We Believe the Working Physicians

Lately, it seems we can't go another day and not hear about another individual, once held high as an icon by their adoring followers, falling from their elitist pedestal in shame when revelations of their lewd and morally reprehensible behavior are ultimately exposed. As Elizabeth Nolan Brown of the New York Times astutely observed in response to the prevailing zeitgeist:

Social media takes a lot of punches for enabling sexual harassment. But the past two months have shown that it has also provided consumers with an unprecedented power to make their market preferences heard loud and clear. And right now, the market is demanding that companies do something about sexual predators and pests in their midsts.

I believe a similar movement extends to the regulatory world of academic medicine, too. The anti-MOC (Maintenance of Certification) movement, facilitated in large part by social media unconstrained by medical journals owned by self-adoring academic medical societies, is unlocking the self-locking doors of the Accreditation Council for Graduate Medical Education (ACGME).

This is not to say that all academic physicians are bad people. On the contrary, just like not all journalists and actors are sexual predators, not all individuals in positions of power within the ACGME construct or medical societies are bad people. But power and money do things to even nice people. Some people see how easy it is to take advantage of those less prominent, yet no less important, than they are. The blinding influences of money and power permit morally reprehensible behavior to be ignored by others who also benefit from that behavior but don't say anything. Soon, given an inch, a few influential people in positions of power take a mile and before long, they quietly become pests in US medicine's midst too.

Such has been the story of the ABMS and their member boards since the introduction of time-limited board certification. Using highly respected members of the medical community as their work-a-day pawns, these leaders stroked the egos of their revered physician educator colleagues by providing them first class air fare, accommodations at five-star hotels with dinners at the fanciest restaurants with exquisite wine samplings for test writing junkets as their network of carefully-chosen collaborators grew. In return, the leadership of these organizations were held high as moral icons above reproach as plans were hatched for the next test-writing retreat in Costa Rica. Black tie events at the Four Seasons (or similar venue) reinforcing their behavior for the "common good" of medicine become commonplace. Using these respected adademics as self-adoring apostles of the ABMS  leadership, more like-minded individuals were recruited using this simple formula based on avarice, narcissism, and greed: give economically disadvantaged academic physicians a glimpse of what they could have if they worshipped the materialistic world of the ACGME and these riches could be theirs, too. The host of corporate interests like testing companies, publishers, single payer advocates, pharmaceutical and insurance companies, and every medical supply chain company wanting the selling/purchasing power of physicians in their back pocket would make sure of it.

Soon, ABMS Board certification went from a lifetime credential to a time-limited one quite easily: by the threat of "uncertain consequences" by the boards and their medical society sychophants. Dazed and confused, unsuspecting working physicians were dragged into the PearsonVue testing back offices for "recertification" testing using threats to their character and intellect. Those threats became real as practicing doctors realized their "voluntary" board certification process was no longer voluntary, lest they lose their job if their once specialty certification expired and was no longer considered valid by their employer.

And so it has been for years until a few brave souls came forward and questioned the status quo. Thanks to social media, scores of hardworking physicians are waking to their own #MeToo moment as subjects of extortion, strongman tactics, civil liberty violations, and being used as research subjects without their consent. None of this was done to benefit patients they now realize thanks to social media, but to line the pockets and fund the political agendas of a few influential members of the untouchable medical credentialing cartel.

This new movement has even shown that intimidation of a vulnerable physician work force won't hold back the truth.

It's a new time in corporate America, just like it's a new time for the ACGME.

Not only do we believe the women, we believe the frontline working physicians, too.

-Wes