Wednesday, October 11, 2017

My Remarks Before the Ohio Health Committee On MOC®

Here is the testimony I delivered today at the Ohio Health Committee hearing on Ohio House Bill 273 sponsored by Representative Teresa Gavarone in Columbus, Ohio. (Each committee member was handed this evidence packet to refer to before I spoke):
Dear Honorable Committee Members:

Thank you for the opportunity to speak and to provide evidence to the citizens of Ohio regarding my remarks today. My name is Westby G. Fisher, MD. I am a triple ABMS Board-certified practicing internist, cardiologist, and cardiac electrophysiologist from the Chicago Metro area representing Practicing Physicians of America, a group I co-founded that represents over 40,000 frontline practicing US physicians of all specialties and from all 50 states (including Ohio). We vigorously support Ohio’s House Bill 273 that restricts the hospital and insurance industry’s ability to prevent experienced physicians from practicing their trade on the basis of an unproven, costly and time-consuming proprietary marketing product called “Maintenance of Certification.”

I stand before you, on behalf of my working colleagues, as a bedside treating physician with a valid state license. I am not a paid lobbyist. I do not have a political agenda to serve. I do not have hundreds of millions of dollars of funding behind me. I represent the doctor see when you walk in a hospital or a clinic office, feeling scared, vulnerable, or sick.

The issue pertinent to this legislation is the proprietary product owned by the American Board of Medical Specialties (ABMS), a private non-profit corporation, and marketed by their 24 subsidiary specialty boards, as “Maintenance of Certification.” Maintenance of Certification is sold above and beyond physician’s initial lifetime Board Certification, a voluntary credential physicians obtain by taking a test to demonstrate competence in their specialty. I stress again, Maintenance of Certification is NOT to be confused with initial ABMS Board Certification, a voluntary once-in-a-lifetime credential analogous to the “bar” examination performed by the legal profession. Most physicians I know, including me, understand the value of initial, lifelong certification with ongoing Continuous Medical Education training. We should note that Ohio physicians have a proud tradition of supporting one of the strongest Continuing Medical Education (CME) requirements after their initial Board certification for maintaining their licensure, requiring 100 hours of CME every two years.

Maintenance of Certification was conceived by the American Board of Internal Medicine, the largest member board of the American Board of Medical Specialties that certifies on quarter of all US physicians, they claimed, to assure “continuous professional development.” Initial voluntary attempts to market this extra distinction failed because doctors already took responsibility for their own Continuing Medical Education and did not see additional centralized Maintenance of Certification testing as helpful or appropriate.

Sadly, this initial failure to voluntarily engage America’s doctors resulted in a new chapter of coercion and threats to physicians that continues to this day. In 1990, the American Board of Internal Medicine abruptly announced the end of life-long Board certification, claiming doctors needed to “keep up” with medical advances and threatened “uncertain circumstances” if they did not participate in Maintenance of Certification. To avoid significant backlash of the entire physician community, they grandfathered senior, predominantly male physicians certified before 1990. Younger doctors, closer to training, reluctantly complied.

Despite 30 years of existence, time-limited certification has never been proven to improve patient safety or care outcomes compared to lifetime Board certification. To be even more clear, let me emphasize that doctors are not picking up their Maintenance of Certification board review packet in order to figure out how to deal with a complicated patient down the hall. This is not the way it works on the ground. Instead, younger, more economically vulnerable, and increasingly female physicians were discriminated against with this change that persists today. The change also converted the once “voluntary” aspect of lifetime board certification to a mandate, since more hospitals insisted their physicians be board certified (as did insurance companies), thanks to their lobbying efforts. Through this clever regulatory capture, employed doctors were left with no choice but to sign a MOC contract that relinquishes their free speech rights and requires they become research subjects without informed consent.

Using the very real threat of the loss of employment, repetitive physician re-certification by way of Maintenance of Certification instantly became a remarkably successful business model for these non-profits, providing the American Board of Medical Specialties $343 million in revenue from certifying and recertifying US physicians in 2011 alone. In fact, the costs of board re-certification for the average physician have mushroomed 244% in the last 15 years, over 4 times the rate of inflation each year.

In 2005, the American Board of Medical Specialties registered the Maintenance of Certification® and MOC® trademarks and insisted all of their member boards end lifetime certification and would only recognize time-limited re-certification as valid while also adding the requirements to perform Practice Assessment, Patient Voice and Patient Safety exercises for physician to perform every 7-10 years, too. These represented even more precious hours of physician time as well as fees. The inevitable consequences of this monetary goldmine were predictable, especially when they operated with little to no oversight for years.

It is important to note that the requirement for time-limited Board certification (as opposed to lifetime Board certification) pre-dated the world wide web. But as the web grew, so did practicing physicians’ ability to fact-check the claims made by the ABMS and their member boards. Many of those facts uncovered are in the packet included before you. By 2013, physicians uncovered inconsistencies between tax filings and ABMS member board web page disclosures. They found bylaw changes that permitted unlimited conflicts of interest. They found undisclosed lobbying. They uncovered the secret funneling of over $77 million of their physician testing fees piecemeal from 1990 to 2007 to create the ABIM Foundation that was supposed to define and promote “medical professionalism.” Excessive salaries, multi-million dollar golden parachutes, first-class and spousal air travel, health club memberships, luxury condominium purchases, and off-shoring of our testing fees for retirement funds doctors learned, were all funded by us. Even a felonious ex-cop who had been fired from the Washington DC police force for inciting reprisals against a journalist was hired to serve as “Director of Test Security” for these organizations making them more akin to a protection racket than a protector of the public. It is no wonder, then, that legal fees at the ABIM and its Foundation have grown from an average of $146,000 per year before Maintenance of Certification was introduced to over $1 million per year after Maintenance of Certification was introduced for its defense against physician lawsuits. Ironically, we pay those fees as well. Anti-trust suits and class action law suits are pending against the ABMS and American Osteopathic Association. Rest assured anyone speaking in opposition to House Bill 273 somehow has a financial interest in the program or the data they sell. Keep that in mind in the weeks ahead.

Physician shortages and burnout are real problems today and affect every state in the union. How does Maintenance of Certification affect this? No one has bothered to conduct a study examining the psychological, economic, or employment outcomes of highly experienced physicians who fail a re-certification examination of which there are many. Nor has there been a study on the impact that Maintenance of Certification testing has on a doctor’s loyal patients. Hundreds of tweets and emails I receive each year speak to the reality of the tremendous negative effect on decent, highly-respected colleagues too embarrassed to go public with their failure, many of whom quietly leave medicine. The Maintenance of Certification profit-making machine is creating a physician brain drain and a shameful exodus of too many good people.

This is why 23,000 US physicians signed an online petition to end Maintenance of Certification monopoly. That is why the Pennsylvania Medical Society issued a formal “Vote of No Confidence” against the American Board of Internal Medicine in June of 2016. That is why the AMA House of Delegates (including the Ohio delegation) voted to end Maintenance of Certification at the same meeting. This is why a new, competing board called the National Board of Physicians and Surgeons led by unpaid board members to independently verify a physician’s participation in Continuing Medical Education was created and a growing number of hospitals accept as an alternative to participation in Maintenance of Certification. And that is why the Ohio State Medical Association has voted to support this bill. Physicians across the country are not blind to the corruption, and the burden to practicing physicians and their patients is not trivial. Twenty three states have introduced similar bills to this one, and 8 have enacted those laws.

Despite all of this, I am sure that opposition to House Bill 273 will remain strong. When one considers the numerous subspecialty board review courses that exist, and the gauntlet of tests a physician must endure to become licensed, certification of physicians is a $2 billion dollar-a-year enterprise. Our opposition will tout the duration, breadth, and scope of training required by ABMS member boards as the best validation of physician knowledge, while ignoring a physician’s clinical experience entirely. But as Dr. William Osler famously said, “He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.” The fact that this shameful bureaucratic continuous re-credentialing system has wrapped itself in a blanket of highly respected, well-meaning physician contributors should surprise no one, but it does not change the facts. In other states, opponents to similar bills as Ohio’s House Bill 273 have been strangely silent about the corruption, preferring instead to focus on the public’s “need to know” talking points as a way to spin away from the ugly truth. Why is that? Do they believe corruption is inevitable? Do they assume practicing physicians will just shrug and write another check?

Winston Churchill once said, “Criticism might not be agreeable, but it is necessary. It fulfills the same function as pain in the human body. It calls attention to an unhealthy state of things.” Maintenance of Certification is very unhealthy for our profession. The time we take away to defend our profession in this very sad chapter of our profession is time we take away from our patients, including your constituents. That is why we need your help and your attention to this uncomfortable matter.

In closing, of course initial board certification is important but this has nothing to do with repetitive re-Board certification known as MOC. Of course physicians want to self regulate and want to participate in CME, but they should not have to prop up coercive program based on threats to our integrity and civil liberties for their profit. Scare tactics about patient safety and physician self-regulation are just that; last ditch efforts of intimidation to prop up the gravy train.

Thank you for having the courage to vote against the status quo, against the multimillion dollar lobbyists, and thank you for protecting Ohio physicians and their patient’s access to them by voting in favor of House Bill 273.
-Wes

24 comments:

  1. After reading Dr. Fisher's presentation, the majority of issues and related facts are laid out with crystal clarity. It is now the Ohio State legislature that is on trial. I implore them to cast their vote honorably. Failure to pass Bill 273 would lead me to one inescapable conclusion: they are for sale and corrupt to the core.

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  2. Superb, Dr. Fisher.

    You're doing immensely important work, kudos.

    Hat tip from Canada.

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  3. We deeply value all the selfless efforts you and others are making to correct the ills stemming from ABMS MOC. We support you and the PPA.

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  4. "ABMS with its MOC mandate is a spear in the side and bitter vinegar for all."
    That's what the founders of the specialty boards, if they were alive today, would say.

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  5. The ABMS is unbelievable. The financial hooliganism they have inflicted on physicians is beyond anything that we can imagine! Using them like cash-cows for self-dealing political agendas and personal wealth building is repugnant; it violates all ethical norms.

    Such atrocious behavior should be sufficient to justify strong "anti-MOC" legislative relief and draw the ire of lawmakers.

    Isn't it illegal already what they have been doing under anti-monopoly and RICO laws? Has anyone made the IRS aware of these over-the-top profiteering executives with their outrageous incomes, political stunts and other outlandish activities?

    This is so strange to read about in Newsweek and on this blog. To think that it has dragged on for so long. And why is that Chicago anti-trust/MOC civil case against the ABMS stuck in the judicial system for, what is it now, going on two years? That is just plain wierd and even eerie to think that a testing franchise has that much influence.

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  6. Passing strong anti-moc anti-restraint of trade legislationWed Oct 11, 05:25:00 PM CDT

    Stop MOC

    No to MOC and no to ABMS collusion with partner NGOs, insurers and hospital industry lobbyists.

    No to MOC and no to the restraint of trade.

    Please investigate ABIM/ABMS and enforce the existing laws protecting Americans from ABMS coercion and injury.

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  7. This is incredible document and should be an exhibit in a court of law or public assembly and used as damning evidence against the ABIM/ABMS!

    ABIM's Project Professionalism 1992-1994 (Funded by "cleaned up money transfers" via the ABIM Foundation and ICE from certification and MOC fees.)

    Exhibit A (for immediate review concerning ABIM corruption, fraud, and hypocrisy)

    ABMS is "7 for 7" in the ABIM's seminal report on signs and symptoms of breaches in "professionalism". (A study ABIM funded themselves using the psychological method and "principle of projection" to determine the most egregious "signs and symptoms". This is a strange, but interesting fact.)

    "SIGNS AND SYMPTOMS [CHALLENGING AND DIMINISHING PROFESSIONALISM]
    Seven issues that challenge or diminish the previously
    identified elements of professionalism are described
    below and include:
    1. abuse of power
    2. arrogance
    3. greed
    4. misrepresentation
    5. impairment
    6. lack of conscientiousness
    7. conflict of interest"

    "Project Professionalism was sponsored by the ABIM Committee on Evaluation
    Competence and Communications Programs. For additional copies please call 215-446-3630 or fax 215-446-3470.
    First printing 1995, second printing 1996, third printing 1997, fourth printing 1998, fifth printing 1999, sixth printing 2000, seventh printing 2001.
    © American Board of Internal Medicine, 510 Walnut Street, Suite 1700, Philadelphia, Pennsylvania, 19106-3699"


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  8. We need the federal government to investigate the ABMS and their partners for wrongdoing. We need guarantees and legislation which prevents the ABIM/ABMS' from future persecution, involving their violatory acts against personal privacy, acts of discrimination and the trammeling of constitutional rights.

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  9. Wes, my only feedback to you is the lawmakers need to be aware that these non profit organizations fuel their deranged agenda off the back of the American Taxpayer. In essence society is funding the ABIM and the ABMS to make the field of medicine more onerous and less available to patients. I was on a recent trip with a well placed AMA HOD member. He also is a well placed member of a cardiology sub speciality organization. He stated that the greatest elephant in the room is the loss of income for all of these organizations. The fear of losing income from the MOC cottage industry was driving fear and anxiety throughout the entire ABMS and ABMS sister organizations. They all realized they totally screwed this up but are too cowardly to make the business decision they will ultimately make. Change radically or be extinguished. Be nimble and agile or face extinction. Cut your salaries, pare down your operations and stop pretending the corrupt MOC process is a mandate. It is NOT. It is a parasitic burden for the existence of hundreds of thousands of hard working physicians. The ABMS angered too many of us at the same time and made things much worse by pretending the problem does not exist. Rich Baron needs to be fired. Cassel needs to go to Federal prison. Jaime Salas will win a massive award once the Court system is restored in Puerto Rico. Rich Chazal will forever live in shame and infamy as the ACC President who sold out his procession. And one day, we will look back as the pure white integrity of Cutler, Fisher, Teirstein, Edison, Kroll et al and reflect on how goodness will prevail over greed, evil and the ugly nasty rotting stench emanating from Walnut Street.

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  10. Even non profit organizations are not all equal.

    Houses of worship feed the hungry and provide comfort to the homeless. Universities offer free tuition to indigent students. Hospitals take care of the uninsured who are sick. Classy organizations like the Bill and Melinda Gates Foundation provide micro loans, fund vaccine research, redistribute wealth to the Third World.
    Even the ACC and the ACP give scholarships for research, encourage our young doctors to continue to contribute to science. They pay for travel stipends to allow impoverished fellows and residents to participate in Scientific Sessions.

    What exactly does the ABIM do to deserve its oxymoronic "non profit" status one must wonder.

    Does the ABIM discount the exam fees for residents and fellows? Has it ever offered scholarships?
    Does it offer payment plans to our hard working under paid under appreciated residents and fellows?
    Does the ABIM fund worthy scientific clinical research or basic science research?
    Does the ABIM volunteer its services, time, money and resources to the poor and indigent population in its home city of Philadelphia?
    Has the ABIM ever tried to educate patients or amplify medical science or support its health care sister organizations in a charitable fashion?

    Does the ABIM do anything worthy of its tax fee non profit status?
    Has it ever done anything in the past worthy of its tax free non profit status?

    Why should the American Taxpayer financially support any parasitic organization that is selfish, greedy, corrupt, tone deaf and unwilling to examine its unsavory behavior?

    What will galvanize the good men and women who are Diplomates of the ABIM to petition the IRS and Congress to stop subsidizing the ABIM in its pursuit of their reckless agenda?


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  11. ABMS tangled up in their own MOCWed Oct 11, 11:17:00 PM CDT

    The cost of MOC keeps rising

    Let's add the legislative costs to MOC. And the costs of all those federal judges who have had to put up wit the ABIM/ABMS legal shenanigans. How much cost is that in taxpayer $$$? The ABMS and their darn MOC is causing everyone grief from physician to patient to public servant. It is an outrage.

    And when you look at their tax forms, you see the money is all going to the executives and key officers. MOC is unsustainable and digging into the cost and vital needs of maintaining initial certification. Initial certification may just collapse under the weight of MOC and the universities will end up certifying physicians as it perhaps should have been done all along.

    This multi-billion dollar private enterprise may have run its course. Specialty board certification and testing should be back in the hands of clinical and academic practicing physicians. They are the ones who volunteer to put together the test questions anyway, but somehow ABMS executives, committees, and internal CEOs muck it all up.

    You really don't need a CEO or all that overhead to certify a physician. The CEO are lobbying for their pet projects anyway and meeting with insurance companies. Wait until the raw footage comes out.

    Psychometricians are not even that useful as you see the messy failure rate that they and the expensive staff cannot seem to get a handle on. And the financial numbers from retakes of all those specialty board tests create the appearance of deep conflicts of interest or just plain incompetence.

    Calculate all the time and cost it takes physicians to oppose MOC. It is the height of insanity that some referee does not come in and throw the ABMS out of the game for all the cheating and low blows they have inflicted on physicians.

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  12. When they say that “the ABIM receives no industry funding” one has to pause. From all the testimony provided here and elsewhere we can see it is another patent lie.

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  13. Bonedoc, "When they say that “the ABIM receives no industry funding” one has to pause. From all the testimony provided here and elsewhere we can see it is another patent lie."

    The ABIM/ABMS chairmen and executives from Brem to Baron have had their hands on industry funds and were party to providing documented and undocumented “favors” and "grants" to and from their many colluding partners without cessation. Dr. Fisher’s flow sheet of money and conflicts of interest provided in his testimony to the Ohio state representatives and their healthcare committee is alarming. And as everyone who has looked into the matter with any depth can see what Fisher presented is only a small window, a tip of the iceberg looking into the manifold corruption that appears have taken on a life of its own at the ABMS and its partner corporations. And the money goes in and out of the government in DC, which everybody also knows. What Fisher did not present was the global nature of the money and influence. He did not mention how the powerful private equity firms have infiltrated the organizations to put a stranglehold on healthcare and it links to the purpose behind the quality assurance/certification-testing cartels. The international connections and branches of the operations is little discussed and a total mystery what they are doing abroad when they cannot even handle the health system woes in the US.

    From the royal houses of the EU to the Middle East and their corporate holdings and interests to the investment banks in the US and onward to Asia, we have a story of financial influence and political power that is not being told. It is there unreported. There is other funding and influence confirming that industry money and those who control it have their hands and designs all over the ABMS. Where are the professional investigative reporters!

    Wes Fisher is a physician and look at all that he has uncovered. This is part of the enigma of the money machine that is the ABMS. We have editorial control in the media and much less of the gutsy reporter to dig deep and go far and wide to unravel the truth. Separate what is true from what is false.

    And no one is discussing it in Congress where corruption on their plate is perhaps too extensive and deep for the shallow abilities of the government’s allready full domestic platter. One looks at the health industry corruption in other countries and in the United States. Settlement after settlement with the DOJ, but few people actually pay the real price and go to jail.

    We learn of corruption of big pharma. GlaxoSmithKline settles with the DOJ time and time again. They get busted in Africa and Asia. Look how the former "internal CEO" of the ABIM had strong familial ties to top key GSK executives in the US corporate offices in Philadelphia. We read of donations to the city where Beimiller was a key deputy. Land deals that show more than the appearance of favored status for the big clients. (Is that why they had to let Suzanne Biemiller, the form “internal CEO” go without an honorable mention from the ABIM?)

    Control physicians and you control a great deal of the healthcare system. Is that not part of what MOC is about. Corporate power and money? Or is it the whole thing? Where do all those threads really go. Follow the money and who controls it.

    Who is really going to dig?

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  14. Dr. Fisher,

    There are no words to express your ongoing advocacy on this issue. You have made great strides and all of us are indebted for the time and energy you have devoted to addressing this critical issue. Thank you very much.

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  15. No opinion available yet from judge in AAPS v ABMS per 9/30 memorandum.

    330 million patients and over 1 million physicians could be adversely affected by a dismissal of this important anti-trust case involving MOC and a physician's right to work and a patient's right to care.

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  16. ABIM 1936 Articles of Incorporation, a mission of fifty years or less

    If the ABIM/ABMS adhered to the original Articles of Incorporation bylaws, which were honored from 1936 - 1975 on the duration of the corporation would we be in the messy situation we are in today? Read the first four articles below.

    According to the ABIM's articles of incorporation bylaws the organization was to be administratively dissolved in 1986 (or sooner). What was the wisdom in setting a time limit to the mission of establishing medical specialties?

    The original article of incorporation states its purpose very clearly and simply:

    "The American Board of Internal Medicine"

    "We, the undersigned hereby associate ourselves into a corporation of non-pecuniary profit under the provision of Chapter 394 of the Code of Iowa, 1935, and acts of amendatory therof and assuming all power, rights and privileges ganted bodies corporate under said provision, do adopt the following Articles of Incorporation, to-wit:

    Article I
    The name of this corporation shall be The American Board of Internal Medicine, Incorporated.

    Article II
    The principle place of business of the Corporation shall be in the City of Des Moines, County of Polk, State of Iowa.

    Article III
    "The business or object of this corporation shall be the certification of specialists in the field of internal medicine and the establishment of qualifications for such certification as well as the procedure necessary for the accomplishment of such business or object."

    And the ABIM set clear limits to its duration in straight language we can all understand:

    "Article IV
    This corporation shall become a body corporate upon the filing of these Articles of Incorporation with the County Recorder of Polk County, Iowa, and shall endure for fifty years from said date unless sooner dissolved by three-fourths vote of all the members, or by act of the General Assembly or by operation of the law."

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  17. ABMS EXECS: Doctors of Spin and Sin?

    The federal courts are ripe with discrimination cases and many other surprising complaints against the ABIM and other boards. We see this plainly under the watch of Christine Cassel and Richard Baron and their predecessors. There have been decades worth of examples of egregious conflicts of interest, but nothing happened to any of the ABIM/ABMS executives or officers committing the offenses.

    The ABMS as a watchdog "umbrella" organization under Kevin Weiss and Lois Nora skirted its responsibility of providing oversight to the ABIM's abuses. This puts blame and culpability for many of the violatory acts, over-reach and serious ehtical breaches and constitutional violations committed against candidates and diplomates on the ABMS as well.

    Under ABMS bylaws (see tax forms) written by the umbrella executives and board of directors, an offending member board must be placed on probation until a remedy is reached, with right to appeal. It is unfortunate that the ABMS and its member boards have never used any of their ethics policies on themselves, or followed the normal rigors of vetting thoroughly and enforcing any conflicts of interest or duality of interests policies.

    How can an organization as flawed as the ABMS testing franchise consider themselves to be qualified for the task of being involved in the business of physician self-regulation, when the franchisees and their Chicago "advisory board" have obviously never achieved the level of self-regulation regarding themselves?

    This is a conundrum that deserves discussion and some corrective action taken by the ABMS associates mentioned here: http://www.abms.org/about-abms/associate-members/

    But then the next mysterium appears without a satisfactory or resolute answer.
    Who among any of the ABMS associates are good at self-regulation?

    And who do any of them have to answer to?

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  18. Conundrum,

    Transparency is not an ABIM/ABMS attribute. Consider the following:

    Why does ABIM fail to disclose that their current Chief Medical Officer is not a practicing physician as they suggest in their background data provided on Richard G Battaflia, MD, but in fact he worked exclusively as a professional financial services advisor to insurers and hospitals for PcW for the past 16 years?

    Why does Battaglia still not have a PA medical licence and why does he not come to work at the ABIM Walnut St. offices in Philly as he should as chief of medicine?

    Why does Battaglia still reside just minutes away from his former Pricewaterhouse offices in Buffalo, NY. As he does not live in Philly, what does he do for the ABIM and how much does get expensed in per diem and first class travel? Where does he go? As with the former "egregiously conflicted" ABIM CEO Christine Cassel there are a lot of mysteries still about how she got away with such nefarious political and financial abuse of ABIM' cash and it's clients.

    Corruption appears to be encouraged in the verbal job description. It is endemic throughout the ABMS.

    Battaglia's job description states he is liaison to physicians and stakeholders about the future of MOC and certification.

    Does the ABIM encourage such appearances of unlimited conflicts, and does Battaglia meet with PcW clients (insurers/hospitals) in behalf of the ABMS/ABIM?

    As a former employee and advisor to the NCQA, and given his close association with the CEO Ms O'Kane, and the ABIM failure to disclose the highly conflicted PcW director/management position, should Battaglia be allowed to be in such a sensitive executive position at the ABIM/ABMS?

    ABIM - Failure to disclose egregious conflicts of interest
    http://www.abim.org/about/executives.aspx

    OBFUSCATED BIO (2 yrs ago: read last paragraph for obtuse reference to being a consultant to national and international organizations with academic universities mentioned first. But nowhere do they say that he was a Pricewaterhouse financial services advisor for 16 yrs working with the American and CARIBBEAN Division. They generate 12.25 billion revenue out PcW's 37.7 billion annual market share.)

    http://www.abim.org/news/richard-battaglia-named-chief-medical-officer-of-abim.aspx

    Personal LinkedIn bio ABIM CMO
    https://www.linkedin.com/in/richardgbattaglia

    More to follow ...

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  19. A PcW insider at the ABIM/ABMS?Sun Oct 15, 04:57:00 PM CDT

    Why the ABIM/ABMS cannot be trusted

    More conflicts of interest, transparency and disclosure problems at the ABIM

    Is Richard Battaglia, ABIM's CMO, the Chief Medical Officer? Chief MOC Officer? Or Chief (PcW ) Merger/Money Officer?

    Another act of betrayal by the ABIM/ABMS: the evidence

    ABIM's CEO, executive staff and team of communications officers failed to state specifically the most important and most recent work history of "Dr" Battaglia. They intentionally left out of his biography the fact that for the prior 15 years Battaglia worked as a full-time manager and director for Price Waterhouse Coopers (PcW) in their $12.25 billion advisory practice (North American and Caribbean region.) This constitutes 32.5% of their annual revenue of 37.7 billion dollars. PcW is based in the United Kingdom with a network of offices in 157 counrtries.


    Who were his major clients at PcW? Insurers and hospitals. This important data was left out of his ABIM employment history on purpose because of the politically and financially sensitive work he did as a corporate propagandist for the insurers and hospital lobby. Some would view what he was doing was a betrayal of his "colleagues" pushing physicians into the quality chasm ditch of healthcare reform luring them with pretty glossy brochures prepared and paid for by the "industry", the same "industry that ABIM/ABMS claims it receives no funding from. (How can an honest and transparent CEO think he could get away with such a politically stupid maneuver? Richard Baron et al just deleted, upon careful deliberation to be sure, the employment history of a man who would be the liaison between physicians "and other stakeholders" concerning the future of MOC and certification. This boondoggle covers all seven of the deadly sins that kill professionalism. With the serial nature of ABIM’s deceit it tarnishes their reputation beyond shellacking it over with their patented brand of varnish. Of course they knew that such a disclosure would arouse an investigation by anti-MOC physicians and who are leery and weary of ABIM/ABMS' deceitful practices.
    Here is another familiar client of PcW that that shoud be familiar with almost every candidate and diplomate who has certified and recertified with the ABMS. Person PLC.

    Here is an example of the devious nature or clever business practices that PcW and Pearson are known for using offshore tax washing to avoid paying US tax: Is that why Pearson's partner ABIM will not list Pearson as a top contractor letting the world know how much it's professional testing division makes for the UK based company.
    When Pearson US Took A Tax Break https://www.world.tax/articles/when-pearson-us-took-a-tax-break.php

    Here is a bit about PwC: https://en.wikipedia.org/wiki/PricewaterhouseCoopers

    "PricewaterhouseCoopers (doing business as PwC) is a multinational professional services network headquartered in London, United Kingdom. It is the second largest professional services firm in the world,[5] and is one of the Big Four auditors, along with Deloitte, EY and KPMG.[6] Vault Accounting 50 has ranked PwC as the most prestigious accounting firm in the world for seven consecutive years, as well as the top firm to work for in North America for three consecutive years.[7]
    PwC is a network of firms in 157 countries, 743 locations, with 223,468 people.[8] As of 2015, 22% of the workforce worked in Asia, 26% in North America and Caribbean and 32% in Western Europe. The company's global revenues were $37.7 billion in FY 2017, of which $16 billion was generated by its Assurance practice, $9.46 billion by its Tax practice and $12.25 billion by its Advisory practice.[9] PwC provides services to 422 out of 500 Fortune 500 companies.[4]


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  20. courtship and marriage?Sun Oct 15, 05:02:00 PM CDT

    Mergers and aquistions at PcW involving Richard G Battaglia

    And here is a bit of propaganda work and example of the kind of advising that Richard G. Battaglia was doing while at PwC. Physicians should not be treated this way where they are deceived over and over while they burn the candle at both ends serving patients.

    There is no question in my mind that MOC must end and that the ABIM/ABMS is a house broken beyond repair.

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  21. “From Courtship To Marriage
    A two part series on physicianhospital alignment
    Part I: Why health reform is driving physicians and hospitals closer together
    Part II: How physicians and hospitals are creating sustainable relationships
    “This document combines two reports published by PwC Health Research Institute between December 2010 and April 2011 on physician-hospital alignment. Part I of the series examines how health reform is pushing physicians and hospitals closer together, and profi les physicians’ interest in alignment. We explore the hurdles that must be overcome for alignment to be successful and discuss how hospital leaders need to be more transparent about everyone’s roles and responsibilities when partnering with physicians. Part II of the series looks at how physicians and hospitals are creating sustainable relationships to make alignment work for both sides. Our research focuses on three interlocking issues that support successful physician-hospital alignment: shared governance, aligned compensation, and changing physician practice patterns. We conclude our research by synthesizing key elements of successful alignment strategies and identifying a step-by-step method for aligning health systems with physicians.”
    https://www.pwc.com/mx/es/industrias/archivo/2012-02-from-courtship.pdf

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  22. You are judged by the company you keep.

    https://books.google.com/books?id=bJycAwAAQBAJ&pg=PT118&lpg=PT118&dq=the+great+tax+robbery+pearson+plc&source=bl&ots=jvAgG20E5F&sig=4DhpvNeIAUF5i9bNM1ln9pqLTKI&hl=en&sa=X&ved=0ahUKEwiQlJaBo_TWAhXJSCYKHWMrAocQ6AEIFTAD#v=onepage&q=the%20great%20tax%20robbery%20pearson%20plc&f=false

    https://m.huffpost.com/us/entry/1850169

    https://www.google.com/amp/amp.miamiherald.com/news/business/banking/article98087702.html#ampshare=http://www.miamiherald.com/news/business/banking/article98087702.html


    https://www.google.com/amp/amp.timeinc.net/fortune/2015/01/21/everybody-hates-pearson#ampshare=http://fortune.com/2015/01/21/everybody-hates-pearson/

    ReplyDelete