Wednesday, November 01, 2017

The Hidden Message Coming From the AMA

This morning I received a press release from the American Medical Association (AMA) that said "New AMA Research Finds One in Five Physicians Ready to Reduce Clinical Work Hours." The press release pointed to "new research" (sorry, it's behind a pay wall) that appeared in the Mayo Clinic Proceedings from "experts" from the AMA, Mayo Clinic and Stanford University. The lead author of the research was Christine A. Sinsky, MD of the AMA.

But what Dr. Sinsky fails to disclose in her article in the Mayo Clinic Proceedings, is she is also a Director of the American Board of Internal Medicine (ABIM) and a member of the Board of Trustees of the ABIM Foundation, serving as the Vice Chair. This is not a minor lapse in disclosure, since the ABIM Foundation and the entire national Maintenance of Certification debacle may become one of the largest medical education corruption stories in modern medical history. Funneling over $78 million dollars for ABIM testing fees behind physicians' backs to fund the ABIM Foundation appears of little importance to Dr. Sinsky. She is more concerned about our psychologic well-being rather than the behavior of the Foundation she runs with our Maintenance of Certification (MOC) cash. This corruption renders Dr. Sinsky's arguments why physician burnout is at an all-time high mute moot. Turning a blind eye to the facts only deepens physician frustration with our current bureaucratic leadership.

If Dr. Sinsky is so concerned about physician burnout, why isn't she the leading spokesperson at the AMA insisting the leadership there end MOC as it was resolved by the AMA House of Delegates in 2016?

Perhaps it's because she's too conflicted to understand the problem.

-Wes

32 comments:

As it goes with the tax forms so it goes with everything else ABIM! said...

Who is Christine Sinsky and why does she fail to disclose?

We have all seen her name over and over again on the ABIM tax forms.

As a simple online search shows, it gives me no pleasure to say, Sinsky took too much editorial license with what she chose to include and omit from her ABIM Foundation biography. Or, to be fair, perhaps the Foundation's VP, Dan Wolfson, or Eric "Edelson" McKeeby - ABIM's PR man - committed the offending deed of truncating her bio, leaving very important biographical information out. But there is nobody I know that does not approve or dissaprove of that information themselves.

Dan Wolfson, who most certainly had a hand in it, has been with ABIMF way too long. Wolfson is not only conflicted himself, but by the strong association he has with egregiously conflicted individuals such as Christine K Cassel, one of the chief architects of the whole money laundering scandal, fake registration, and the over zealous obsessive stock trading that ended up being a silent debacle for their investment advisors and ABIM executives. They kept that under wraps too.

I think Christine Sinsky, or anyone at the ABIM/ABIM Foundation, could be much more forthcoming about revealing potential conflicts of interest or apparent ones. (Or actual ones that need to be addressed as they arise.)

Something that was not reported in Sinsky's ABIM Foundation bio, or in the attached disclosure questionnaire - and should have been for transparency - is that her husband Thomas Sinsky has a significant level of involvement with the ABIM/ABIM Foundation as well. Who the ABMS appoints to its various boards, councils and committees is by invitation only. And only insiders are welcome. Why is that? What does that tell us about the ABIM and ABIM Foundation?

Christine's LinkedIn history tells even less, so one wonders why the lack of attention to details in giving out work experience that matters to most of us? To not disclose draws more attention usually. One should understand that the internet has made every one of us a quasi-investigator, and when we discover some ourselves, we place more meaning to the "hidden" piece of information.
https://www.linkedin.com/in/christine-sinsky-3a656724/

Here is a bio from Thomas and Christine Sinsky's company website. The information about Sinsky's revolving door NCQA and CMS work history is significant, and should have been disclosed on the ABIMF bio hyperlink titled disclosures:

"SINSKY HEALTHCARE INNOVATIONS

Drs. Christine and Thomas Sinsky are general internists at Medical Associates Clinic and Health Plans, in Dubuque IA. Dr. Christine Sinsky serves on the American Medical Association’s Advisory Panel on Physician Satisfaction. She previously served on an expert advisory panel for the CMS Innovation Center’s Comprehensive Primary Care Initiative, the Veteran’s Administration primary care redesign and on the National Committee for Quality Assurrance provider programs committee with oversight of the Patient Centered Medical Home, from 2007-2011. She is a co-author of the Institute of Medicine’s 2011 report, Health IT and Patient Safety. Dr. Christine Sinsky is a Director on the American Board of Internal Medicine, and a Trustee for the American Board of Internal Medicine Foundation. She has provided testimony to the Office of the National Coordinator for HIT on EHRs with respect to both care coordination and usability. Drs. Sinsky are co-authors of an American Board of Internal Medicine Foundation study of high functioning primary care practices, “In Search of Joy in Practice.” Dr. Thomas Sinsky also serves on the joint ABIMF-American Academy of Nursing Primary Care Initiative.

Both Drs. Sinsky received their B.S. and M.D. degrees from the University of Wisconsin, Madison, Wisconsin, and completed their postgraduate residency at Gundersen Medical Foundation/La Crosse Lutheran Hospital, in LaCrosse, Wisconsin."

http://www.drsinsky.com/about/

Blog Administrator said...

FYI - I think it is ‘moot’, not ‘mute.’ My 2 cents! Please keep fighting the good fight! Can’t wait til MOC is totally dead!

DrWes said...

BA-
Thanks. Correction made.
-WGF

Sinsky and the Wachter Review said...

Christine Sinsky is a close networking business partner of Robert Wachter. That is an important disclosure to make. http://drwes.blogspot.com/2016/01/love-ethics-and-quality-assessment.html

Wachter and Sinsky went to the UK last year to allegedly help them with the task of improving their EHR.
http://www.abhi.org.uk/media/1354/wachter_review_accessible.pdf

Wachter's New York Times handlers had to help with his image before anyone in the UK would listen. Physicians are not keen on measuring things to death, MOC, and too much regulation associated with EHR such as MU would not be tolerated. Only positive incentives.
https://www.nytimes.com/2016/01/17/opinion/sunday/how-measurement-fails-doctors-and-teachers.html?_r=0

http://www.abhi.org.uk/media/1354/wachter_review_accessible.pdf

Anonymous said...

Reposting my comments on your May 3, 2017 blog entry

Anonymous said...

Let us also examine the failures of the other greatly conflicted organization - ACP and the Annals of Internal Medicine.

http://annals.org/aim/article/2614079/putting-patients-first-reducing-administrative-tasks-health-care-position-paper

A puffed chest "ACP position paper" about what constitutes a good use of physician time and health care dollars. If one applies their own metric to MOC and the ABIM, it is immediately apparent that ACP should withdraw all support of MOC and the ABIM. Then why doesn't it? We know darn well why: COI & $$$$$$$$$$$$$$!

Wed May 03, 11:02:00 AM CDT

Anonymous said...

And further, the editiorial comment saying the above ACP position paper is a "timely call" is provided by Dr Christine Sinsky, the VP of Professional Satisfaction for the AMA. The same AMA whose House of Delegates moved that the AMA immediately take steps to end MOC (for the very reasons described in the position paper) and yet chose to take no action. Dr Sinsky states she has no COI in her editorial. What she does not disclose that she is the Vice Chair of the ABIM Foundation. NO COI??? Dr Sinsky, you disgust me!!! The ABIM, AMA, and ACP have formed an alliance rife with self preserving COI.

http://annals.org/aim/article/2613554/designing-regulating-wisely-removing-barriers-joy-practice
Wed May 03, 11:28:00 AM CDT

Anonymous said...

Evolution of modern medicine.

Physician autonomy--take this pill, have this surgery
Patient autonomy--you can take several different pills to improve your illness and I will help you choose
Bureaucratic autonomy--the EMR checklist on my dashboard says that you need to take this pill

ABIM: the poster science - not as robust as their spending said...

Science is just not their thing at the ABIM

AAMC studies have predicted for three years in a row a coming physician shortage exacerbated by an aging population. Here is the recent study with hyperlink.
Conclusion: a need to train more physicians.
https://news.aamc.org/press-releases/article/workforce_projections_03142017/

Not one word about MOC in the AAMC study or the "Sin-sky study". What are they up to?

Why publish now in late 2017 the results of a 2014 capricious survey and turn the BS survey into a research project. (Who really wrote this nonsense.) Whoever it was produce one of the most flawed "research" surveys to date, most likely from the ABIM and ABIM Foundation.

A lost has happened in three years since Aug. 2014. The pendulum has shifted in three years and the WESTAT surevey software (or whatever) Sinsky used (see ABIM tax forms ten years ago for WESTAT consults/software) is even older by seven more years.

I am stunned that they can call this science. It is more propaganda and well time at that!

MOC and Green Acres? Shangri-lala land and the ABMS said...

"Green Acres is the place to be, MOC living is the life for me?"

ABMS November 1st, statement: MOC and the false ride into the land of well-being

The Sinsky affair (fake research) all comes into focus as we witness the well coordinated, but desperate "full-court press advertising campaign" by the ABMS and their fabulously wealthy executive partners.

It is propaganda showered like sweet rain on their diplomates in an attempt to shift the blame of burnout to EHR, and so on. In a ridiculous and embarrasing show the ABMS is not telling physicians in America (and globally) that new MOC solutions coming soon to a Pearson testisng site near year will save you from burnout.

The new "solutions" offered will transform the ABMS MOC into the champion white horse that you will ride into well-being.

What a PR spin in the fake and unbelievable style of Chicago's best advertising firms

From THE STATEMENT (ABMS) [Do they have any sense of reality?]

"ABMS is concerned about the increasing level of burnout, depression, and suicide among today’s physicians and clinicians and is making a concentrated effort to work alongside other professional health care organizations to address this growing problem."

ABMS and its 24 Member Boards are working together to support their colleagues in medicine in advancing this cause through a variety of initatives.

"The ABMS MOC Directory is an online repository of competency-based continuing certification activities. It aligns the Boards’ continuing certification programs with educational initiatives designed to support the development of high functioning physicians, improve physician wellness, and reduce burn-out. More than 150 continuing certification activities in the following areas are indexed in the MOC Directory:
Organizational Culture of Wellness
Efficiencies of Medical Practice
Personal Resilience
ABMS’ recent call for physician well-being activities for the MOC Directory continues its collaborative efforts with national thought leaders and organizations committed to improving physicians’ well-being."

Personally, I have never heard anything as disingenuous in my life. All this sweet-talking bullshit about a life free of stress after hiring felons and unscrupulous lawyers to destroy the foundations of freedom and privacy in our country. These ostriches are hopeless.

Have they ever heard of the AMA House of Delegates?

Anonymous said...

There is no hidden message, Wes, it is just more fools hiding from the truth.

MOC does harm and has to go!

One really has to wonder, how much stuff can they keep fabricating?

How long can the ABIM and ABMS member boards keep pretending; can't they see they have no clothes?

Help them! said...

MOC is a dead horse.

The ABMS killed it themselves, yet they insist on pretense. They pretend to ride a proud vibrant system of voluntary certifications and re-certification, when in fact, ABIM and ABMS boards are nothing more than 24 drunken jockeys wringing their hands and holding on to a useless tattered umbrella. They use it occasionally in remembrance of the glory days, but using it in their dreamlike state like a whip on physicians hard working backs.

The world has moved on and medical science through new technologies is instantaneous. Accessible day or night. The jockeys must give up the dead rotting horse if they want to rehabilitate and be useful again.

Someone in Buffalo Grove should wake them up and start counseling them.

2020 views said...

A miracle on Wabash? Or just more of the same?

Will the AMA fund an independent study on the effects of MOC on physician and patient well being?
At this point in time it is clear that they don't care to, nor will they help implement what the delegates resolved for them to do. To end MOC. The reasons are clear.

The AMA is comprised of an esoteric circle, with an impenetrable inner sanctum - a leadership that no one can get through to.

That elite body is surrounded by a vault full of investments worth hundreds of millions of dollars, which appears to be much more important than the medical needs and psychological well being of the many. Folks who truly suffer.

Why? Because they represent the desires and interests of an elite few.

And the appointed high master of the AMA, is surrounded by a paywall worth 2 million dollars.

He's ingratiated to serve the $11 million they invest annually on information technology equipment with the aim of growing their marketable data/profiles, which of course, they intend to sell.

The AMA has an insurance business, with lucrative premiums. They make a market in insurance and they think of business and advertising first.

Executives meet in dinner clubs discussing the burgeoning new data services and all the other related enterprises selling big data.

Add to that the lobbying, the grants to powerful people and organizations, the $144 million in employee salaries, compensation, and benefits, along with the pension funds and golden parachutes. It all eats up the hours in a day, week, month and year. Until the year is gone.

One can see why the people crying outside beneath AMA Tower on Wabash Street are not heard. We aren't considered important enough to help get relief from onerous and unjust mandates of MOC. The most relevant cause of burn out, financial burden and emotional grief. Ruination.

For AMA's inner core to respond as they should to our elected representation would take a miracle and nobody seems to believe in miracles anymore.

I'm talking about the miracle of real wellbeing and not just idle promises and talk.

This story of pushing back against MOC, corruption and conflicted governance by unethical testing companies is a miracle. By using independent thinking to arrive at the truth, growing a backbone to defend that truth which that was not there before is miraculous. .

The will to speak out in the state legislatures as men and women of conscience transcends waiting for miracles to happen.

The AMA HOD resolution gave us a song of protest to end MOC now. It's a cry heard everywhere among practicing docs and many of their patients. It gives hope that a physician's right to work and a patient's right to care will be reality in every state and territory. The HOD reveals the power of the human voice with a strong resolution to end MOC now.

Humanity in America can't wait

This diverse country made up of a million physicians and 350 million patients all suffer from the bureaucracy of bad decisions every day. We cannot wait for humanity to happen in the hearts of elites who can't see beyond the pay wall.

An private inward miracle?

We could not possibly hope that a woman from Iowa claiming to be a working physician who understands what harms physicians and patients, and what they have endured psychologically', would feel strongly for the other side and advocate for us. Now that would be a real miracle, wouldn't it. Even if only an inward one.

But yet, we all understand there is a moral and social duty - an obligation - to incline oneself toward what is right, true and just.

MOC and the accompanying corruption must end.

Anonymous said...

Why is Christine Sinsky not on the AMA tax forms? She is a VP in charge of a professional services division. She's been there since 2014 in her current role. How much are they paying her?

The price of excellence said...

How much income do the Sinskies, Thomas and Christine, bring hme working at Medical Associates and Health Plans in Dubuque, Iowa? How does Christine maintain a practice in Iowa, work full time in Chicago, lecture and advise around the world, and maintain close ties with the NCQA and CMS to help her HMO achieve and maintain the highest ranking from the NCQA?

Where does she find time to study and do something about physician burn out?

What the Sinsky study reveals is that she took a survey in 2014, sat on it until almost 2018, and then some ABMS/ABIM advertising firm decided to use her face in another phony marketing campaign.

Is that what she is paid for doing as she hops around the world?

Sounds like another Christine we know (Cassel) who also was on a money grab at the ABIM.

It is really hard to keep up with all the revolving door state actors who design and implement burn out for the corporate cronies and Wall Street/LSE elite they really serve. What a cost savings they create for the insurers who demand MOC. No more!

And the nerve she must have to not even mention MOC in her pretty survey. Disgusting.

Paying ABIM/ABMS and NCQA to be exceptional said...

Bridges to excellence? Or MOC bridge loans to stay afloat for the ABIM

The tight financial and political connections between elite members in the quality assurance/testing and accreditaion cartel needs DOJ scrutiny. Not even a warning from Consumer Reprts about quality assurance and testing scams.

I think we all know why. Study the links below for examples of how the ABIM/ABIM Foundation, ABMS umbrella, ABMS specialty boards, NCQA, AQA, insurers and big hospitals, ACOs/HMOs and big data/EHR conpanies created a bridge to their own funancial eel being at the expense of the physicians, patients and taxpayer. Most of these companies pay no taxes or provide boons to corporations like Premier, Inc./CEcity. See ABIM Tax forms from 2009/2010 to present for examples of industry/non profit quality assurance collusion. Christine Cassel was on the board of Premier, Inc., from 2008 to 2014 when she was forced to resign in disgrace. Propublica got this information wrong mentioning 1 year only without reporting the ABIM/CEcity/Premier connection in a follow up report. Why? It is very newsworthy and the Cassel/ABIM conflicts were not pursued. Ditto on that why?

Does it have something to do with the real reason Christine Sinsky was placed within the inner circles of the AMA along with revolving door ABMS/AMA/NBME executive Eric Hawkins. The CEO elect at the ABMS. Yes, ABMS chose their own AMA mole to replace Lois Nora in 2018.

And there is more. Sinsky's close ties with Robert Wachter shows she is also the mouthpiece for the disgraced former ABIM chairman and ABIM Foundation trustee.

When Dr Fisher uses the word corrupt to describe the conflicted individuals and monopolistic cartel you can take that word "corrupt" all the way to the ABIM's big piggy bank cum "Foundation" full of physicians' laundered fees to create their infamous war chest.

Just try to ask the management to describe the pyramidal compensation model of Sinsky's HMO. Compare it to the pay structures at Chris Cassel's career-long employer Kaiser Permanente. Better be seated.
https://www.mahealthcare.com/index.php%3F/about-us/

NCQA "Programs" for Recognition
http://www.ncqa.org/programs/recognition

Superior Plans (insurance) and the ABIM, NCQA, CEcity/Premier as an example of NCQA/ABMS "Bridges to Excellence" financial scheme and MOC.
https://www.superiorhealthplan.com/providers/resources/provider-programs/bridges-to-excellence.html

Sinsky's ABIM Disclosurre Form said...

The unanswered question about board positions and an impossible-to-believe answer about speaking fees

On her ABIM disclosure form Sinsky leaves blank one category. "Officer/Director Positions: Healthcare"

The former is left blank and the latter impossible to buy

According to her own blog site this may be an ommission, because she claims at least two (advisory) board positions at Sinsky.com. Therefore, a false disclosure form may have been submitted to ABIM or edited by their communication team.

C Sinsky alleges to be on the advisory boards of:

Primary Care Progress
https://www.primarycareprogress.org/

And

Industrial Engineering - Primary Care Collaborative
http://www.fammed.wisc.edu/i-practise/

These organizations provide insight to Sinky's agenda and biases in healthcare.

Also several websites make reference to Christine Sinsky's frequent speaking engagements, so to assert on her ABIM conflicts of interest disclosure form that her financial take from talks and consults is $1-10,000 is absurd.

Dr Sinsky made several trips to the UK with Bob Wachter recently to help overhaul the NHS EHR. The 1st class air travel of one trip to London w/hotel would put put her over the top of the range.
(They went with venture capital advisors too, along with many folks from quality assurance corporations--even an e-patient advocate, so they may have flown in a chartered flight.

There was an extensive number of conferences and visits to NHS sites, plus followup visits and countless conference calls. The EHR review is ongoing. A multi year program with slow implementation. Very costly consults. Financial arrangements have not been disclosed.

Tax forms for Primary Care Progress based in Massachusetts reveal a new NGO launched in 2010.

Tax records (most recent 990s) of PCP do not list Sinsky as Director or on any advisory board.

No mention is made of consultat fees, but their tax form revealed over 1 million in grant money with over one third going to 4 executives. Familiar grant sources listed at end.

There are some large expenditure which were unspecified. Tax forms are unusual in that all important financial data about people and sources of money are referenced in the front pages by "see ATCH" 8, 9 and on and on. Quite unique way of obfuscating and pushing everything to the end pages in horizontal view. Nothing but blanks about who and what until very end. Requires patience.

The National Philanthropic Trust is listed as a new significant donor. Two out of the three or four directors are related.

The other organizatin Sinsky claims advisory board status for is the Industrial Engineering - Primary Care Collaborative. Their website was not very easy to find info on, but this org also did not claim Sinsky as an advisory board member. But she did speak during at least one conference and served on discussion panels. UW.

2015 Sinsky Study: admin and operational tasks said...

Burnout and the ABMS quality chasm cabal: navigating wave after wave of ABIM propaganda and disinformation campaigns

One of the points made already why did Sinsky, et al sit on this survey result for 3 years? A 2015 AMA study from 2015 "On physician satisfaction and dissatisfaction..." was published only one year later.

In the background to the 2015 study (pub.10-2016) burn out rate was an increasing concern from 2011-2014. Rising quickly 46-54% on Maslach's scale. A separate study 2012- 2013 surveys reveal stress syndrome at 50% and burn out at 27% with 9% expressing they would leave medicine within 2 yrs.

EHR, insurance battles, etc., Table 1 has a broad outline of the problems, but no mention of MOC.

Sinsky sat on these studies as well. She was corresponding author on the 2015 survey/interviews. Then she went to England!

And with all the changes in healthcare and the physicians being hitched up with digital mail order brides (EHR) and forced out of private practice into the arms of corporate medicine, one is alarmed at how callously ABIM rolled out the forced MOC plan of advanced payment and additional busy work/data collection.

Pushing 2 year MOC increases the burden and stress of MOC 5-fold.

The continuous exhibition of reckless behavior and conscious suppresion of this data in their decision making is a failure of greatest import. It is a failure of their prime duty to protect physicians and the public.

Did the ABMS ever get anything right? Any reasonable human being would suspend MOC immediately given the emergent situation.
The only rational thing now is to end MOC and motivate insurers and hospitals/medical organizations to alleviate the egregious conditions that are outlined in the studies.

Instead of "fixing" healthcare abroad, it is time for a focused approach here at home. Beyond MOC and beyond MU and MACRA. Fix it..
End the corruption and usury.

MOC is waste, abuse and corruption on an unprecedented scale. How many more will the ABMS and their associates allow to be harmed by their greed and political misdeeds?

The ABIM is coercing and tricking physicians into jumping into their quality chasm with the only possible outcome being continuous lifelong burn out. Their easing of burdens is a marketing scam. The new MOC with its 2-year testing, endless quizzes, costly MOC points, data collection and surveys will be so damaging to one's well being, that even in retirement one will not recover from it.

The gullibility of the human mind is almost limitless and so is the ABMS' sway on that mind with their disinformation and slick marketing campaigns.

ABIM footprints in the sod said...

Nothing to disclose?

Sinsky's boss John Tallent and her Iowa employer Medical Associates Health Plans
https://www.linkedin.com/in/john-tallent-44a85a8/ (Nothing to dislcose?)

Christine Sinsky's employer/boss in Dubuque Iowa, Medical Associates Health Plans/CEO John Tallent, has/had significant board relationships.
https://www.mahealthcare.com/about-us/

Greater Dubuque Development Board (John Tallent)
http://www.greaterdubuque.org/gddc/who-we-are/board-of-directors

American Trust Savings Bank/ATBancorp with over 2.3 billion in assests (John Tallent Dir.)
http://www.bloomberg.com/research/stocks/private/person.asp?personId=60174836&privcapId=4514528&previousCapId=4367633&previousTitle=ATBancorp,%20Inc.

A review of Medical Associates Health Plans website is not transparent as there are no links to MAHP officers and board. That always makes one curious.
https://www.mahealthcare.com/about-us/Medical Associates also has a non-profit foundation.
https://www.guidestar.org/profile/42-1172640

American Trust Savings Bank had no links to its leadership either. Strange.
https://www.americantrust.bank/home/about-us.html

ATCapital
http://at.capital/about-us/

ATBancoprp (why is everything so hidden layer within layer like peeling an onion)
http://at.capital/about-us/

ABIM Iowa Partner Review: ending discrimination and trade restraints in the profession of medicine said...

Common threads of change everywhere and the imperative to end MOC

FYI: Medical Associates Clinics, PC is an Iowa corporation (HMO). The Charity Foundation they operate is poorly funded. They could do more for the community and they could do more for women. That is my opinion.

Medical Associates Clinics, PC and Medical Associates Health Plans has been described in court documents/civil complaints by employees (partners and non-partners) as a male dominant culture rife with discrimination and offensive behavior and attitudes toward females.

Women have complained over the years of serious rampant pay and gender discrimination.

Lawsuits by such employees were filed and settled typically within a year, thus keeping Medical Associates Clinics and Health Plans out of the media's attention - keeping the obvious mistreatment of women out of the court and away from the awareness of physicians. Brave, respectful, and violated women who complained to Medical Associate's management trying to change the culture from within were retaliated against for speaking up concerning their own and all women's rights.

The right for equal pay and equal treatment, including fair/equal advancement and opportunity to hold higher positions. We hope this has changed, but the court records are unmistakably clear and cogent in addressing the violation of women. We would hope things have changed, but yet we also understand that the same CEO has been leading Medical Associates Clinics and Health Plans for 20 years.

Medicare 5 star ranking for Medicare Health Plans but not so for the Medical Associates Clinics

Medical Associates Health Plans has received a five star ranking form Medicare five years in a row, but only as an insurer. (Christing Sinsky worked for CMS. She helped create the ranking system.) But unfortunealtly the Medicare ratings for the Medical Associates Clinics is far below the five star ranking. The CMS Medicare compare site shows a much different picture of the clinics as self-reported by Medical Associates themselves.

What stood out in the "Medicare Compare" star ratings for Medical Associates?

The first thing that caught my eye, was their inability to respond adequately to depression getting an unfavorable rating. I thought of Dr. Sinsky's inability to respond to the real crisis in medicine regarding burnout/depression/suicide corresponds analogously when seeing this unfavorable rating. The management of high blood pressure is ranked low, also, and several other categories including costs of medications. They got one star. Read it for yourself with a grain of salt. Even the 5 star ranking for their health plan has certain key elements that take more weight in the evaluation. Some hospitals and clinics do not participate or did not participate in time, which affects ranking/rating.

Medicare compare Medical Associates Clinics, PC
https://www.medicare.gov/physiciancompare/#profile&loc=DUBUQUE%2C%20IA&lat=42.5005583&lng=-90.6645718&flow=default&type=GPRO&paging=1&keyword=MEDICAL%20ASSOCIATES%20CLINIC%2C%20P.C.&previouspage=S&dist=15&pid=3870491228&providertype=GPRO&name=MEDICAL%20ASSOCIATES%20CLINIC%2C%20P.C.&id=3870491228&loctype=c

MOCBLOC: fighting against gender inequality said...

Standing up to fight against discrimination

Lawsuits by female Medical Associates (clinic and health plans) employees with issues of discrimination, pay disparities and sexism (cases 3 and 4 involve a female physician and accountant who were victims of violations of federal and state law)

1 Medical Associates Clinic, PC (dft) iandce 2:2005-cv-01052 362 12/29/2005 12/19/2007
2 Medical Associates Clinic, PC (dft) iandce 2:2016-cv-01002 362 01/14/2016
3 Medical Associates Clinic, PC (dft) iandce 2:2004-cv-01010 442 03/15/2004 05/03/2005
4 Medical Associates Clinic, PC (dft) iandce 2:2003-cv-01014 442 06/17/2003 10/29/2004

ABIM also has court records showing extremely poor treatment of women including racial discrimination. Whistle blowers have been retaliated against. Christine Sinsky should be aware of this as a VP, Director and Trustee, but like many other things the ABIM has not made a declaration that they strive for/have a discrimination-free work environment where employees, executives and officers can come forward without being harmed or gagged as we have repeatedly seen. As long as they mandate MOC, they can never claim that their clients are not discriminated against. Discrimination is the normal course of business for the ABMS and its member boards. This culture has to change.

All of the above issues lead not to well-being, but to unhealthy being. The AMA must address the horrific treatment of physicians by the BBMS, insurers and hospitals. The NCQA should be fined every day that they insist that MOC is a valid measure and encouraged for insurance companies and hospitals to stop discriminating against physicians, with all the harm it does to patients. MOC is discrimination in action. The discrimination and restraint of trade must end as countless people have so expressed.

I would hope that the AMA and ABMS and others could encourage and ensure that there is fair treatment of their staff and employees ( all races and nationalities without gender discrimination) throughout the boards and medical societies. The growing number of female physicians must have all their rights and human dignity. This goes for mandated MOC as well.

The struggle to end MOC is the same as the struggle to end discrimination against people. It is surprising that physicians and their patients have been stripped of their rights, no longer viewed as citizens by two dozen private "not for profit" testing companies and their umbrella organization that remains mute.

Sixth Sense said...

The Hidden Message Coming From Medical Associates Health Plans 501(c))4) 990 Tax Forms

It is obvious the CEO John Tallent does not want to reveal to the public his compensation, benefits and "share in the company" choosing to hide behind a wall of a few low paid employees who comprise the board of directors of MAHP. We shall also mention that John Tallent served for years (and still does, but that's hidden too) on one of the largest regional banks ATBancorp with billions in assets.

ATBancorp has two family members at the top positions and typically has 23 to 27 board members. It lists only four of them on their web site. Why the cryptology coming form an Iowa "grassroots" bank and model NCQA 5-star HMO?

I am baffled. Do these two related organization and other affiliate companies have "shares" in the offices of the Seretary of State of IOWA, and whatever other neighboring states they operate in? If find the lack of transparency and hidden conflicts of interest and compensation stonewall to be intriguing.

The Medical Associates Clinic, PC, Medical Associates Health Plans and their banking partners is as veiled as the AMA and ABMS and their partners are in their operations and mutually beneficial transactions.

How can non-profit entities be so elusive to the taxpayers who are very interested in the 10 trillion dollar American non-profit industry and if they are placing a burden on the public debt in this country. It is a huge question that needs addressing. As we see the quality assurance cartel that mandates MOC for profit is an industry as big as a regional private bank.

Just look at the Medical Associates Health Plans' 990s (IRS tax forms) and tell me if there is not something odd about $36 million in revenues coming from a non-profit organization to feed their for-profit contractors at Meducal Associates Clinic to the tune of $34 million dollars. The rub is that the CEO (and other highly paid execs) who personally benefits from the tax break does not care to list himself and salary on the organization's public tax forms. Mr. Tallent only signs the tax schedules and claims officer status?

After 20 years of service to this for-profit/non-profit hybrid HMO (with a lightly funded charitable foundation), how can the financially talented CEO get away with not being transparent about his and other executives compensation packages?

Is it because they have short changed women (and perhaps patients) for years and are embarrassed to have to explain where their lofty salaries and benefits have all come from?
I read the court documents, and have knowledge of IOWA, so let's not pretend otherwise.

This is a question that perhaps Christine Sinsky, who maintains a practice at Medical Associates Clinic & Health Plans, while working as VP of Physician Satisfaction at the AMA, would like to address. (ABIM Director, ABIMF Trustee to boot.)

Or perhaps Dr. Baron would like to speak a little bit about why his compensation is through the roof at the ABIM and ABIM Foundation. (Pushing a million dollars or more after all is said and done.) A lot of the questions and answers all seem to point to the level of discrimination and taking advantage of the vulnerable ones (clients and employees) as they relate to an organization's profit. How far is a non-profit or hybrid corporation willing to go to to abuse others to procure profits for themselves?

With the ABIM it is very strange how a great deal of the corruption and obfuscation points to Iowa and that problematic fraudulent reporting to the IRS about where their BIG IOWA PIGGY BANK (ABIM Foundation) was really domiciled.

And how about that NCQA "MOC collaboration", Drs. Chris and Rich! When do we get some answers to the questions and real tackling of the problems?
http://etf.wi.gov/publications/dc_content/dc_2007/state_medical_associates_2007.pdf

Anonymous said...

The problem with stink is that it rubs off. All of these organizations/people are smelling like one big pile of stink. Gone on, Baron & Sinsky, keep your heads in the sand. You pretend to not see us but we can sure smell you!

When Medical Science Merged with Self-Dealing Politics and Personal Corporate Profits said...

When Corruption Came of Age at the ABMS, AMA and ACP

Here is some other notable "Physician Satisfaction News" courtesy of AMA VP Chrisine Zinsky (ABIM, ABIM Foundation) in support of Healthfinch and Athena Health (Only coi to report on this study!) The conflicts in this study shed light on all the other studies, which exclude MOC as a significant factor in physicians "dissatisfaction".

Here we present a study conducted by Christine Sinsky (AMA VP, Physician Satisfaction). and an AMA-funded study links EHR burdens to burnout published in ACP's Annals of Internal Medicine.
"Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties"
https://www.healthcare-informatics.com/news-item/ehr/study-ambulatory-physicians-spend-half-their-time-ehrs-desk-work

After reading the study one would presume burnout from EHR is bad right?

Not if you own shares in the privately held company Healthfinch, which will reduce the burden of those repetitive EHR tasks and reduce burnout.
https://pitchbook.com/profiles/healthfinch-profile-investors-funding-valuation-and-analysis

What type of tasks?

Tasks such as automated prescription refills made less burdensome by Christine Zinsky's privately held company Healthfinch. (This app is a screening tool and is now sold by Athenahealth. Thanks to the brilliant marketing of Zinsky, the AMA and ACP.

Did we forget to mention that Christine Zinsky is on the ADVISORY COMMITTEE for Healthfinch.
And did we not mention that Dr. Zinsky has substantial shares in the company. (We cannot determine yet if Zinsky is paid additional shares and cash, just like her business partner and former ABIM Chairman Bob Wachter, when he was Safety Chairman for IPC the Hospitalist Company. In the case of Wachter it was publicly traded and one could access reports via the SEC. Wachter's company was sued for billing fraud under the false claims act and settled with the DOJ for $60 million.
https://www.justice.gov/opa/pr/healthcare-service-provider-pay-60-million-settle-medicare-and-medicaid-false-claims-act

Is it public fraud to use AMA funds for a conflicted employee (or several in this case) like Christine Sinsky, while she also works for the ABIM and ABIM Foundation, which claims to "receive no funding from the healthcare industry". I find this a fascinating phraseology, which like all ABIM policy flies right back into your face when you try to inquire about the corruption there.

Here is a classic example of the power of medical society/taxpayer funded healthcare advertising and how it personally benefited Christine Zinsky, her stock price and aids her associates at Healthfinch and AthenaHealth's in their marketing campaign to make huge profits by easing physician EHR burdens. The founder of Athena Health and their ties to government and government funding is another story.

Healthfinch's drug refill app graduates to the Athenahealth marketplace 10/26/2016

https://www.xconomy.com/wisconsin/2016/10/26/healthfinchs-drug-refill-app-graduates-to-athenahealth-marketplace/

This investment opportunity for Dr. Zinsky was made possible by the venture capital division of ADAM STREET PARTNERS

http://www.adamsstreetpartners.com/dedicated-strategies/venture-growth/recent-investments/?investment=10

ADAMS Chicago Venture Capital Top Tier Team

http://www.adamsstreetpartners.com/dedicated-strategies/venture-growth/
http://www.adamsstreetpartners.com/team/terry-gould/


Health Finks. Didn't Dr. Sinsky say she was not on any healthcare company boards? said...

Becoming slaves to our machines with ever increasing complexity (and being a slave to corrupted tools of the industry)

Christine Sinsky, MD, Advisor to Healthfinch, is advisor to a company that hopes to thrive on the continued uncertainty, burnout, financial distress, and overall dissatisfaction of physicians with the technological revolution in medicine.

Before TARP showered $30 billion on the EHR corporations, there was very little interest, because there was little money. Little interest, little money. Big money, big passion for it. Now even Madison is getting in on the deleterious action.

Healthfinch is taking some of the app pie involving automated solutions for EHR and repetitive click syndrome that physicians are burdened with along with countless other bureaucratic demands.

"Money can't buy you happiness" said Howard Hughes.

http://www.healthfinch.com/money-doesnt-buy-happiness/

Healthfinch, "Trailblazer in innovation"

http://www.healthfinch.com/healthfinch-recognized-by-madison-magazine-as-trailblazer-in-health-innovation/

Healthfinch is learning how to market their products and services from Christine Sinsky, who is Vice Chairman of the ABIM Foundation Board of Trustees earning $16,752 for five hours of work per week (latest tax form). Sinsky did double duty influencing the ABIM, and spreading the ABIM as well as well, where she took home $14,950 as a director. That' $31,522 working ten hours per week or 2 hours a day, five days a week.

Working full time with the AMA as VP for physician satisfaction, a consulting firm, and maintaining a practice in Iowa, one would think she is on a get rich quick binge.

And maybe she is.

The advisory board of Healthfinch.
http://www.healthfinch.com/our-team/

Henry David Thoreau said we have become the "tools of our tools."

Yes, we have, and healthfinks are paving the way - making a fortune off hardworking physicians, vulnerable patients, and the taxpayer who already has $20 trillion on their backs.

AMA News: Unbelievable said...

Storyline

Using AMA/ABIM employee/director spent time and grant money for "research" to promote one's familial interest in a venture capital startup in healthcare

Didn't Dr. Sinsky disclose she had only "$1 to 10K" (on ABIM's disclosure form) invested in Healthfinch. Just a trifle. $1.00 to $10,000. Right? But everything Chris Sinsky disclosed, or omitted so far, seems to have been false reporting. So, what about the modest disclosure concerning her Healthfinch stock?

We believe this is perhaps the biggest fib of all on her ABIM disclosure form. Here's why.

One can easily reason this out for oneself and conclude with fair certainty that Dr. Sinsky would not waste her time and energy on a few dollars. Secondly nobody in the private venture capital millieu would even talk with you unless you have a great deal of money to risk, and be willing to kiss your cash goodbye like chaff in the wind.

You must be a "good fit" for them, as they say. Especially healthcare tech startups. It is risky. Health tech is a very crowded scary space and Healthfinch has a dozen or more competitors. Plus the venture groups responsible for the "underwriting" do not want to be sued, for misleading an insouciant investor.

Even though private, they can still get some action from the SEC, DOJ or FTC. So the venture groups pick typically investment companies to work with and only few select high net worth investors to fund their offerings. It is simpler, with fewer supportive phone calls and a lot cleaner financially for them. As we said it is less likely for the SEC or DOJ to write a hard letter or come knocking on the door with a warrant to search and seize your computers and files.

Companies like Healthfinch will burn through cash quickly, faster than a goat on twelve square feet of grass, and you can be sure these money munchers in Madison will be back for more, usually with some more team members--so the venture partners will have to cough up even more money. When they try to get the next traunch of money it will dilute everyone's holdings. You have to hold the investment quite some time until it grows significantly or gets bought out. And then the venture guys cash in and distribute the capital gains.

Or more likely they will deliver the bad news that the CEO and executives (who lived high on the hog in Madison for several years, dining near the capitol building with its fine cuisine) will tell you you have lost everything. It goes this way very often. If you were a committee advisory board member or a director, your "advisory efforts" if you are egregiously conflicted might put the company at risk or on the SEC watch list.

If there were serious complaints through attorneys that someone was fraudulently displaying themselves as a casual investor (1 dollar or more) when in fact they were fully vested in the project and it was discovered they were using AMA funding on physician satisfaction, not as it was intended, but fraudulently to push the company into a high recognition status, then that advisory board member would put themselves and the company in legal trouble.

Anonymous said...

It would be even worse if the DOJ got wind of the fact that a high ranking AMA VP and ABIM board director/trustee was marketing for Healthfinch using a closed circle of networking non-profit NGOs and their affilates.

AMA VP Woes: The Finch That Resembled A Fish said...

Double Trouble

AMA VP puts Charlie the finch and the ABIM in legal trouble (plagiarism and fraud)

There could be angry investors complaining to the FTC or state attorney generals if the news broke that the company Healthfinch was completely insolvent. The company didn't disclose that their technology was obsolete, no longer viable or compatible with the newer versions of EHR (not enough venture capital to keep themselves in the Epic/Cerner competition loop and keep up). Pharmacies finally upgraded their software to work more efficiently and accurately.

The books were not being kept accurately as revenue declined and the founders lived like kings. The CFO inflated numbers, and even the Venture Groups did not keep up with their due diligence for their investors, choosing instead to focus on that succesful handful that they know will be home runs. All investment is at risk for the finch.

In other words, Healthfinch's proprietary solutions, in this worse case scenario would now be worthless. The products did not compete well. Another company had more funding and sold their product for less pulling the old Standard Oil trick on them and others in the very crowded aggressively marketed space.

Athenahealth may have wanted to test the markets and only toyed with Healthfink and their animated finch. They kept the bulk of the revenues for themselves and their stockholders (understandable) paying only a small pittance to Healthfinch for years, just for the "privilege" of being on their healthcare app market site.

And if that is not bad enough, Microsoft and Starkist might sue for plagarism

"Sorry, Charlie! No offense, but you just did not have what it took to be a winner. You looked too much like Microsoft's friendly-eyed (but extremely annoying and dull) paperclip to be an original successful star."

"Lose the finch. He looks more like a cross between that obnoxious hook (clippy the paperclip) and an old Starkist tuna fish."

Starkist might really bring suit against Charlie if they knew. MSFT might sue over clippy the paperclip eyes and glasses and being the incarnation of annoying male staring eyes.

https://www.theatlantic.com/technology/archive/2015/06/clippy-the-microsoft-office-assistant-is-the-patriarchys-fault/396653/

Anonymous said...

Christine "let them eat cake" Sinsky is the Marie Antoinette of modern medicine.

FunderBeam on Healthfinch and its valuation said...

Healthfinch independently valued at 50 million dollars (10.65 million invested by 6 investors)

Does ABIM's disclosure form submitted by Christine Sinsky reflect reaality? (Time and time again on the ABIM disclosure forms we find glaring omissions and inaccuracies. Ties to the industry and sitting on corporate boards ignored.)

Here is some clarifying information about Healthfinch compiled by an investment watchdog site called FunderBeam. Christine Sinsky's claim of $1-10,000 investment draws suspicion immediately looking at the numbers and statistics.

https://www.funderbeam.com/startups/healthfinch?ref=teleport

Funderbeam outlines the funding by venture capital groups (10.65 million) and how many investors there have been (6), what the valuation of the company is (50 million).

What FunderBeam shows is a very small startup company with less than 11 million in funding with 6 investors. It has a couple dozen to 49 employees. Christine Sinsky is not only an investor, she is an insider with the company as well (advisory board). The valuation of the company at $50 milion (at last funding period 01/2016) and the Sinskys' working relationship and stock investment with Healthfinch puts into question how much Sinsky has invested in Healthfinch. The lack of current and accurate disclosure on the part of the ABIM's BOD/BOT member is troubling. The investment of time and stock should be calculated as the total investment. We can see that the valuation and investment growth is significant. This reminds us of the lack of disclosure of Christine Cassel on her cash and stock payments for years from Premier, Inc., (2008-2014, which got her into great trouble.

The other significant point is that Healthfinch was founded in 2009 in anticipation of making money off of the chaotic changes and EHR mandates coming from new health reform laws. The ABIM and ABMS lobbied for capturing markets and entrapping physicians financially and psychologically in this regard. Now we find that another Christine is playing financially and playing of of the emotional impact of studies (funded by her employers) to turn a profit for herself and her consulting firm bearing her own name.

Christine Sinsky's colleague/business partner Robert Wachter has disgraced himslef in the same manner selling himself out as the golden poster boy of corporate self-dealing, while working at the ABIM. Wachter's speaking fees are 40-80K plus expenses, so can we believe Christine Sinsky that her consultation company revenue and valuation is $1-10K.

ABIM: Dr Christine Sinsky and Her Improbable HealthFinch Investment//Consult Valuation said...

The Truth Swoops Down from Above on the ABIM and AMA
(in the image of a finch wearing green-shaded accountant's glasses)

Dr Christine Sinsky and the $1 to $10,000? investment/advisory board compensation question?

"HEALTHFINCH (2009, Madison, Wisconsin) Source Funderbeam

FUNDING PROBABILITY SCORE 68%
TOTAL DISCLOSED FUNDING $10.65m
LAST ROUND VALUATION ESTIMATE $50.00m
DISCLOSED FUNDING ROUNDS 3
LATEST ROUND Jan 04 2016
LATEST FUNDING STAGE Series A
NEXT ROUND ESTIMATE -
DEVELOPMENT STAGE Scale
NUMBER OF INVESTORS 6
NUMBER OF COMPETITORS 13
MONTHLY WEB VISITS ESTIMATE 1,314
TWITTER FOLLOWERS 1,187
WEB TRAFFIC OUTLOOK 2 / 10

HEADQUARTERS United States
TEAM SIZE 20 - 49
FOUNDED 2009
WEBSITE http://www.healthfinch.com

Note: Christine Sinsky, MD's employer Medical Associates Clinics and Health Plans own Medical Associates Health Plans of Wisconsin a 501(c)(4) corporation domiciled in Iowa.

https://projects.propublica.org/nonprofits/organizations/391519198

ABIM Open Secrets Report on Lobbying said...

We find all this very disturbing. The ABIM and AMA should show their concern also with an independent audit of all their disclosure forms and related parties.

Also troubling is that Sinsky's employer Medical Assoiciates in Iowa/Wisconsin, Illinois, uses RSM US, LLP accountants, as has the ABIM for years until recently.

Recent accounting changes and accounting irregularities discovered at the ABIM

Did RSM US' (McGladrey) departure from ABIM' service recently have anything to do with large unexplained accounting fees paid to RSM two years in a row (when no lobbying activities were recorded according to Open Secrets circa 2011-2012) funding that could be associated with activities other than accounting?

The ABIM might want to have their tax esoterica explained to physicians who paid for it. If you did not know already, the ABIM falsely reported on their lobbying activities (saying they paid for no lobbying) to the IRS. In fact they did. Christine's whole ABIM paycheck sas like a ten year trip to between Santa Fe and DC lobbying for her thirty year health reform agenda and servicing her friends "in the industry".

She purchased a multi-million dollar home for herself to live in with a chauffeur (courtesy of Robert Wachter's ABIM Foundation trusty investment savvy) during the few times she showed up in Philadelphia. "I can't stay at the Franklin with the surgeons and geriatrician committees, get me something with a damn view. You don't want Mike and me to suffer burnout and chronic fatigue. Tell our concierge service super to get us some better caterers too. And tell them to have the chauffeur ready to pick us up around 2."

It is time (past due) for that independent audit that everyone, including the AMA, has been calling for. It is time for the ABIM to stop saying that they receive no funding from the industry, when they collude with insurance companies, large hospitals, NCQA, quality assessment tech giants and so many others to mandate MOC. This results in forcing physicians to pay and cram for "failed tests" who cannot work or see patients otherwise.

Accounting irregularities? What accounting irregularities?
http://www.accounting-degree.org/scandals/

Anonymous said...


Touche'

Perfectly aimed!

Anonymous said...

The wise usually take the middle view on things stating that things are never as bad as you think or as good as you imagine. But after looking more closely at the AMA, they are worse than I would have ever thought possible.