Wednesday, August 16, 2017

Fake News: Annals of Internal Medicine's Disclosures

On 15 Aug 2017, the editors of the Annals of Internal Medicine published the Study "Effect of Access to an Electronic Medical Resource on Performance Characteristics of a Certification Examination - Randomized Controlled Trial" that was heavily marketed front and center on their website using the happy physician testing picture shown to the left.

The article touted a comparison between open book vs. closed book testing that was conceived exclusively by the American Board of Internal Medicine and executed by their conflicted corporate partners at PearsonVue and a new $10.5 billion corporate heavyweight from the Netherlands, Wolters Kluwer. In a veiled attempt at full disclosure, the conflicts of interest of the study were carefully articulated in a lengthy disclosure statement hidden behind a paywall. True to form, nearly all of the editors of the article claimed "no financial relationships or interests to disclose."

Most internists in the U.S. know these editors' disclosure is little more than fake news. The Annals of Internal Medicine is an academic medical journal published by the American College of Physicians (ACP). On its last available Form 990, the ACP earned over $24.6 million in a single year selling their Medical Knowledge Self-Assessment Program to US physicians to study for their board certification and recertification examinations. Even the accompanying editorial was written by ACP's former senior executive vice president, Steven E. Weinberger, MD, who disclosed he was an employee of the ACP and earned royalties from authored material on UpToDate.

In addition, the supplement supplied by the authors had portions of the recruiting notice redacted so avoid true disclosure. But when a copy of the actual recruiting notice is revealed here, it is clear that PearsonVue had more than a minor role in the research and had access to the study registrants' names, addresses, and probably more.

Each of the 825 physicians enrolled in the study received $250, costing US physicians (who unwittingly funded the ABIM Foundation) $206,250 for "incentive payments" for this study, not including the time and salaries of those who conducted this study for the ABIM's benefit. None of the participants were told about the financial benefits to the ABIM, PearsonVue, Wolters Kluwer, or their content creators for participation in this study.

Such conflicted "research" published in an academic medical journal that misleads the public and US physicians represents little more than a free advertisement for the financial agendas of these colluding organizations and sets and incredibly low (and untrustworthy) bar for all of academic publishing.

-Wes

31 comments:

  1. Thank you for your tireless efforts to expose all that is worong with never ending recertification

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  2. Thanks for calling out the fake news for what it is, Wes. The global Elites keep pushing what is good for their evil agendas, and none of it is good for doctors or their patients. The 1% get richer and more corrupt. Everyone pays more and receives less in return.

    Maybe we can have a holiday where there is no fake news for one day a year. Every time I turn on the news on tv I hear about Nazi white supremacists who are hunting people. I think of all the children who aren't white having horrific nightmares, because there is no way they aren't hearing this. I check my twitter and see videos yet to ever be shown on television of counter-protestors attacking that man's vehicle with an object, looks like a baseball bat or something else slammed onto his bumper, then another video shows people piling onto the back of his vehicle smashing an opening through the back window, all ready to attack. If I was startled might I speed away from that? If I was attacked from behind might I back up and get out of there, having no other out? It hasn't happened to me, but I think that might be my reaction. The Virginia Governor has also been exposed as having actively recruited and paid people to come out against "The evil Nazi white supremacists".

    So far ABIM isn't coming at any doctors with baseball bats, pepper spray and other violence. Not yet anyhow. But everyone stop and consider what all fake news does to people, especially little kids who don't know what's fake and what's real. We tell them the Tooth Fairy and Santa Claus are real, so it undermines all credibility in the end.

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  3. Everyone who did the study was ABIM funded, even the author listed last on the "study" Dr. Stephen J Durning, was and is an ABIM contractor. Interestingly, Durning was part of an ABIM Foundation/John A. Benson award winning study published in 2012: "A multi-institutional study exploring the impact of positive mental health on medical students' professionalism in an era of high burnout.
    https://www.ncbi.nlm.nih.gov/pubmed/22722352

    Dr. Durning has done several studies on burnout and mental health due to stress and many other factors that medical students and young physicians face. It is quite surprising that given Durning's forte in studying the adverse effects of testing, that this data collection was not mentioned. And another notable remark is Durning's reasons for involvement in the study were not disclosed. Is this not just like the tobacco industry studies of the 50's and 60' and beyond that secretly conducted secretly their own studies that linked cigarettes with cancer and heart disease, but kept it as "proprietary knowledge". In other words the results were kept from the public. They were kept from the hapless consumers of something harmful for them, because such knowledge would be harmful to the bottom line and deceptive practices of powerful corporations.

    MOC consumers have a full right to know what the ABIM knows. The public has a right to full disclosure of everything, especially when it is put in jeopardy by the action or inaction of a corporation. And ABIM chairman in the past has withheld knowldege from clients and the public about the ill effects of tobacco consumption. Why? Because he was paid to do so. There are no words for such a thing.

    Perhaps an informal discussion on Dr. Durning's findings (or suspicions) would enlighten us. Durning's involvement was not by accident. Everyone knows MOC is harmful to the mental health of physicians. It is harmful to patients and the families of physicians. It is fair to use the tobacco companies' many cover-ups and whitewashing of the facts that cigarettes caused cancer and heart disease. MOC has many unintended consequences that are not being studied in the light of day and according to unbiased science--science that is not controlled by corporate interests. This includes, loss of livelihood, burnout, unnecessary stress, disease, marital problems, divorce, additional mental health problems of physicians' children, or finding time to even have a family. Other adverse effects include premature retirement, early deaths and even suicides.

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  4. The founders of the ABIM, comprised of AMA and ACP members, had much more common sense and followed their conscience in the 1930's compared to the current leadership. They would not introduce MOC. It would kill physicians' spirit for lifelong learning. And they knew that such a harmful election to introduce MOC was against all the principals and philosphy of self-regualtion.

    Let's be brutally frank. Just as medicine has and should take a strong stance against tobacco consumption and cigarette smoking, so should the healthcare policy makers take a strong stance against MOC. For goodness sake, mandated MOC is a money maker only. It is a unhealthy grasping for power by the medical boards.

    But there is no evidence that MOC makes better docs. MOC is unnecessary and even harmful in the most deleterious ways. It can literally tear a physician's practice and life apart. And MOC can severely harm the physicians patient relationship and continuity thereof.

    Doesn't the public, but above all physicians who have been pushed, bullied, and abused for too long, deserve the truth. Don't we the people deserve to have a vote about our self-regulation?

    Above all we need facts not fake news and pseudo science. And we need more transparency. It is time for admission of the harmful effects of MOC. It is time for a real survey. A release of any studies, even common sense suspicion regarding the harmful effects that have been conducted so far. Here is what Dr. Durning has been studying--all related topics. Why else would he be asked to partipate as a contractor studying stress and the over testing of medical students and physicians.
    Now you know why the photo has MOC test takers smiling.
    It is propaganda and we need for it to end. MOC and the propaganda about it and start speaking the truth.
    https://www.ncbi.nlm.nih.gov/pubmed/?term=Durning%20SJ%5BAuthor%5D&cauthor=true&cauthor_uid=22722352

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  5. MOC: isn't it the same ugly ploys and deception that big tobacco used

    What is most remarkable about this study is that it looks and sounds exactly like the tobacco commercials of old using glowing blissful physicians in the photos holding a cigarette at the center of attention. Of course the photos back in the 1930's 40's and 50's were all with healthy subjects and they were touched up with Hollywood technicolor for the face and the appropriate color of shoe polish for the hair. Cigarette smoking was touted as a healthy thing and unless you smoked you were often made to feel rather awkward in society.

    Fast forward to the ABIM RESEARCH LABS. MOC is being flaunted as healthy and even desirable. Don't let the advertisers at the ABMS and their corporate sponsors fool you.

    Today we have Photoshop for our advertising graphics and photos. It can do fantastic things.

    With the ABIM's advertisement, the actors are front and center and looking blissful and healthy in their seats allegedly taking a certification or MOC two-year open-book test. What rubbish! It would be much better if they were levitating in the air and had their hands and feet in a meditative poses. But even so, the well-grounded ABIM outsourced actors did a good job pretending as though the test posed no real life problems. A marvelous breeze. In fact the Pearson's best computers that money can buy--supplied for the study courtesy of George Soros' NGO money. That West Indies zephyr seems to be blowing the hair of one test taker like he were in Jamaica or the Cayman Islands.

    Let's get real. This is propaganda and ABIM 'mind control'

    The ABMS Big Piggy Bank "TOMOCCO Road" corporate banksters who bankrolled the open-booke testing project, i.e., ABIM Foundation/ABMS/ACP/AMA/Pearson/Wolters Kluwer/Offshore International Investors and Private Equity, would now have us believe that an ABIM test will just "take itself" with Wolters Kluwer's hovering watchful eye protecting one. And miraculously it appears that Pearson has also gotten its act together. They have supplied the lucky "bliss-takers" with fast stock-traders' computers with lots of RAM, if we believe things as they appear in the photo.

    Yes, the diplomates faces make us believe that a Pearson/ABIM/Wolters Kluwer test can be taken in a state of complete Satori without the Zen masters cane beating us into attention. Big Bro ABMS suggests to us, there are no phantasms, no hallucinations that will come on the blissful journey dancing down their gold-paved TOMOCCO ROAD. No worries about losing job, face or ability to feed one's family.

    The ABIM would have us believe with their special interest partners that taking a pilot program/paid test is the same a the real deal. It is not. This pilot test did not even count. "Just sign on and be reassured they say. Trust us, we have you covered."

    Nonsense, who is their right mind could accept any of their disinformation?

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  6. Who are the highly conflicted designers of this study and who is the corresponding author

    The test takers did not report any stress at all. Why? Was it all a state of non-identification, as though the MOC two-year testing is and will be a snap? Were they inspired by a distant 'observer' that knows all and sees all? Is it fair to say that the testers in the ABIM fake news story have no thoughts in their heads? No cares whatsoever? In fact, they appear to have vanquished all their doubts, cares and transcended ignorance. Wait, is this Pearson Vue or a Scientology Center where they are free of all their hidden demi-urges. No more responses as though the mind and all life were just one gentle current of flowing limpid water and sweet perfumed air.

    Let's examine more closely; there is a big credibility problem with the article, and especially with the photo.

    There is no photo credit at all and judging by the big beautiful window and the light coming in this cannot be a Pearson Vue testing center. There are no monitors, test administrators. And the proximity of the test takers to each other without screen guards on their computers, is concerning. Call the 800 hotline for irregular conditions and behavior right now. The photo gives the whole ABIM scam away. It is too contrived to show us enticing bliss. Don't worry or fall for it. It it almost certain that the photo was just a screen capture or image grabbed from online, and the happy testers are not taking a test but gaming after all.

    So it is not real life, rest assured. Besides, if it were real the ABIM and Pearson would have a nasty double-felon floating in the background watching over you looking in from the window or a hidden camera above--and either taking notes, snapping photos and recording the event.

    But above all the goon would be making sure you or the other guy were not stealing precious ABMS/ABIM/AOA/NBME/UpToDate/Project Dx/MAYO/CLEVELAND Clinic/Kaplan recycled "open-book" copyrighted test questions.

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  7. Fake certification numbers report: what's it for? And why are the ABIM and other member boards quietly trying to check on licensure status for countless physicians in their database listed as certified? (A physicians cannot be certified if they do not hole an unrestricted license to practice medicine. Retired, inactive, volunteer, training, temporary licenses do not quality as an unrestricted medical license.

    The ABMS as of January 2017 reports 860,000 certified doctors. This is a fake statistic. ABIM boasts over 200,000 certified physicians. This is a bogus estimate.

    Consider how many of those counted actually retired early and did not tell the ABMS. The ABMS is too embarrassed to admit how many physicians are leaving medicine because of them and their MOC. How many physicians that do not qualify because they have no unrestricted license to practice. There are a great many docs out there who are retired/active. Right now there are countless certified physicians who do not practice medicine at all who are on the ABMS specialty boards websites as being certified.

    The ABMS has not done its due diligence and tracked down those physicians that are lifetime certificate holders, who no longer qualify to be listed as certified. Have they announced to all physicians nationally and around the world that they have a problem and need to revise certification statuses for countless docs. What will that do to their fake statistics when the news hits the wires.

    Here's a blog that verifies that the ABIM is probing to update their very outdated data, which inflates their ranks. Even those grandfathers participating in MOC, who do have an unrestricted license will bring the number of MOC participants down. Is this part of the financial obfuscation at the ABIM. Holding their finger in the dike, but they have run out of fingers? There are just too many things wrong with this broken, bloated, bureaucratic testing business.

    Do the ABMS and member boards wish to keep the numbers of certified docs and MOC participants high to confuse the public and their clients, while at the same time they are actually actively and consciously reducing the number of physicians through unnecessary burdensome testing that pushes physicians out by testing failures or by pushing docs away from the ABMS and MOC's failed system?

    ________________________________________________________________________________________

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  8. Is the ABIM/ABMS going to re-categorize physicians who are grandfathered without an unrestricted active medical license?

    "FSMB records indicate no active medical license found."

    One is seeing this message more and more on the FSMB website. What does it mean? Has the ABIM or ABMS made any announcements about why they are sending out letters to physicians and not making a public announcement about a change in policy or one that is likely to occurr soon. Will the ABIM make some unilateral decision on grandfathered physicians' certification themselves. Or non-grandfathered certified physicians who are not licensed practicing docs. They will either take away the certification if no active license is found, or they will list the physician as retired. They have not decided yet. Here's what one blogger wrote, who says that the ABIM did not respond after mailing out redundant letters to him.

    "After 40 plus years ABIM does audit to see if I have a medical license
    What is that all about?

    I received a letter from the ABIM informing me that " during a recent audit, ABIM was unable to confirm that you have a valid license to practice medicine." I was requested to send a copy of my license within 30 days and " if ABIM is unable to confirm that you hold a valid license to practice medicine,ABIM will be obliged to suspend your Board Certification and report your certification status as "Not certified".

    I replied the same day by Email and send a hard copy of my license by letter . A few days later I received a second letter identical to the first and again I replied by mail with a copy of my license.I have had no reply.

    I wondered about their audit procedure. I was able to verify my license in less than 2 minutes by going the website of the state of the medical board in the state in which I have had an uninterrupted license at the same address for over 35 years.If their audit process is as inadequate as it appears to be they will waste more than a little time and effort to confirm licenses and waste time and efforts of diplomats replying to the requests.

    Why , after forty years, does ABIM consider it necessary to determine if I have a license?

    Is this somehow related to their widely criticized maintenance of certification (MOC) program and the efforts of some organizations to link MOC with state medical license requirements?

    Have others received similar letters? Any thoughts about what this is all about?"

    http://mdredux.blogspot.com/2017/06/after-40-plus-year-abim-does-audit-to.html

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  9. Lisa:

    The very widely distributed videos show that the young man's front bumper was damaged when he plowed into the back of a stopped car, and his rear window was attacked after he had killed one woman and injured nineteen. To try and paint him as the victim is truly despicable.

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  10. I called ABIM in July about this ABMS certification/unrestricted license dilemma. It appears to be a big mess. First, it took a long time and several calls to get through. I don't have all day to wait for a live person to answer. Serious problem in keeping staff or what? Either they have had to cut back on phone staff to pay for the high executive overhead, or they are inundated with calls. Finally after days of trying, I spoke with someone who said they were not sure what they were going to do with those certified before 1990, 1987, 1988 etc., the so called grandfathered diplomates. But with the time-limited diplomates it was clear that they were going to decertify any MDs who do not hold an unrestricted license to practice medicine. The phone person was very familiar with the topic and what to say to non time-limited diplomates to assuage them and did not need to be coached for an answer. Maybe someone can call them and get the full story. They seem reluctant to come public on this one.

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  11. Probably the only thing keeping them from decertifying the entire lot of grandfathered physicians with limited or no license is that they are understaffed and it takes time to go through their databank, send out letters and wait for a response. Does anybody know what the grace period will be? I presume they have to see what the actual damage is going to be to their false reporting on their websites before deciding to clean it up or hide it all as usual. Incidentally on the phone they have advertisements running while you wait. "ABIM has over 200,000 certified physicians." And yet they make it out to be a drip drip problem. No, it is a gusher and hellcat fire on the drilling rig.

    The other big holdup is most likely the fact that the "Christine Cassels of the world" are numerous in their files who are listed as certified but they are not real physicians. They are politicians and business representatives pretending to be docs in front of congress and sitting on lucrative corporate boards who hire such politicians to lobby for them. Many of these lobbyists and political figures are "certified doctors". Some have unrestricted licenses in name only, and others are registered with limited or expired licenses. Will the Cassels of the ABMS world be decertified or listed as special cases? In this case, I speak of the ones who had some special golden parachute clause in their contracts."Certified for life" no matter what hits the ABIM rig because of their past negligence and greed. Did Cassel really walk away with a 1.7 million dollar deferred payment and no legal liability for the damage she did to the corporation? And a politician like that with all the egregious conflicts of interest to boot is considered to be a certified internist? Unbelievable.


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  12. The ABIM contract author Steven J Durning has worked testing MKSAP products and ACP products are on sale at the ACP online services/products/book/store.
    https://store.acponline.org/ebizatpro/Default.aspx?TabID=251&productId=21910

    Testing theory and psychometrics! Maybe we should go back to an emphasis on essays and direct contact evaluations to learn about sound clinical reasoning and professionalism. These third party organization who irrationally think they are demigods are just getting stranger and plain weirder all the time.

    What makes sense is just common sense and is quickly becoming the millennial consensus.

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  13. Even the ABIM's study title sounds fake. Couldn't they say it in a few words?

    "MOC Test: Open Book Versus Closed Book" -
    Using business partners UpTodate owned by Wolters Kluwer - ticker symbol WKL.AS.
    And Pearson PLC ticker symbol PSO.

    Conincidentally both these companies stocks are at 20 year lows, while the stock markets are at all time highs. ABIM keeps losing money and all three companies are desperate to keep their corporations afloat. That is the backdrop on which the whole "study" of partner products and messages of "we got it wrong" is all about. Trying to stay afloat!
    The causes are negligent fiduciary stewardship and overspending on executive compensation and perks and trying to sell MOC to clients. Very few physicians are buying it. They want out. With Pearson and Wolters Kluwer investors have lost a great deal of money and they want out. WKL.AS is the only one that has rebounded somewhat off its lows. But they are all in the tank. Physicians are being asked to sink with them, so that the CEO and other key executives can keep the big payday going. But all the money in the world will not repair a shattered boat such as the ABIM.

    And concerning the study: honestly it is not a "Randomized Controlled Trial" at all. It was only on corporation testing one new product. UpToDate. What will they test next? How much time will they keep wasting piloting around in circles before they run out of gas?

    ACP is hoping that physicians buy into the new MOC because they have lots of MOC products and services they sell already:
    https://www.acponline.org/cme-moc/moc/learn-more/abim-exam-preparation/review-courses/orlando-fl
    And new ones in the pipeline including a the build out of a competitive clinical tool they claim works faster than UpToDate called DynaMedPlus:
    https://www.acponline.org/clinical-information/clinical-resources-products/dynamed-plus

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  14. What was proven with ABIM's study? Nothing? Who were the winners and who were the losers?

    The real winners were the "placebo group" - the third group that they overlooked for good reason. The third group is comprised of the real self-regulating physician who did not want to take their 250 dollars. The group comprised of almost every practicing physician in the country and around the globe - those who choose not to do the ABMS' mandated MOC.

    There should have been a third control group made up of those who did not get paid to play with the ABIM. The third control group who devoted that day (and additional travel time) not to MOC testing, but to their patients. This third group was able to use both open and closed book methods in real life using UpToDate with a more focused, practical and hands-on approach.

    Who will turn out to be the better physician? The pragmatic physicians working hard treating real patients, or the ones "on vacation" in la la land getting paid to do a pilot study that does not count? No need to even break a sweat over it. You will not lose your job this time around, but wait until the next one that counts and you are sick to your stomach and have a splitting headache and high blood pressure on that day.

    Obviously the physicians who chose not and did not get distracted with a stressful, burdensome and onerous theoretical testing regimen countless of miles away from home excelled. They always will. They were and are the superior time-tested physicians with better patient outcomes. Real outcomes. If the test counted, their corticosteroid levels would have been well beyond the normal ranges, because of the fear involved. Even the fear of ABIM's penchant for suing physicians. They make you sign your rights away without any choice with a take it or leave it contract. That is part of the reason the ABIM is dreaded, feared and hated today. They don't get it. Are they dense as well as negligent. But even into 2017 they were still trying to take a Puerto Rican physician down maliciously. They spent five years terrorizing him. And we don't know anything of what their sanctions "panels" do behind the scenes to keep physicians trembling and paying. Not a healthy way to live and work!

    (And just to note about the home/office option that is proposed as an enticement: this means if you don't take the two-year test at a Pearson center then as the ABIM proposes one would take the test at one's home or office with an unknown/unvetted third-party online testing proctor staring you down from his or her remote camera in India, Nigeria or the Philipines. They will take you data, confirm your identity and create a personal file on you, making sure that you don't act irregularly or steal ABIM's copyrighted questions or go to the bathroom to read the answers on the mirror.)

    What's next for the ABMS, ACP, Pearson, Wolters Kluwer entrpeneurs? What's next after blowing a lot of money?

    "More study is warranted, they say, i.e., "we will spend more money to divert attention from the fact that mandatory MOC needs to end today as the AMA House of Delegates resolved last year and as the state legislatures are overwhelmingly supporting this year."

    Conclusion and summary of the study

    The end of mandatory MOC is in sight with statutory relief from the state legislatures coming if physicians stand firm against MOC and fight for what is right for themselves and their patients. What's at stake? Real self-regulation and the opportunity to stay focused choosing to learn what is relevant for one's own patients and practice. Studying with with real joy and interest, not the phony political scut and pecuniary interests that the ABMS keeps foisting on us.

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  15. I almost missed this one. They took their jolly time publishing it in ACP's premier anals for internists. My second residency here in the states shoved this down our throats along with an ACP membership. More government taxpayer money blown. Same with the AMA. Data profiling systems R us. Gotta have your number and pin, so they can have a number and pin on you. I thought I was escaping this bisque when I flew across the pond. Everything is getting worse.

    I got an email on one of my patients that I saw yesterday who passionately wanted to go out hunting. Two docs, internist and cardiologist, wanted to 'categorize' him as a palliative care/hospice patient and take away his meds. He's 80 and does not want or deserve to be 'defunded'. His daughter was looking for help and advice. Patients and doctors are becoming impotent against this powerful palliative care machine. I bring up this issue, because it reminded me of our fight against MOC. They want to take the life and passion out of us and not let us go out hunting for the 'truth'. That is something that makes us tick as doctors. To use our training, compassion and science to the best of our ability. It was supposed to be reason over emotion, but much has turned the other way around and has often turned into an emotional ideology--not sound reasoning. I'm talking about dumb MOC and stupid palliative initiatives. One has to be smart every moment or we falter and succumb to the 'dumb scinece of MOC' and the tyrannical rants of the ABMS. Part of the unintended consequences of cost-saving humanitarian initiatives. Particularly when mindlessly followed.

    Its the same way with this MOC fight. ABMS wants to render us powerless to truly care for our patients by shoving MOC down our gullets. Killing the spirit to hunt for the truth each moment. To follow the ABIM is to follow a mindless path of burnout and endless multiple choice decisions. Pseudo-reason. Real medicine is not like that. It is not mindless, but dynamic and living.

    This decrepit study is little more than a paid advertisement for Wolters Kluwer, UpToDate and the shameful publisher. I could tell you an earful about them, but encourage people to go online and see the power and breadth of business and social influence that they wield. WK is into everything if you did not already know. In this study, they bribed youngish physicians to get acquainted with a product/service that has many conflicts of interest, including financial and political. Sadly it was paid for with funds taken from the 'notorious' ABIM Foundation. Physicians' surfeit fees, which should have been returned to them by now. We all share this strong opinion, I'm sure.

    This was a private industry commercial and should have been labeled as such--a paid advertisement. Wolters Kluwer and Pearson should have put up the money entirely and not ABIM Foundation. This was totally improper. A commercial masquerading as science. I am always surpriesd by the actions of this elite 'group of business men', but never quite astonished yet.

    Back to work, sorry no time to spellcheck or edit. NO MOC NOW!

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  16. Thank you, Dr. Wes.

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  17. This is now beyond outrageous!!

    This front cover picture is now sending the message, for the abuser beast ABIM, that those victims that they have been raping and abusing (professionally, economically, and yes ... emotionally too) all along ACTUALLY enjoy the act. How repulsive.... Shame on ACP to be such an accomplice!!!

    ABMS/ABIM certification and MOC is not a badge of honor anymore. It has already been corrupted into a scar of shame and involuntary bondage on those practicing specialist physicians who are made to bear it on their forehead.

    The public should ... and will know about it. Time to shatter the ABMS/ABIM LIES, now.... once and forever.

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  18. What is the ABIM, ABMS, and AAMC doing partnering with Human DX, Ltd.? What is not being disclosed?

    What is Human DX Ltd. (Human Diagnosis "Project")? Is Human Dx "information" or "advice"?Profit or not-for-profit? It has a Delaware incorporation/Registered as foreign co., CA
    https://www.humandx.org/

    "Human DX, Ltd." rents office space in SF 20 minutes from UCSF.
    It is somehow one of 8 finalists for 100 million six-year grant/prize from the MacArthur Foundation.

    If they win, who will get the money. Does the CEO and Director draw a salary? How much?
    Some sources say that it has revenues of a half-million dollars. Its website is vague on many things.

    What is the ultimate purposes of this "information theory" business, that is "not advice", but will aid in diagnosing undeserved patients?" Does this Delaware based company plan to declare itself and incorporate as a non-profit charity? Right now there is nothing found.

    DX top contributors/users of site MKSAP 17? It boasts having 5000 physicians in 60 countries connected to it.

    News and data

    John and Catherine MacArthur Foundation Grant
    https://www.macfound.org/press/semifinalist-profile/human-diagnosis-project/

    "AMA, Others Strike Long-Term Partnership With Human Diagnosis Project"
    https://www.ama-assn.org/alliance-forms-expand-physician-access-millions-americans

    Human DX Team Partners

    American Board of Internal Medicine
    American Board of Medical Specialties
    American Medical Association
    Association of American Medical Colleges
    Association of Clinicians for the Underserved
    National Association of Community Health Centers

    Can a Crowdsourced AI Medical Diagnosis App Outperform Your Doctor?"
    Scientific America AUGUST 10, 2017 - IN THE MEDIA
    AUGUST 10, 2017 - IN THE MEDIA

    "The Human Diagnosis Project Combines Doctors With AI To Bring Health Care To The Uninsured"
    AUGUST 10, 2017 - IN THE MEDIA

    "Want A Diagnosis Tomorrow, Not Next Year? Turn to AI?"
    AUGUST 9, 2017 - IN THE MEDIA

    "Major Medical Associations Back AI Project for Patient Diagnosis and Specialist Care"
    JUNE 30, 2017 - IN THE MEDIA

    Jay Komarneni, President and CEO of the Human Diagnostics Project"
    APRIL 26, 2017 - IN THE MEDIA

    McArthur Foundation six-year grant
    "One of These World-Changing Ideas Is About To Be Worth $100 Million"

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  19. Enough is enough....Fri Aug 18, 09:11:00 PM CDT

    Wake up...... All. Don't fall into the dishonest and cunning trap of the ABMS/ABIM and argue on the questions of cost and time burden or even practice relevancy of the MOC exam. There should NEVER be a MOC exam at all. Lifetime learning, not lifetime examining....

    It has NEVER been professionally or morally justifiable for a self-appointed group (and a "small" one) of docs in the BOARD who are accountable to no one other than their own ego and greed, to be allowed to "test" another group of docs who are at least equally qualified and yes, equally certified (I might even say with good conscience and confidence, often better qualified... ) and claim that they the BOARD KNOW better. "They" set the questions, "they" set the answers, "they" set the pass-fail standards, and "they" keep everything on the dark. In the the black box, with no due process. And "THEY" can take away your right to work, right to your profession, right to practice and right to a livelihood, at their aloof pleasure!?

    Worse still, Pass or Fail, you don't and will never be allowed to find out what you get "right" and what you get "wrong" ( for obvious $$$ reasons, and anything other than patient benefits). And this is called "safeguarding" the patients interest???!!! The truth is so blatantly simple and heartbreaking. What an "insult" to us all ( and to our patients whom we care)!!!!

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  20. dr wes, the comments to this article are missing on nejm website..

    http://www.nejm.org/doi/full/10.1056/NEJMp1612106?query=featured_home

    do they always remove the comments later or this one was intentional..

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  21. Excellent points, Anonymous HUMAN DX, LTD. CA SEC STATE CATEGORY: "Information Theory" and quite sadly AI really WOULD outperform many doctors in the area where I live. I go online to see that there are still professional, smart, decent, dedicated doctors in my country...for now. PLEASE don't retire any of you good doctors out there, PLEASE. Doctors long ago were the independently wealthy altruists who wanted to "give back to the community" and find an area in which to serve people as Jesus would. These were also some of the smartest people in town. Naturally, over time, "Physician" was a great honor, because of the great things these folks did, whether for pay or in a country settings perhaps in exchange for a chicken or whatever the patient could offer in exchange.

    Then all that prestige and Elite status was something that groups who had not attained much social status decided that they had a right to. So becoming a "Physician" turned into an EEOC or other issue. It was increasingly about the entitlement of the Physician-to-be, and at some point that became even more important than whether or not someone was truly suited to become a Physician and meet the demands of that profession. There is no IQ test to get in, is there? If so I met a lot of doctors who cheated on that exam.

    Now I am seeing that the AG is "going after doctors" if opiods are prescribed. Listen up everyone, only counterfeits can truly explain the carnage that we're seen. So if you are doing right by appropriately prescribing pain medicine, for example, post-surgical but that pharmacy has fentanyl labeled as something else because the counterfeits are getting through somehow, then you get in trouble:
    https://www.justice.gov/opa/pr/attorney-general-sessions-announces-opioid-fraud-and-abuse-detection-unit

    If you operate on someone and DON'T prescribe pain medicine, you are a total dick and risk medical malpractice for torturing that patient--even though there are these new guidelines that say not to treat people's pain and inflict great human suffering. All the liberals who think having the government control healthcare is good, please get off the crack or whatever is causing you're judgement to be impaired. Has anyone found a cure for Big Government Liberalism? That is Nobel Prize material for certain. Maybe if there are enough really smart doctors left, a way can be found to get the Artificial Intelligence to prescribe controversial medicines and if there's fallout over than then blame programming.

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  22. x - you mean this ABIM-sponsored ad/op-ed planted in the NEJM?

    "Knowing What We Don’t Know — Improving Maintenance of Certification
    Richard J. Baron, M.D., and Clarence H. Braddock, III, M.D., M.P.H.
    N Engl J Med 2016; 375:2516-2517December 29, 2016DOI: 10.1056/NEJMp1612106"

    Ur right. Comments are gone! What censorship as this nation has not seen since McCarthy era.
    Even Bob Wacther's comments on the now defunct "Wachter's World" are suddenly archived and still available from his canceled commercial blog sponsored by Wiley--now transferred to the site's co-sponsor Society of Hospital Medicne SHM.

    The trick is in trying to find "Wachter's World" now without the "Wayback Machine". Lots to hide there it seems. So it is the same as censorship. We don't know if Wiley dumped Dr. Wachter or if it was just dropped due to inactivity. Wachter may have made the politically dumb decision to "pull the site" himself.

    MOC helped make Wachter's career image, reputation and political ranking go bust, not just w/one or more bad missives, but a decade of ABIM politicking and shady finance, such as the luxury condo purchased for egregiously conflicted folks like Chris Cassel and the rest of the 17th floor gang. The IPC The Hospitalist Company coverup gave Dr. Wachter more than a moral black eye, it turned his silver tongue into pewter.

    MOC needs to go away. It is a career buster for the corrupt as well as the honest. That is the karma of MOC. Corruption run amok and all it touches.

    MOC is a bane to physicians' professional educational life and it does harm to patients. MOC is one of the most corrupt educational schemes (scams) in the history of the United States.
    What more do legislators and policy makers need to know. End MOC and never look back.


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  23. The title of the MOC commercial/UpToDate ad should have been:

    "Adverse effects of being stuck within a closed testing continuum without professional i'MOC'ulation or statutory immunity!"

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  24. Physicians will quit rather than be subjected to this fgd two-year exam, the monstrous ten-year exam or any of the in between 'la di da' bs that a doc is mandated to "voluntarily" do!

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  25. MOC is proven harmful to patients and physicians, especially in our current crisis of physician shortages and patient bottlenecks.

    Quite frankly, the entire ABMS is burying their heads in the sand hoping that the storm will pass. Dumb, dumb dumb. They are not even able to keep up with their promises involving certification. They have a failed system of fraudulently failing physicians without cause. Has an ABIM psychometrician ever been called to testify before congress. "State your name and occupation." "Excuse me, but what is a PSYCHO-M.......?"

    The ABIM cannot fulfill the promise of even sticking to a simple ethics policy.

    The ABMS lies and says that each member board is responsible for its own conflicts of interest. Not true, the ABMS is the oversight board for the members. Read the bylaws.
    The ABMS is not only colluding it is covering up the fact of its collusion in creating a MOC Ponzi scheme and running a protection racket.

    ABIM finds it too difficult to focus on their core "mission" of certifying docs. Certification is third or fourth string to Wall Street finance, ; the ABIM special teams on security is obliviously running away from themselves ending up playing defense for "legal matters". Lawsuits against them were brought about by their own hideous pursuits. Capturing MOC (revenue) is second fiddle to certification and prevents them from doing a conscientious job.

    They are even hoping that nobody calls them out for falsified physicians numbers claimed to certified and participating in MOC.

    There is no scrutiny from authorities, no accountability. This has helped fuse the problem into a rigid immobile mess. And who has the spine to just say no, when they've conspired with their real stakeholders the PAYERS, NCQA, AHA, ACGME, TJC, AAMC, ACCME, and so many others.

    What is wrong?

    The entire ABMS chose to deceive the public with their failing system of evaluating physicians according to the principles of sham and scam. Pseudo science. Their dynasties of corrupted executives and chairman has a taint beyond belief of graft and cronyism. The ABMS cartel of "affiliated corporations of new formation" have done their part to induce the physician shortage. These self-dealing crony capitalist companies work, not for the public, but for powerful and profitable special interests diverting money away from "we the people" and into the hands of corporations and the ultra-elite.

    The words "egalitarian" and "rational distribution of finite resources" is bold-faced hypocrisy rolling off their elitist lips. The same lips that deceive us by saying they take no money from private industry. They take comp and stock from the rich and rob the poor, while charging huge over-priced fees for deceptively advertised and fraudulently packaged products to physicians who are tested, billed and scammed "until death do us part". It is a sham marriage of policy cum legislative mandate; the end result is coercion and rapacious habit. Corrupt executives feign "public goodwill" and "charity", while stabbing their colleagues in the back. They use the public as a mouthpiece putting fake words in their mouth, while plowing under healthcare's finite services back into the earth.

    MOC is a morally decrepit and financially fraudulent program. Shame on the ABMS and ABIM!
    Shame on their partner organizations who are equally to blame for injurious craftiness and graft.

    When put under even the slightest light and heat of scientific scrutiny, MOC implodes and explodes in the lab.

    When put in the social laboratory, the context of real life, it is perfectly clear what MOC is and means to everyone. MOC is the incorporation of patent lies, consumer fraud, all public suffering; the ABMS bares the hallmarks of creation of indentured life for clients/consumers and global expansion and adventurism for the elites. MOC waves the banner of aggression abroad and flails through interstate commerce the trademark of illegal trade.

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  26. Conflicted CEOs galoreTue Aug 22, 03:25:00 PM CDT

    Will the real ABIM CEO please stand up

    Biemiller was former deputy chief of staff and policy advisor to democratic Philly mayor Michael A. Nutter. Judy Cassel, a close associate of Suzanne Biemiller comes from the same political party/team and served the same administration before heading over to the ABIM.

    It is interesting and worth noting that corruption and scandal still hovers like a cloud over Mayor Nutter and some of his people for the handling of the sale of the GasWorks facility/services and the improper use of city money as a "slush fund for personal use". Of the latter charges, of course, the mayor denies any wrongdoing and calls his accusers conducting the Philly credit card and financial audits snakes. Biemiller, who headed the GasWorks sale somehow failed to inform the city council of side deals to enrich the directors to consider the deal. They would get the "consideration payment" whether the sale occurred or not. When the contracts and payments to GasWorks executives leaked out there was fury in the press and city government about it.

    And the ABIM would try to sell us on this new "internal CEO" and failed to mention the controversay and potentially lethal baggage that would come with such a political hire?

    One wonders why politicians/bureaucrats like Biemiller and Cassel would go into hiding at a place like the ABIM. It may be clear to some and totally obscure to others. Most clients of the ABIM remain unaware of the totality of conflicts of interest that is the ABIM. Both Biemiller and Cassel had no medical background or medical quality assurance skills. Nothing to qualify them to run the ABIM.

    One assumes what one will from the history of politics and financial controversy that Cassel and Biemiller move away from as they endeavor to "help transform American healthcare" at the ABIM.

    We ask ourselves what's actually going on?

    It is rather odd that the ABIM never announced the departures of their "internal CEO" Biemiller in December of 2016. An item of such importance as the departure of a CEO would warrant a press release, even if a few lines. So we still hav eno confirmation on this. Does the ABIM therefore have two "new CEOs" - an "internal CEO in Judi Cassel" and an "external CEO" in Suzanne Biemiller. Perhaps Biemiller is no longer under contract but works for the ABIM from home like all the other executives there.

    Also what should have been disclosed is that Ms. Biemiller and Ms. Cassel are two close friends and political allies. This is concerning. What does this mean for the "non-partisan" nature of the medical boards when we see partisan politicians and not apolitical physicians guiding the organization?

    Note in Biemiller's bio she is stated to have helped move the ABIM from an "authority-based model to one that actively engages its community in program design." What does that really mean?
    Most likely it means that it is just a PR stunt and more propaganda, and part of the "we got it wrong" tactical approach combined with "we are listening."

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  27. Who are ABIM's real stakeholders? It is not the public or physicians.

    More intriguing is who are the "stakeholders" that ABIM made a shift toward in its manner of communications with them as stated in Biemiller's Econsult Solutions bio.

    Because Suzanne Biemiller's husband is and has been for years a key executive, attorney, bribery officer, and policy counsel based in Philadelphia for GlaxoSmithKline, we can understand who the real stakeholders of the ABIM are. The real stakeholders of the ABIM are and have always been for decades, not the public or physicians, but the healthcare industry and special interests.

    And ABIM's stakeholders have always been the revolving door relationships its officers and executives (and the entirety of the ABMS) have had with the government and its "payers".

    Christine Cassel and Richard Baron are two prime examples of this who have had egregious personal conflicts of interest spanning two or three decades. A combined fifty years of conflicts. Senator Grassley took notice of Cassel's conflicts in 2014 when ProPublica ran a series of stories on her and the NQF. Cassel worked for Kaiser, Premier and others at the time - the same private industry Cassel claimed the ABIM took no money from.

    The saga of ABIM's egregious conflicts of interest continues today.

    Biemiller and the ABIM never disclosed to the public or physicians her family's close relationship with the healthcare industry. GSK. Where is the communication and where is the transparency. I see little of the former except for lip service and nothing of the latter.

    As a further slap in the face to physicians and the public, who did the ABIM put in charge of ethics as Biemiller was terminated? None other than Biemiller's friend and political ally Judy Cassel.

    Does anyone have any idea when the coverups, personal enrichment and political brokering is going to end at this powerful "non-profit" cartel?

    Did we forget to mention that Judi Cassel and her husband are close political allies and colleagues of former PA governor/Ballard Spahr partner Ed Rendell!

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  28. ABIM complaints: contacting the Better Business Bureau to lodge an action with the BBB.

    I am surprised there are only three non-expired complaints filed against the ABIM on the Better Business Bureau website. I spoke to the BBB in 2014 to file a complaint, but the BBB person I spoke with could not find ABIM listed. However, the BBB spokes was wrong, they appear to have been listed since 2010.

    There are no reviews to date. If you wish to file a complaint you will not be able to write a review per BBB rules. I have found that the BBB has been helpful in the past. You may wish to ask to speak with one of their investigators to offer some insight about the ABIM and to find the best ways of resolving issues. It also leaves a documentation of grievances. The forum is an important one.

    To read past complaints against the ABIM click on the link. We encourage you to write a review.

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  29. Recycling the Newbury address does not make any objective sense. Too recognizable. Who's there to receive the money, anyway? Certainly not BostonPride.

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  30. Fyi: Boston Pride has not used that 304 Newbury Street, Suite 309 ~ Boston, MA 02115 address in 12 years.

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