executive compensation plan.
In 2010 the CEO's total income was a lofty $950,170, but in 2011 Kirsch's salary totaled $1,237,257. Of that latter amount the CEO received $143,018 in bonuses, and other compensation of $69,273. That was topped off with $233,115 in deferred compensation, and an additional $17,251 just to break it all down. That is nearly a 24% raise.
The AAMC has shown some very creative use of two bonds issued by
tax ID# 53-6001131 District of Columia in the respectable amounts of
(2011 a) for $45,540,000.00 and (2011-b) at $110,561,183.00.
The CEO's compensation for 2014 stood at $1,307,153.00. All the columns were up for Darrel Kirsch. All the columns were up as they ate their extra pieces of pumpkin pie with two huge dollops of DC City Cream.
The ABMS is the Matrix of Money and Power and so is the AAMC's ERAS. Did you see what ERAS is planning next for the MATCH? It is horrible. See the html link at the AAMC' ERAS.
Whether it is MOC the Match or MCAT, it's all bunch of MOC! And it all comes with an underlying culture fashioned around a milieu of mediocrity. Money and power over others are the wrong nucleic seeds from which to grow any educational program.
Look at the "standard of pricing". The price set for MOC is rigged (it is fraudulent) and so are the fees charged for ERAS and the MATCH.
ERAS prices are "standardized prices" based on AAMC's very expensive executive tastes. This is becoming a leit motif among all the quality assurance/testing cartel components.
This price-fixing and greed sets the tone and rules of the game with ABMS MOC.
With ERAS there can be no competing online mail systems/platforms allowed from which to deliver your residency and fellowship applications.
Why? Because AAMC is a monopoly utilizing totally unfair business practices. It is a dangerous monopoly because there is not other game in town whatsoever. Was there ever a time when the AAMC was not like a Standard Oil - the sole business player with which everyone else had to fear. AAMC has an ironclad grip on the markets as they have total control over the medical colleges and almost all of the GME programs.
That gives a very frightening amount of power to an ever-growing-and-profiting large organization like the AAMC.
Maybe there could be some competition allowed to find less expensive ways of putting a digital stamp on residency applications? They can do this themselves with their vast investment war chest to fund some other startups to find a better and more inspiring way.
For example, why must we endlessly pay for a copy of our USMLE scores over and over. This is true for every other examination that we have already paid for. They are gouging us ad nauseum. These are not non-profit organizations at all.
We initially pay several times a test's value or wortth and pay the price in a surfeit of test duress and stress signing an onerous pledge as well. We pay with our dignity for the degrading testing experience/surveillance and we keep paying throughout our lives for copies of everything to licensing boards, employers and whoever needs a document.
And the FSMB has its own diabolical scams going where they will take ultimate control of the dial of our media devices and documents linking their system with the ultimate power of the Matrix itself.
It is beginning to be clear that the ABMS and their cabal comprise a vast MATRIX, a network of testing, qualifying and assurance cartels that swallow up everyone's dollars. And they take away the individuality and uniqueness just because they don't really care about the social ramifications of the herding syndromes which they are constantly creating based on the next bogus "we are listening" nexus.
The next great physicians, researchers and leaders will not come from the MATRIX
MOC is not conducive to continuous learning or generating professional qualities.
The next great researchers, leaders or physicians will come not from such a nexus of pain and mediocrity.
Such greatness will not come through lifelong matriculation into a system of MOC.
The best and brightest will not come from the "ABMS" MATRIX' of control and command at the steps of the First International Bank of the ABMS.
The light touch and intelligence we need will only come from outside the heavy-hoofed digital herd mentality - outside the MATRIX - which is constantly being conditioned into us through the overly-systematized educational process.
According to the "principle of MOC, there can be only one system for everything. In this case there can be only one ERAS. One match system! So there can only be one pricing system. It is a fixed pricing system just as with ABMS maintenance of certification.
ABMS fixes the prices to match the financial tastes and needs of executives and the political agendas they are working on. Fee increases, program changes typically come before or during the time of health reform debates or general elections.
Yes, the ABMS and AAMC are expensive professional lobby firms in case one did not know.
"AAMC Standardized Video Interview [a mandatory pilot program that destroys the first rule of voluntaryness, disclosure, and consent to take part in an unpaid test ride of AAMC new multi-million dollar video systems installed after receiving special financing from the District of Columbia."
"All ERAS 2018 applicants to ACGME-accredited emergency medicine residency programs are required to participate in an operational pilot program—endorsed by the emergency medicine community—to evaluate the use of the Standardized Video Interview as a tool in the application and selection process."
Of course, because the EM community endorsed this pilot video-taped interview process that that somehow makes it perfectly alright to abuse the rights of candidates who want nothing to do with such and intrusive prescreening process. A video that will do little more than to immortalize the AAMC's fervent search for other ways to charge fees.
Another chance to further confuse and degrade our humanity and value placed on live human exchange in the interview process.
In this case a mandated pilot video means more not less potential prejudging and more potential manufacture in the head of useless prepackaged images and imaginary projections.
One is applying for a physician training program and not a media production studio. Or for a position in modeling.
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