Monday, September 04, 2017

Our Unsustainable Fear-based ABMS Physician Credentialing System

"... diplomats would be asked, but not required, to renew the validity of the certificates at periodic intervals or face the uncertain consequences of loss of their status as certified internists, subspecialists or holders of certificates of added qualifications."
(Glassock, R. J., Benson, J. A., Copeland, R. B., Godwin, H. A., Johanson, W. G., Point, W., Popp, R. L., Scherr, L., Stein, J. H., & Tounton, O. D. (1991). Time-limited certification and recertification: the program of the American Board of Internal Medicine. Annals of Internal Medicine, 114(1), 59–62.)
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"Candidates for Board Certification and Maintenance of Certification agree that their professional qualifications, including their moral and ethical standing in the medical profession and their competence in clinical skills, will be evaluated by ABIM, and ABIM's good faith judgment concerning such matters will be final.

ABIM may make inquiry of persons named in candidates' applications and of other persons, such as authorities of licensing bodies, hospitals or other institutions as ABIM may deem appropriate with respect to such matters. Candidates agree that ABIM may provide information it has concerning them to others whom ABIM judges to have a legitimate need for it.

ABIM makes academic and scientific judgments in its evaluations of the results of its examinations. Situations may occur, even through no fault of the candidates, that render examination results unreliable in the judgment of ABIM. Candidates agree that if ABIM determines that, in its judgment, the results of their examination are unreliable, ABIM may require the candidates to retake an examination at its next administration or other time designated by ABIM.

ABIM also may evaluate candidates' or diplomates' fitness for Board Certification – including their professionalism, ethics and integrity – in disciplinary matters, and ABIM's good faith judgment concerning such matters will be final."
(ABIM Online Maintenance of Certification Policies. Available at http://www.abim.org/maintenance-of-certification/enrollment-cost/policies.aspx . Accessed 3 Sep 2017).
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"ABIM's review of evidence seized from the Arora Board Review reveals you were a course attendee. As part of your Examination, you and all other examinees signed a Pledge of Honesty, agreeing among other things that you would not give or receive aid in your examination. The Pledge of Honesty also prohibits Examinees from disclosing, copying, or reproducing any portion of the material contained in the Examination. You were also provided with contact information for ABIM's Exam Integrity Hotline to report inappropriate behavior that occurred with the Arora Board Review course.

ABIM has ethical and professional concerns from arising from your conduct described above. As a result, ABIM is placing a copy of this letter in your file."
(Lynn O. Langdon, MS, Chief Operation Officer, ABIM "Letter of Concern" dated 8 June 2010)
* * *
"The American Board of Internal Medicine is moving against nearly 140 doctors who it says cheated on the organization's certification exams by seeking out, sharing and in some cases purchasing actual test questions from a board-review company.

Board certification isn't required to practice medicine, but is commonly needed for doctors of all stripes to secure hospital privileges or participate in insurance plans.

In suits filed Friday in U.S. District Court for the Eastern District of Pennsylvania, the ABIM alleges that five physicians infringed the organization's copyright on test questions. The suits also accuse them of misappropriating trade secrets and breach of contract."
(Hobson, K. "Medical Board Says Doctors Cheated" Wall Street Journal 9 June 2010.)
* * *
"I must say, candidly, that with over 50 years of law practice I have never before seen the likes of the repeated attempts by Dr. Westby G. Fisher to malign a person based upon an 11-year old “blip” in his long and successful career of public trust. It is, to be sure, unconscionable, to be using invective to shame the ABIM and, along the way, destroying the career and good name of a very honest, competent person, I know that if a member physician were similarly treated you would be mounting the ramparts to obviate its harm to his/her career."
(Letter from Sidney Baumgarten, Esq., Attorney at Law, to Alan J. Miceli, Editor, Philadelphia Medicine Magazine dated 27 Dec 2016)
How much money does the trademarked time-limited ABMS MOC® program generate annually for the ABMS and its member boards?

$392 million. Per. Year.

(This amount does not include the revenue generated by board review courses and study materials sold by colluding state medical societies and medical subspecialty societies.)

Fear and intimidation might sell MOC® for a while, but when the US medical education and credentialing system in the United States relies on fear for little more than its bloated bureaucratic and political purposes, it is non-sustainable. Practicing physicians like myself will not be ruled by fear-based policies and politics, especially when those imposing the mandate are completely unaccountable to our patients and our families.

I would encourage all of my readers to boycott the ABMS MOC® program (irrespective of the "kinder and gentler" model MOC® pivots toward), remain board-certified with the National Board of Physicians and Surgeons, and to consider joining Practicing Physicians of America, to protect our civil liberties of free speech and Fourth Amendment protections against illegal search and seizure.

Our ability to care for patients without such intimidation demands nothing less.

-Wes

16 comments:

  1. Physicians do not reject recertification.
    We reject recertification by the ABMS and the ABIM.

    We reject the mythology that American Medicine will collapse without this contrived money game perpetrated by a cohort of lazy, corrupt, over paid non clinicians. Physicians want an open, accountable, responsibly economical, and practical way to continue their post graduate education. We definitely do not want a secretive society of vampire like, administrators engaging in professional cannibalism. Let us all stipulate that whomever is tasked to head these agencies should contemporarily clinically active and take on call responsibilities. We can scrutinize their claims data and see if they are true clinicians or shifty quasi-physicians hiding in a C-suite board room.

    The AMA HOD meetings will continue to reflect our discontent. The State statutory maneuvers to neutralize the ABMS money grab will be more and more evident now that the TMA and others have set the stage for State AGs and local physicians to litigate against these nasty organizations.

    Keep up the pressure and intensify it. Without the support of the rank and file physicians and especially without our money, the ABMS and the ABIM will lose power rapidly.

    It is long overdue to flush the ABMS down the toilet.

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  2. Today I received my disaffliation letter from BCBS. I took the ABIM recert exam in Oct 2016 and failed by two points. I felt pretty dejected about the whole thing. Quite honestly after waiting 12 weeks for my score I just didn't have the motivation crack open the MKSAP again.

    My biller just told me that if BCBS goes though with their threat I will lose approximately 30% of my income. Not only would I lose that income, 600 patient's would have to find a new doc in an area short on docs. A couple of employees would lose their jobs.

    Our quality metrics have improved year after year, I'm a physician leader in my community. But just because I'm not good at Medical Trivial Pursuit I'm somehow less a physician.

    I'm particularly disappointed with our State Medical Society, whose response to the MOC struggle has been pretty anemic. Sure they put up an anti-MOC website, but it isn't helpful if no one knows about it.

    I have done my part and tried to get involved, wrote my State Legislators, got involved with my Society but nothing happened. No coordination of effort.
    I guess we'll be stuck with the system for awhile.


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  3. LOL with self-regulation when "self" is other than what it appears to be!

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  4. FYI: PHR Troy Brennan Secretary, ABIM Foundation 5-25K donation 2010-11 annual report
    https://s3.amazonaws.com/PHR_Reports/AR-FY11-final.pdf

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  5. https://projects.propublica.org/nonprofits/organizations/222488437
    The US Dept of State funds this org. So has the ABIM Foundation.

    Syria and PHR
    http://physiciansforhumanrights.org/press/press-releases/physicians-for-human-rights-honors-syrian-doctors-two-philanthropists-for-their-work.html?referrer=https://www.google.com/

    Ukraine and PHR
    http://physiciansforhumanrights.org/about/people/staff/christine-mehta.html

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  6. Christine Cassel Board Member Human Rights Committee of the NAS, NAE, and NAM
    http://www7.nationalacademies.org/humanrights/CHR_161625.htm

    Current global human rights abuse cases and the various stages of work
    http://www7.nationalacademies.org/humanrights/CHR_178116.htm

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  7. NAS (Science, Engineering and Medicine) Revenue 2015 $321 million
    "National Academy of Medicine
    The Institute of Medicine (“IOM”), which was established in 1970, has been reconstituted as the National Academy of Medicine (“NAM”) effective June 1, 2015. NAM is a separate membership organization within NAS, and issues position statements on policy issues related to health and medicine, cooperates with the major scientific and professional societies in the field, identifies qualified individuals to serve on study groups in other organizational units, and disseminates information to the public and the relevant professions. The financial activities and results of NAM are included in the NAS financial statements."

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  8. ABIM and links to the "Domestic Terrorism" of George Soros and his organizations?

    Have ABIM's professional medical politicians been involved closely with George Soros for decades? Has the ABIM been on a harmful collision course with physicians since the time of the secret registration/formation of the American Board of Internal Medicine Foundation in 1989?

    The answer is yes, clearly!

    Consider ABIM and George Soros' activism in light of recent accusations involving Soros' acts of "domestic terror".

    Is George Soros a domestic terrorist supporting mayhem? Should ABIM Foundation's documented support for George Soros and his organization(s) raise questions of concern?
    http://www.washingtontimes.com/news/2017/sep/2/petition-asking-white-house-declare-george-soros-t/

    According to many Americans the answer is yes to Soros being a domestic terrorist!

    A recent "WE THE PEOPLE" petition on the official White House website calls for George Soros' assets to be seized with the initiation of a RICO/Domestic terrorism investigation into his affairs and the many political/social activist organizations under his control.
    https://petitions.whitehouse.gov/petition/declare-george-soros-terrorist-and-seize-all-his-related-organizations-assets-under-rico-and-ndaa-law

    The petition reads:

    "Declare George Soros a terrorist and seize all of his related organizations' assets under RICO and NDAA law
    Created by E.B. on August 20, 2017

    Sign This Petition
    Needs 0 signatures by September 19, 2017 to get a response from the White House

    147,682 SIGNED 100,000 GOAL
    Whereas George Soros has willfully and on an ongoing basis attempted to destabilize and otherwise commit acts of sedition against the United States and its citizens, has created and funded dozens (and probably hundreds) of discrete organizations whose sole purpose is to apply Alinsky model terrorist tactics to facilitate the collapse of the systems and Constitutional government of the United State, and has developed unhealthy and undue influence over the entire Democrat Party and a large portion of the US Federal government, the DOJ should immediately declare George Soros and all of his organizations and staff members to be domestic terrorists, and have all of his personal an organizational wealth and assets seized under Civil Asset Forfeiture law."

    What about the ABIM and it principals involvement in subversion of democracy and the free press?

    The controversial ABIM Foundation has been a large donor to George Soros' NGO IMAP. How are we to interpret the ABIM Foundation's $385,000 secret monetary aid/financial support for George Soros financial/social/political projects? (2003 $325K, 2008 $60K)
    http://imapny.org/about-imap/funding-information/

    Note: Richard Baron and Christine Cassel have had a close relationship and participation in the Commonwealth Fund along with George Soros through his chief representative and personal spokesperson Michael Vachon.
    https://sipa.columbia.edu/faculty-research/faculty-directory/michael-vachon

    Richard Baron (Bio revealing his partisan activist gov/corporate/private involvement including the Commonwealth Fund.)
    http://abimfoundation.org/person/richard-j-baron-md-president-and-ceo

    Christine Cassel and Robert Wachter and the Commonwealth Fund
    http://www.commonwealthfund.org/publications/newsletters/quality-matters/2006/september-october/editorial-advisory-board-and-team

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  9. ABIM: acts toward a closed society

    Christine Cassel has many marks on her record. Here is another conflicted involvement at physicians expense with the Commonwealth Fund's "Commission toward a high performance health sytem" published in 2009--just months before ABIM seized property of thousands of physicians and persecuted them violating their constitutional rights.

    "ABSTRACT: This report from the Commonwealth Fund Commission on a High Performance
    Health System offers recommendations for a comprehensive set of insurance, payment, and
    system reforms that could guarantee affordable coverage for all by 2012, improve health
    outcomes, and slow health spending growth by $3 trillion by 2020—if enacted now to start in
    2010. Central to the Commission’s strategy is establishing a national insurance exchange that offers a choice of private plans and a new public plan, with reforms to make coverage affordable, ensure access, and lower administrative costs. Building on this foundation, the report recommends policies to change the way the nation pays for care, invest in information systems to improve quality and safety, and promote health. By stimulating competition and delivery system changes aimed at providing more effective and efficient care, the policies could yield higher value and substantial savings for families, businesses, and the public sector."
    http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2009/Feb/The%20Path%20to%20a%20High%20Performance%20US%20Health%20System/1237_Commission_path_high_perform_US_hlt_sys_WEB_rev_03052009.pdf

    Commonwealth Fund: Journalists Being Trained by Pro-Obamacare Group on How to Report on Obamacare?
    http://www.freedomworks.org/content/journalists-being-trained-pro-obamacare-group-how-report-obamacare

    George Soros, Christine Cassel, et al: Project Death In America
    (Special publication on "How to present death to the press.")

    "A Journalist’s Resource Guide, COVERING THE ISSUES OF DEATH AND DYING
    A primer for journalists covering stories on the end of life"

    Excerpt: "Contact the New York-based Project on Death in America (PDIA, 212/887-0150).
    Find out if there is a PDIA Soros Scholar in your area and, if so, do a story on his or
    her activities. This Faculty Scholars Program supports outstanding clinicians,
    educators, and researchers in disseminating existing models of good care and creating
    new approaches to educating health professionals. Each year the program awards about
    ten two-year fellowships, of up to $70,000 per year. Reporters can receive a list of
    current and past scholars, as well as the topic each one is studying."
    (Or visit its website: www.soros.org/death.html)

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  10. To the Party of the Third Party - NCQA is not accountable or legally responsible for anything

    Disclaimer
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    Lengthy website use terms
    http://www.ncqa.org/terms-of-use

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  11. NCQA lobbies congress to continue funding the NQF
    http://blog.ncqa.org/ncqa-urges-congress-to-fund-nqf/

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  12. NCQA's government funds/revenue makes them accountable to the taxpayer and federal law.

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  13. Has the Congress approved new funding for the NQF?

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  14. 70% of the NQF's funding may go away after this week unless congress acts. What will happen if they lose that money? And are they really non-partisan and non-profit.

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  15. Yikes! How long will this new VA EHR take to learn. What if I prefer the simple nature of the old Cerner-based VA system.

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  16. Roughly 25% of ABMS certified physicians apparently do not have an active medical license according to a manual calculation of FSMB and State Medical Licensing Board data.

    Over 50% of ABMS certified docs do not participate in MOC.

    These statistics are much greater if we only include ABMS physians who are grandfathered in ABMS certification and maintenance of certification MOC.

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