Sunday, December 09, 2018

Boarded to Death: Physicians Sue the ABIM

On Thursday 6 December 2018 in the Federal District Court of Eastern Pennsylvania, a class action lawsuit on behalf of over 100,000 internal medicine physicians was filed against the American Board of Internal Medicine (ABIM) by four internists.

The plaintiffs brought the action pursuant to the Clayton Antitrust Act, 15 U.S.C. §§ 15 and 26 to recover treble damages, injunctive relief, costs of the suit, and reasonable attorney’s fees arising from violations of Sections 1 and 2 of the Sherman Act (28 U.S.C. §§ 1 and 2). The suit alleges that there is illegal tying of the ABIM’s initial board certification product to its maintenance of certification® (MOC®) product in violation of Section 1 of the Sherman Act and illegal monopolization and monopoly maintenance in violation of Section 2 of the Sherman Act. The suit claims that after the ABIM's attempts to sell a voluntary "Continuous Professional Development" accolade program failed to recruit enough physician interest, the ABIM created a wholly new market product for itself, time-limited board certification (later branded as "Maintenance of Certification®" or MOC®), forcing physicians to purchase this product or lose their specialty certification. It also alleges ABIM induced hospitals and related entities, insurance companies, medical corporations, and other employers to require internists to be ABIM-certified to obtain hospital consulting and admitting privileges, reimbursement by insurance companies, employment by medical corporations, malpractice coverage, and other requirements of the practice of medicine. As an indication of ABIM's illegal tying and monopoly maintenance, the suit claims, is that the ABIM is able to charge inflated monopoly prices for MOC®, increasing the fees it generates from MOC® 276% since 2000. Each of the plaintiffs have claimed substantial harm caused by MOC®.

A link to the full Complaint can be found here.

-Wes

Update: The original class action anti-trust Complaint filed 6 Dec was amended 23 January 2019 to include claims under the RICO Act and state law unjust enrichment claims.

98 comments:

  1. If physicians only knew the whole truth they would be even more outraged and they would seek civil and criminal remedies in the courts and with an interested group within the DOJ or OIG.

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    1. Very true. I graduated when Cardiology Fellowship was a two year program. After being in practice for several years attempted to go back to do an International third year after doing Interventions for nearly ten years in order to obtain certification. The ABIM refused to certify my return to training stating that Cardiology Fellowship was NOW a three year program and therefore even if I completed the mandatory additional year they would not allow me to sit for the International Board.They are a Mafia and a group of criminals and need to be taken down.

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    2. If you know the "whole truth", then let it be known so as to vindicate us all!

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    3. This ABIM is so dirty organisation , I got info from insider that they fail the candidates to keep certain paying recurring income, how do we joon this class action law suit

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  2. The fraud and abuse needs to be documented properly and reported in a series of federal complaints.

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  3. Nothing to do with public safetySun Dec 09, 03:54:00 PM CST

    What we are witnessing is a conspiratorial business partnership and grossly scandalous capital venture. No theories here, just facts to be uncovered.

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  4. Bravo! Thank you for all of your hard work. We will forever be grateful.

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  5. Court Docs 2009-2012Sun Dec 09, 03:57:00 PM CST

    By the way Jacob Weinstein (former Ballard Spahr Attorney and Benjamin Mannes worked for Ballard Spahr/ABIM to attack and limit competition in the test study markets. And to intimidate physicians by violating their due process and constitutional guarantees.

    Yes, this was a complicit and conspiratorial action, maligning public safety and abusing the authority of NGO on up to highest offices and institutions in our country.

    Can we file a class action too?

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  6. Looks like a solid suit, better than the others.

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  7. Someone let me know when we're ready to take on ABOG. I'm all in!!!

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  8. FREEEEEDOOOOOMMMMMMMMMMMMMM!!!!!!!!!!!!

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  9. Just took the "Knowledge Check-in" this past weekend and it was a complete and utter disaster.

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  10. Thank you so much for initiating this unprecedented legal action. Now, we FM docs need to band together and take on the ABFM. Let's bring down all these corrupt specialty boards!

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    1. I was boarded through ABFM for 20 years( 3 rounds of exams). I then said goodbye to jumping through their hoops. I have maintained my CMEs for my own sake, and that of my patients. I have been unboarded for the past decade, and still work full-time and have NEVER had a issue with employment. My mini-revolt worked out for me. Give it some consideration.

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    2. Was at the same job for 24 years before I decided to try something different. EVERY position I found had being Board Certified as a requirement. Thankfully, I've maintained my certification, but I agree. It's a racket.

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  11. Can others join this lawsuit? Class action?

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  12. And the ABFM...

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  13. The four plaintiff's hard MOC stories are heart wrenching. None of this should have happened. MOC has to be stopped.

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  14. Thanks to all working to end MOC; you are helping to bring hope back into medicine by cleansing the health system of the burdensome and wasteful things that do harm . . .

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  15. Don't assume it is over until it is over... or that it has even REALLY begun.

    We see these games in big business and government every week... Follow the money.

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  16. Joint commission should be reigned in too. And the "non compete" clause in physician contracts should be banned as unconstitutional and harmful to communities

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    Replies
    1. Agree! Non-compete clauses are unconstitutional.

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  17. I think the recent DOJ letter showing their position as "pro-competition" would be useful in this case. I also remember reports of conflicts of interest being disclosed in articles about members of the ABIM board of directors and insurance company executives.

    I think all of that should come out (and likely will during discovery). It really is time to end this nonsense.

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  18. Thank you for posting this great news in regard to the futile, unprofessional, and harmful to public health circumstances that the ABIM has created. As a doctor and all the hours I work, I must spend time to study old or general information, then I am to pay to take this useless test. I could spend that time with patients, who are doing great btw, or with my family.

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  19. The US Declaration of Independence withstresses three inalienable rights.
    The right to "life, liberty and the pursuit of happiness."

    The ABIM Foundation "Physician Charter", with its pursuit of "professionalism", negates all three inalienable rights.

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  20. I just started on my MOC due in 3 weeks, 3 years backed up in fees $750 for NICA unique to Florida, $175x 3 years for ABPN, $450 for AAN for SAE then $650 to renew my state license in Jan for a grand total of $1975 just to practice. They get you now with this quarterly reminder and a cough it up note every 3 years. I took 2 years off and I’m still getting charged. As I read through copious mind numbing instructions in between patients I could feel myself becoming angry. It took away from my resources, my time from work and family and I was upset clicking mindlessly at a questionnaire where you can look up answers. I didn’t understand the purpose. I know how to work up temporal lobe epilepsy & why do I need to know the new gene for a rare disease I’m never going to order. I learned about genes for rare diseases back in residency I still don’t order the old ones! That’s why you read journals or you look up when you need it. I’m not a resident anymore. I’m already upset writing this. No more! We are done we must speak up against it! It is in place because we enabled it! Kudos to Wes and team for this initiative. Bravo well done. Let’s not lose the momentum!

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  21. The ABMS MOC® mandate is a highly monetized prescription for disaster.

    Instead of the inalienable right to pursue medical education in the spirit of excellence, MOC forces on doctors the alien rites of "strife, mediocrity, and the pursuit of burnout."

    "Excellence is not an act [for physicians], it is a habit." - Aristotle

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    1. They took the fun out of a self directed learner in the 90s! It is money making for them, a cause of plenty of extra expense and time and innane questions. I’ve never put in an IUD!! The sub specialies depth on General Internal Medicine requirements is stupid. I’ve been using some Playback Now ACP lectures from National ACP meeting and the questions didn’t even mesh w/,’ sone of the lectures and I’m oretty confident some had the wrongvanswer as the correct one when the questions did go w/ lecture. Burn out cause big time! We live and care for patients and will seek to learn

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  22. I think ABA is doing the same I can’t tell you how many hoops we have to jump and the money we need to shell out. They grandfathered some and so we have no advantage doing it except the burden of not only doing the on line questions but have to do practice improvement every five years which I think is a scam. They have these modules u can buy or do simulation which is 2500$ plus travel etc. Any ideas if we can join?

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  23. What was the process of getting the 100 internist to get together an do this. Specifically how did you get them to sign on? How did you find them? I want to know because I would like to organize a similar effort for Family medicine.

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    1. Thanks God FP folks are interested on stop abuse. Any Dr. whom lose board certification for any reason is practically abolish from practicing as excluded from all possible jobs. We need to join before is too late

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  24. ABIM's response to the class-action lawsuit:

    "ABIM is disappointed to learn of a lawsuit filed on behalf of four diplomates. The organization will vigorously defend itself, recognizing that doing so will consume resources far better dedicated to continuous improvement of its programs."

    Yeah, we know how much money the "ABIM" has spent over the past ten years "vigorously defending itself". They have defended themselves by using corporate thugs to spy on physicians and launch offensive propaganda campaigns.
    Why? In order to demonize physicians and demoralize doctors professionally aiming to destroy doctors' political will and the strength of a combined unified voice.

    ABIM went on the offensive attacking their "captured customers'" moral and professional character and spent physician' fees (needed for certification test development) over and over again on undisclosed and egregiously conflicted lobbying activities during politically important congressional years.

    They attacked using ABIM's finite financial and administrative resources in a well-orchestrated effort to influence politics during election cycles and as important healthcare legislation was in various committees and up for important votes.

    ABIM wasted millions $ going on the offensive to defend their bogus copyrighted question-pool. Their poorly registered copyrights based on publicly shared medical science. Their obscure portfolio of tests is written in the obscure language of the ABIM by an inadequately documented volunteer workforce with undisclosed relationships and benefits.

    People rightfully go after MOC, but the whole monopolistic corporation is a "captive-customer" funded political house of cards.



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  25. "Geez, how we gonna pay [static][for] another MOC lawsuit and keep our pay increase and bonuses?"

    "I know, we spent $2 million [static] [dollars] on that time-barred hail Mary pass down there in Puerto Rico."

    "Thrown out of court, but not before we beat the kid up pretty bad for five years. Docs got the message."

    "Not enough though."

    "I've got an idea."

    "What is it?

    "Let's get another unsolicited grant from the Robert Wood Johnson Foundation for about 4.3 million for the Choosing Wisely "discussion".

    "Great idea. We still have that [digital static][scam?] [scheme?] goin' good."

    "Professionalism market is down but we're expanding globally on this baby soon."

    "We can get [static] [Vince?] to arrange for a short term loan from the Foundation so we can meet payroll if we need it."

    "Nice having a private bank thanks to [inaudible] and [buffering] [Hanc? Hank?].

    "Might have to cut bonuses for junior staff to keep ours. I'll talk with [static] [Dan?].

    "Good, then we can transfer the money back if we remember."

    "If we don't remember we can just chalk if up to more accounting sloppiness on the part of our CPA."

    "I thought we got that other company now that is working with PR to clean up the books in case we are inspected or audited by those fringe [buffering] [as****s] who claim we're greedy.

    If we keep the money or put if back it doesn't matter with our financial team players. They know we've got a big election coming up in less than two years.

    They keep tight or they know its out the door and no more jobs within our system."

    [laughter]

    [snickering]

    "[laughter] and that pretty much means 87% of the job market for their specialty."

    You still going down to DC next week for the committee discussion? Maybe you can work on that unsolicited grant with the insurance lobbyist guy you know.

    Yes, I'll do that. But get this. They put me up in Trump's new fancy hotel. Got a great rate. [inaudible] got some great [inaudible] .

    Why, Trump's property, isn't that place completely wired?

    Only their people are under surveillance, not ours. Just as long as we don't talk with our people in Asia or the Middle East we are good. Tell the team that too.

    Gotcha. Only direct messages when dealing with other countries and our partners.
    [
    Gotta go. By [the] way how's the snow up there. Still driving down to [inaudible] next week?"

    Yeah, my people know the underwriters on two of our policies. They've got some backing from both [inaudible] and the re's are good with it.

    Ok, whatever they throw at us? I'll take care of that other thing with [inaudible] to see what he can [do]. Talk soon, bye bye.

    Have a nice [day?].


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  26. What the ABIM Propaganda Relations Department (ABIM PR®) issues to their "captured customers" is just another threat, another intimidation campaign.

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  27. Quite right. When you look at how much money the ABIM has spent over the past ten years "vigorously defending itself" and who they went after and why, one wonders if the ABIM is really a certification company after all.



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  28. Has the ABIM been involved in "pay to sway" campaigns for decades? Not just the past decade.

    " The attached article on PAY TO SWAY is somewhat political in nature, most likely the result of recent editorial change at the "paper", but the story behind it is interesting.

    The article explains how an NGO such as the ABIM with modest investments could use their "captive customers" wallets and purses to fund for their "pay to sway" campaigns.

    This is precisely what the ABIM has been doing. Christine Cassel is the ultimate example of a political lobbyist/propagandist/consultant in bed with corporate special interests. 95% of Cassel's time and efforts while at the ABIM and NQF served the "pay to sway" campaign model.

    Cassel got paid and the lobbyists got paid. And everyone involved expected to prosper.
    What is unfortunate is that the ABIM never disclosed that Cassel (and Baron) are public and private consultants working for the corporate special interests.

    Baron had to get around this, after ProPublica held up Cassel's conflicts of interest high for all to see. This forced Baron to restructure using more inhouse "consultants" and "brokers" and far fewer clinical physicians. There are no active clinical physicians working at the ABIM at the present time.

    Baron hired two veteran City of Philadelphia democratic party administrators as his chiefs of staff, ethicists and director of human resources. The former chief of staff with familial ties to GSK was a registered lobbyist with the city of Philadelphia, for example.

    This would be an interesting subject for an investigative journalist. Part of the quandary we are in today in the world is that there are fewer and fewer of true investigators who follow the money to whatever party has their fingerprints on it.

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  29. If four doctors were harmed by MOC, that is four too many.

    If even one doctor closes their doors because of MOC that is one too many.

    My own mother was a recent victim of MOC when her internist/GP retired early.

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  30. The sad part is there are actually doctor who feel the ABIM or ABFM and MOC are good and think we should suck it up. Those losers are the same academic assholes that created this shit to start. Some of them are not academics just high and mighty jerks who thinks if it's good for them everyone else has to do it too. They fear NP's so they think MOC is going to save them and distinguish them from them. What a bunch of clueless fuckers.

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  31. How can we join the class action lawsuit?

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  32. The ABIM has most certainly drawn the ire of internal medicine physicians, but the Reign of Terror goes on. The problem is much more nefarious, with the ABIM only appearing as point guard to even bigger entities. Its all about control of a profession that has tremendous influence on healthcare spending, much to the chagrin of these players. And there is no other profession in the observable Universe that has to jump through these meaningless recertification hoops. When was the last time an attorney had to "re-Bar"? The ABIM is a shill organization to health insurance companies, hospital systems, and their deeply ingrained, politically connected mouthpieces. They are the ones who give the ABIM their near-dictatorial, career ending powers. If it weren't for those overlords, recertification certificates would have the same gravitas and use as perforated tissue paper on a roll. And by the way, I strongly favor rigourous initial board certification standards and a tightening up of CME requirements.

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  33. Respectfully YoursWed Dec 12, 01:55:00 PM CST

    If MOC cannot be stopped, then we can see clearly how deep the corruption is and how far it goes.

    Dwight Eisenhower warned us about the dangers of the Military Industrial Complex when he left office in 1960, but the problem only got worse.

    Now we are looking at two mega-systems that dominate our country's commerce and politics.

    Strange, that we are being warned about the Medical Industrial Complex - not by our president, not by our media - but by grassroots organizations and individuals in concerted efforts to tell the truth and find solutions to the current crises that we face as citizens of the most powerful nation on earth.

    It is a sobering reality as we witness two out-of-control mega-systems vying for control of the nation's wealth. And around the world. As the staggering mega-trillion dollar debt keeps growing.

    If we cannot see ourselves clearly in the mirror of relationship, and adjust/respond appropriately we have to ask ourselves what is wrong.

    Is it that the mirror has become so dirty that nobody can see anymore.

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  34. Ill join the lawsuit.
    sign me up. let me know how.

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  35. Instead of paying the ABPN more money to take another useless test and document useless information a SECOND time (did the MOC first in 2008.... my employer insisted), I am moving. I am moving out of the country to NZ to practice psychiatry in an interestingly less regulated environment. Yes, "socialized medicine"....yada, yada.... But I can spend time with the patients, not have overpriced "me too" antipsychotics that patients demand. And live and work in a much better place.
    Screw the ABPN and the entire Board Cert process. When I started, being Boarded was seen as an honor, something to be proud of, but not HAVE to have to be a practicing physician.
    Indeed, my employer has realized the stupidity of this process and changed the Privileging process so that "boarded" is not required to be employed there.

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  36. I want to take this opportunity to thank Dr. Wes for really taking this issue and running with it, acting as an investigational journalist, if you will.

    Dr. Wes, I have been reading your blog for years, and because of you, I have been writing my representatives in Washington, and at the state level. This is what we as physicians must do. We, as a profession, should no longer put up with the Racketeering(https://encyclopedia.thefreedictionary.com/), as this is what it is.

    As stated above"This would be an interesting subject for an investigative journalist. Part of the quandary we are in today in the world is that there are fewer and fewer of true investigators who follow the money to whatever party has their fingerprints on it."

    You, Dr Wes, have done a remarkable job, but might I suggest that you turn all of this over to a fantastic investigative journalist. Here is a link to a wonderful group that might take this over:

    https://www.thebureauinvestigates.com/got-a-story/public

    And to all who have commented: THANK YOU!

    Let's keep the ball rolling.


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  37. Kudos to Dr. Wes, who championed this effort on behalf of patients and physicians. I recently wrote an email to Dr. Baron of ABIM:

    I am a 67-year-old interventional cardiologist who has to recertify this next year under what I believe to be onerous requirements.

    I have maintained and met all of my MOC requirements.

    I do not want to take an expensive and stressful exam to recertify for something I’ve practiced for 36 years.

    Why can’t the short open book MOC exam be available for 2019? That would be the year that all those originally certified when the exam was first offered in 1999, need to recertify. Why must I/we recertify in the most challenging way?

    The response that I have heard from the ABIM is that the short open book exam will not be available until 2020 and I will then be uncertified.

    It is an unnecessary penalty to the oldest of us in the field.

    I and almost all of my colleagues believe that the recertification process as it is constructed is a sham and have lost trust in the integrity of the process.

    This is the inflexible response that I received from Dr. Richard Baron of the ABIM:


    Dear Dr. R-



    Thanks for writing, and for your commitment to staying current in your field and demonstrating it by choosing to maintain your certification in Interventional Cardiology.



    I have shared your email with our leadership team, and it has sparked a lot of discussion- it is communications like yours that often cause us to re-asses policies and consider perspectives we had not thought through. I know you will not be happy to hear this, but we are not going to be able to offer you the delay you are requesting. The basic issue is what happens when we implement something new: there are always going to be “transition issues”, with many doctors “on the edge”. In the interest of fairness, we administer the program as the program- the options in place at the time are the options in place at the time. Innovation will always create that problem.



    What I can tell you is that, should you decide to take the long form exam in 2019, you will have access to UpToDate while doing it- another innovation we have launched, but one that will be available to you.



    And I can also share with you something we have not yet announced but will in October: we plan to offer the KCI as a “re-entry pathway” for those who have lost certification; two consecutive successful performances on the KCI will allow someone who was certified but whose certificate has lapsed to restore their certification. So if you don’t take the long form exam next year and you allow your certificate to expire, you would be able to re-instate it with two consecutive successful performances on the KCI. (This idea was also suggested by diplomates who had let certificates lapse who asked us why THEY couldn’t take the KCI?) That option may or may not be of interest to you, but I wanted you to be aware of it.



    Thanks again for reaching out. And for all the good you do for patients.



    Rich









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  38. Just recently completed the Knowledge check-in. Out of necessity to continue to practice, I have to continue to participate in this farce. Looking around, I was way older than many others at the testing center. This is taking us away from the life-work balance one must have, especially as we have have growing families and commitments. This is on top of all the other nonsense we have to face in our practices.
    I can only hope that something positive comes out of this.

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  39. This Class Action lawsuit will provide the one thing the ABIM understands and that is their collapse via demonetizing this corrupt organization. It is amply clear to everyone the only thing the ABIM wants is our post tax dollars. It is ludicrous for any organization to take our post tax dollars and then dictate to us how to make our lives more difficult. Everyone is sick and tired of funding this aloof organization with millions of dollars just so they can sit in an office in Philly pretending to be real physicians. Of the 100,000 Diplomates who are affected by this corrupt MOC process if a minority join in a Class Action lawsuit think how quickly the ABIM will run out of money. 15,000 Diplomates x $8,000 per capita= no mathematical way the ABIM will ever exist anymore.

    My MOC will be up for renewal in 2022. If the ABIM rescinds my MOC status and materially alters my ability to perform my duties as a physicians, I will sue them in every single legal venue available. I will chase down every single ABIM Trustee.

    Dr. Baron, you have made a serious mistake. Every legal arena is now in play. The Civil Courts. The State Courts. The Federal Courts.

    You can't piss off your entire constituency Dr. Baron.

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  40. It has been said that the ABIM will outlive the NBPAS because only a small number of physicians have joined the NBPAS instead of abandoning the ABIM MOC. I totally disagree. The question is how many Diplomates will allow their MOC status to lapse in essence depopulating the ABIM MOC cohort? Dr Baron have you calculated how many of us are so upset we will just not do the NBPAS or the ABIM MOC? Let's say 10,000 physicians every year will refuse to renew your excise tax on our professional lives. That would mean that in less than 10 years, the ABIM budget will shrink 50%. Unless you decide to make up for the lost revenue by soaking the residents and fellows. Actually if you victimized the fellows and residents I would not be surprised by such a slimy maneuver.

    Everyone I have spoken to is allowing their MOC to lapse. Call it passive aggressiveness. And I can promise you, Dr. Baron if you interfere with anyone's ability to make an honest living as a physician these people will come after the ABIM with pitchforks and torches. And you will lose mightily in every single lawsuit. And let this be a lesson to every other complicit physician organization addicted to the MOC cash flow. ACP, AMA, ACC, ABP.....the list goes on and on. We're all pissed you people have sold out the practicing doctor for this deranged MOC debacle.

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  41. How 'bout that ABMS "Vision for the Future Commission." Really!

    If those corporate shills (minus 1) have the tenacity to call themselves a "commission", then I have the right to call myself THE POTUS.

    What a sham commission. It's all a farcical propaganda and public relations campaign where the public is virtually shut out, save for the ones they place on the "commission".



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    1. I refused to further recertify after my hideous board certification lapsed in 2014. I was no longer proud to count myself as a doctor granted this title by such a corrupt gang of extortionists and said no more. I was immediately decredentialed by the hospital I was working at as a nocturnist for 5 years and then the other hospital I had been at for 7 years kicked me out 2 years later. I blame my fellow doctors for this cabal being foisted on doctyin the trenches slogging it out thanklessly caring for the suffering masses because they are basically cowards. Anyways I have been able nonetheless to find good work opportunities but it has not been easy. I have had to travel great distances from my home and family every other week to work. I hope the ABIM and it’s unscrupulous, selfish, money loving, deceitful corporate leaders go to jail and rot in hell.

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  42. Flash in the Pam

    The ABIM's response to the class-action lawsuit pouts on and on about how the suit will hurt the "continuous improvement of its programs".
    This was written by a team of expensive propagandists.
    Costly pros who have "nothing-to-do" with clinical medicine.
    They write "ITS" programs instead of "OUR" programs.

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  43. This important ANTITRUST action did not name any individual ABIM defendants. Why not?

    I'm sure these cunning MOC® execs could use the talents of their fellow in's to structure "programs that improve the quality and safety" within our commercial prisons . . .

    https://psmag.com/social-justice/thousands-of-privately-owned-companies-are-profiting-from-the-us-prison-system

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  44. The plaintiffs should subpoena every computer server including all the data they tried to hide on the Dark Web. There should be a log of activities for the infamous ABIM Pleasure Condo. Let's see if Rich Baron used it as a crash pad after a boozy night with his chums in Center City. Let's see all the correspondence between the Board of Trustees and their lobbying firm. Let's see who really decided to move all that money offshore and why. Let's subpoena Wachter, Cassel, Johnson, Krumholz, and all the others who have made themselves millionaires off their administrative fiefdom. Let it all come out in court.

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  45. Class Action suit was necessary after complete abdication by Attorneys General to bring Federal charges under RICO (Racketeer Influenced and Corrupt Organizations Act).
    This would provide Civil and Criminal penalties to the Principals.

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  46. Fuck the ABFM and Fuck ABM, ABIM and Fuck the doctors and academics who support this shit. They are ruining hard working doctors lives.

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  47. The last post summarizes concisely my anger, my resentment and my disappointment in the ABIM. Nothing I can add really. All I can say is thank you for expressing our livid position on MOC and the anger we all feel about being used as data rats. And thanks for posting.
    The sentiments above are my exact sentiments. I'm as mad as hell and I'm not going to take this MOC crap anymore!

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  48. the day the earth stood stillFri Dec 14, 06:52:00 PM CST

    Without physicians this country would be paralyzed. The economy would grind to a halt in a matter of days. Even one still day translates into billions of dollars down the bloody drain. Strange at it sounds the ABMS with its morbid MOC mandate is engineering us in that direction.

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  49. Every stick has two endsFri Dec 14, 07:59:00 PM CST

    We've been beaten long enough, now its their turn. NO MORE MOC!

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  50. Moc is shoved down our throats at the point of a 'stakeholder's blade.

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  51. For those who haven't heard about the National Board of Physicians and Surgeons, you may be interested in checking out their website (https://nbpas.org).

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  52. There should be multiple accrediting agencies and re-certification should not be based on an 8 hour exam rather on completing CMEs that are relevant to one's practice. ABIM is a scam and we don't need organizations whose interest is primarily financial and not educational.

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  53. ABIM/ABMS is a mixture of political bullshit and corporate hot air.
    We're sick and tired of it.

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  54. I would love to be a part of this lawsuit. How does one go about participating? This is long overdue! Greatly appreciate those four brave physicians for taking on ABIM.

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  55. Somebody knows where all the bodies are buried.

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  56. [ABMS Resident Recruitment Strategies Making MOC Marketable]

    Whereas, Young physicians report feeling disenfranchised with the current Maintenance of
    2 Certification (MOC) system; and
    3
    4 Whereas, Young physicians represent the future of medicine and have the most vested interest
    5 in maintaining quality of MOC; and
    6
    7 Whereas, At least one specialty board excludes young physicians from service on the board of
    directors1 and another requires directors to be “of mature age”2 8 ; and
    9
    10 Whereas, The American Board of Medical Specialties recently launched the initiative
    11 “Continuing Board Certification: Vision for the Future” and is seeking comments from
    stakeholders3 12 ; therefore be it
    13
    14 RESOLVED, That our American Medical Association submit commentary to the American
    15 Board of Medical Specialties (ABMS) Continuing Board Certification: Vision for the Future
    16 initiative, asking that junior diplomates be given equal opportunity to serve on ABMS and its
    17 member boards (Directive to Take Action); and be it further
    18
    19 RESOLVED, That our AMA work with the ABMS and member boards to encourage the
    20 inclusion of younger physicians on the ABMS and its member boards. (Directive to Take Action)

    ReplyDelete
  57. The X Factor

    Schedul D Part X

    (1) Federal income taxes 0
    DUE TO RELATED PARTIES 1,113,864
    ACCRUED PENSION OBLIGATION 30,196,370
    ACCRUED POSTRETIREMENT BENEFIT 14,041,700
    ACCRUED VACATION 1,202,602
    DEFERRED GRANT REVENUE 1,941,206
    (6)
    (7)
    (8)
    (9)
    Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 48,495,742

    ACP 2018 Treasurers Report (See Pensions)
    https://www.acponline.org/system/files/documents/about_acp/who_we_are/2018_treasurers_report.pdf

    Part Time Employment for Physicians - ACP Online [Reduced cost?]
    https://www.acponline.org/system/files/documents/running_practice/practice_management/human_resources/part_time.pdf

    ReplyDelete
  58. In the year of our Schedule D 2017

    IX(1) RETIREMENT PLAN INVESTMENTS 458,429


    X(1) Federal income taxes 0
    Executive Retirement Plan 473,768
    (2)

    ReplyDelete
  59. FSMB Schedule D 2017

    (1) Federal income taxes
    DEFERRED COMPENSATION 1,242,579
    (2)

    ReplyDelete
  60. AHA Schedule D


    (1) Financial derivatives.........
    (2) Closely-held equity interests........17,197,141 F
    (3) Other
    (A) Hedge Funds 38,942,026 F

    (B) Inflation Hedge Bonds 20,223,971 F

    (C) Investment In Subsidiaries -3,442,296 F
    (C)


    1) Intercompany Receivable 36,683,397
    (2) Deferred Compensation Assets 1,449,955
    (3) Collateral Value Life Insurance 1,247,424
    (4) Annuities 170,643
    (4)
    (5)
    (6)
    (7)
    (8)
    (9)
    Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 39,551,419

    (1) Federal income taxes 0
    Lease Payable/Def. Lease Allowance 15,087,690
    Investment Payable 19,313,682
    Accrued Retirement Expenses 12,825,208
    (4)
    (5)
    (6)
    (7)
    (8)
    (9)
    Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 47,226,580

    ReplyDelete
  61. ECFMG Counting Down to 2017

    (1) Financial derivatives.........
    (2) Closely-held equity interests........
    (3) Other
    (A) MASTER TRUST 110,852,357 F
    (A)

    1)INT IN NET ASSETS OF FAIMER 47,108,545

    (1) Federal income taxes 0
    LEASE AND LEASE INCENTIVE LIAB 2,395,431
    457(B) PLAN OBLIGATIONS 608,847
    DUE TO NBME 1,029,902
    (4)

    ReplyDelete
  62. It is wonderful that action is being taken against ABIM.
    Is this a case of physicians getting tire of clinical practice and creating jobs for themselves by devising ways to irritate those of us who are trying to practice in difficult times? If they could help streamlining practice regulations; dealing with government and many insurance companies; figuring out a good electronic health record and ability to use it; and integrating results of recent research into our practices, that would be a valuable contribution to medicine.

    ReplyDelete
  63. JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS
    1 RENAISSANCE BLVD, OAKBROOK TER, IL 60181-4294 | TAX-EXEMPT SINCE AUG. 1953

    Schedule D (Form 990) 2016 Page 3
    Part VII Investments—Other Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
    (a) Description of security or category
    (including name of security) (b) Book value (c) Method of valuation:
    Cost or end-of-year market value
    (1) Financial derivatives.........
    (2) Closely-held equity interests........
    (3) Other
    (A) Mutual & Comingled Funds - Domestic Equity Funds

    (B) Mutual & Comingled Funds - International Equity Funds

    (C) Mutual & Comingled Funds - Fixed Income & Bonds

    (D) Mutual & Comingled Funds - Domestic Equity Funds 31,089,260 F

    (E) Mutual & Comingled Funds - International Equity Funds 31,958,652 F

    (F) Mutual & Comingled Funds - Fixed Income & Bonds 697,684 F

    (G) Common & Collective Funds - Measured at NAV 20,245,439 F
    (G)
    (H)
    Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 83,991,035


    1.(a) Description of liability (b) Book value
    (1) Federal income taxes
    Deferred Swap 21,347
    Unrestricted Operating Pledge to Affiliate 1,600,000
    Fair value of hedge 195,535
    Accrued pension liability 12,048,314
    Due to Affiliate
    (6)
    (7)
    (8)
    (9)
    Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 13,865,196

    Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements TRANSFER OF NET ASSETS TO AFFILIATE - OPERATING - 1600000

    ReplyDelete
  64. Description of property (a) Cost or other basis
    (investment) (b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
    1a Land .....
    b Buildings ....
    c Leasehold improvements 4,153,780 125,872 4,027,908
    d Equipment .... 6,680,967 3,570,109 3,110,858
    e Other ..... 4,537,720 2,127,474 2,410,246
    Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 9,549,012
    Schedule D (Form 990) 2017
    Page 3
    Schedule D (Form 990) 2017Page 3 Part VIIInvestments—Other Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
    (a) Description of security or category
    (including name of security) (b) Book value (c) Method of valuation:
    Cost or end-of-year market value
    (1) Financial derivatives.........
    (2) Closely-held equity interests........
    (3) Other
    (A) 81,145 - VANGUARD 500 INDEX FD (VFIAX) 20,028,197 F

    (B) 44,070 - ISHARES ETF (IJH) 8,363,523 F

    (C) 174,268-POWERSHARES S&P 500 QUALITY ETF (SPHQ) 5,306,467 F
    (C)
    (D)
    (E)
    (F)
    (G)
    (H)
    Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 33,698,187

    Part VIIIInvestments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
    (a) Description of investment (b) Book value (c) Method of valuation:
    Cost or end-of-year market value
    (1)
    (2)
    (3)
    (4)
    (5)
    (6)
    (7)
    (8)

    Part X Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
    1.(a) Description of liability (b) Book value
    (1) Federal income taxes
    DEFERRED RENT 5,781,188
    DEFERRED COMPENSATION 1,855,780
    (3)
    (4)
    (5)
    (6)
    (7)
    (8)
    (9)
    Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 7,636,968


    Schedule D left blank. Why? NCQA has investments and just under 900K in income.
    11Investments—publicly traded securities . 12,665,152 11. 17,413,433
    12Investments—other securities. See Part IV, line 11 ..... 27,193,535 12. 33,698,187
    13Investments—program-related. See Part IV, line 11 .. 13
    14Intangible assets ............... 14
    15Other assets. See Part IV, line 11 ........... 1,719,825 152,292,711
    16Total assets. Add lines 1 through 15 (must equal line 34)... 60,684,182 1684,811,375

    ReplyDelete
  65. They are worried because they gonna be all wearing jump suits pretty soon.

    ReplyDelete
  66. URAC
    ↳ AMERICAN ACCREDITATION HEALTHCARE C
    1220 L ST NW STE 400, WASHINGTON, DC 20005-4013 | TAX-EXEMPT SINCE FEB. 1992
    EIN: 52-1740069 Classification (NTEE)
    Business and Industry (Community Improvement, Capacity Building)

    10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,284,970 3,219,800

    a Gross amount from sales of assets other than inventory 28,618,567
    b Less: cost or other basis and sales expenses 26,145,017
    c Gain or (loss) 2,473,550
    d Net gain or (loss).....Medium Bullet 2,473,550 2,473,550

    f Investment management fees ...... 99,542 99,542

    1Cash–non-interest-bearing ........ 2,397,099 11,517,963
    2Savings and temporary cash investments ......... 3,260,642 21,814,816

    11Investments—publicly traded securities . 22,426,017 1133,307,949
    12Investments—other securities. See Part IV, line 11 ..... 12

    8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 199,582 180,873 18,709

    14 Information technology ...... 620,583 453,486 167,097

    Schedule D investments is blank. Moved to cash with sales of investments. Where did the money go? Offshore investments? Hedge funds. We'll only find out next year.
    https://projects.propublica.org/nonprofits/organizations/521740069/201831239349300433/IRS990ScheduleD

    ReplyDelete
  67. ABMS Partners are very profitable. Executives arrange for huge paychecks.

    ReplyDelete
  68. ABMS, ABIM suck. MOC sucks! Big Ponzi Scheme between multiple partners and medical industry.

    ReplyDelete
  69. The ABPS (American Board of Physician Specialties) I have found to be a great answer to the ABIM's tyranny. For decade's the ABIM has maintained a lower pass rate to FMG's than American trained physician. Despite many of us doing residency in the same programs as US trained grads, FMG's have somehow always had much lower pass rates...seems odd. I took the ABIM board certification test twice & got the exact same score both times & failed, despite protesting practice exams & question bank scores in the 90's. The ABPS has a 7 yr. Certification, 200 question, single best answer exam. Same breadth of topics covered. I aced that exam on the first try, weeks before failing ABIM's & used the same material to prepare. The ABPS has been very supportive of its diplomats & is giving the ABIM a serious run for superior recognition as a educational provider. Look them up, it's a really amazing organization that I am happy to go to for all my CME & certification needs.

    ReplyDelete
  70. I am very glad that people are speaking up and taking a stand against this politically and financially motivated nonsense of the MOC. We should do the same in Psychiatry. I know a very caring and competent psychiatrist at the hospital where I used to work who gave up on getting his Board Certification, because the oral exam was very subjective, it was very costly, and it did not impact his practice. I also struggled with getting certified, but eventually passed. That piece of paper on the wall cost me $35K and 6 years of my life. I'm very thorough and caring. My patients are generally happy and several drive 6-10 hours one way from out of state. There is no correlation between Board Certification and performance. It just means you know how to take tests well. That's just not my strength, especially under stress. Fortunately there is the National Board of Physicians and Surgeons, and I am now certified by them while I jump through the hoops of the ABPN again. I had to pay the ABPN a $700 application fee and a $700 exam fee so I can maintain my status. And, they want my $35K certificate back. What a rip-off. Then they want us to go through the Continuous MOC every three years, so I can have more stress and they can milk me more often. Shameful. Especially since the old-timers, board members themselves, are grandfathered in to life-long certification. It's all about money at our expense.

    ReplyDelete
  71. Dr. Wes, Thank you very much for the phone call last week. I am thrilled to have donated to the cause. Thank GOD for the brave soles taking on the fraud and monopoly corrupted MOC of the ABIM. Sooooo long overdue.

    ReplyDelete
  72. What do you call a nonMoc approved doctor?Thu Dec 20, 01:01:00 AM CST

    Doctor

    ReplyDelete
  73. MOC is a money scam for corrupt politicos. MOC has to go.

    ReplyDelete
  74. Some states have already banned MOC. Oklahoma, for example.

    ReplyDelete
  75. I went looking for alternative boards here in California. And sadly, this is what I found:

    Never heard of this organization, but alas, these boards are all the same.

    https://law.justia.com/cases/federal/district-courts/california/cacdce/5:2013cv01670/571848/332/

    My question is this: If we already passed the USMLE, graduated a residency program, and are licensed by the state we practice in, why do we need board certification in the first place?

    Passing through a residency program is tough enough, keeping current is a requirement of the states, I guess I'm at a loss as to why we need to purchase yet another seal of approval in the first place??

    ReplyDelete
  76. Thank you so much for doing this! The revocation of the original certificate was a bait and switch tactic. This is an unfair decision on the part of the ABIM.

    ReplyDelete
  77. The ABIM may have been sincere in their desire to modify MOC, but the Knowledge Check-In is a huge step backward. KCI means that every two years internists are responsible to take an exam that covers the breath and range of internal medicine like the 'high stakes' ten year exam. Your time and preparation for KCI is the same; online access to UpToDate is unhelpful given the vignette-style question and time constraint.

    KCI puts physician under the constant stress of having to be tested every two years over the course of their entire career with no supporting data this improves patient care or produces better doctors.

    ReplyDelete
  78. We should all do this. It should be a national lawsuit initiated in each State and then a Federal OIG investigation and indictments for fraud, theft, larceny with jail time,

    ReplyDelete
  79. What's the status on the lawsuit?
    The ABIM was supposed to have responded by the 6th of January.

    ReplyDelete
  80. It warms my soul to see the legal action against the ABIM. Over the years the board has damaged the careers of many physicians. They are a greedy, self-righteous, deplorable bunch of white-collar racketeering criminals who deserve to burn in Hell. Someone definitely needs to publicize the necessary info to join the class action. They have given MD's a bad reputation and deserve the maximum punishment. They are a disgrace to the profession !

    ReplyDelete
  81. I let my ABIM certification go in 2017. It was difficult to find a job recently but I found a great one doing home visits on Medicare advantage patients. They don't require it .

    ReplyDelete
  82. Her is a new one from ABIM. As someone away from clinical practice living overseas but with academic teaching involvement no reason to spend the money and jump through the hoops. Now ABIM tells me if I don't redo the exam soon I may lose board prepared status and could need to do 1 year of training. Why stop at rescinding my senior resident year, why don't they they simply rescind my medical degree, undergrad degree, high school and elementary school while they are at it.

    ReplyDelete
  83. I am in Family practice and have the same problem. I have certified 3 times and passed every time. I did not recertify a 4th time because of financial restrains. I resent having our boards report to the insurance industry and government. I originally saw the board as a tool to gauge my fund of knowledge and improve my ability to practice good Medicine. I now see the boards being used as a way to make money for themselves and the insurance industry. They take our limited time to make us jump through hoops so the insurance industry can have more marketing tools to charge the clients more money.

    ReplyDelete

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