Saturday, February 08, 2020

MOC's Sword of Damocles and the Platinum Rule

The current issue of Mayo Clinic Proceedings has an article entitled "Maintenance of Certification and the Platinum Rule: An Existential Crisis" by Richard G. Ellenbogen, MD, E. Sander Connolly Jr, MD, and Fredric B. Meyer, MD. I encourage all to read it and the accompanying editorial by Suzanne M. Norby, MD from the Division of Nephrology and Hypertension and Mayo Clinic.

It is clear that MOC has morphed into a money-making endeavor for legions of third parties, including insurance companies, hospitals, and a myriad of other corporate interests eager to capitalize on the control and sharing of physician data. While the concept of using the "Platinum Rule" to guide the evolution of MOC is a step in the right direction, the "MOC existential crisis" will not end until the "Sword of Damocles" (as the authors aptly put it) is removed from working physicians' heads. We simply cannot work with the threat of the loss of our professional careers if we fail to purchase the unproven MOC (and any other required "continuous certification" product).

The ABMS MOC paradigm will only survive if becomes truly voluntary and its lack of purchase will not affect our right to earn a living.


P.S. (Updated 9 Feb 2020 @ 13:45PM CST) As we have seen time and time again, the physician influencers and apologists of the American Board of Medical Specialties (ABMS) have historically abandoned their moral imperative to working physicians and their patients to “first, do no harm.” Corporate interests invariably supersede this ethic. It should come as no surprise, then, that the lead author of this piece has a similar track record working for the National Football League.

Physicians wishing to support the plaintiffs in their ongoing effort to end Maintenance of Certification are encouraged to contribute here.


Unknown said...

"Overall, ABNS approached the challenges raised by MOC in
a thoughtful, elegant manner, which also closely aligns with recommendations set forth by the Vision Commission."

What a steaming pile of self-serving garbage. Just another handful of ABMS stooges promising to listen and change. ABNS is revenue neutral? Sure they are, just like the rest of the ABMS parasites are. The lawsuits are blamed on "activists" of course. ABNS is as rotten as its 23 companion ABMS boards. Quitting MOC was one of the best things I ever did. No regrets.


Researchers active in propaganda for years and not medical science? That's not a question. That's concerning.

A perusal of the reference materials cited in earlier "research" conducted by the same authors and their ABMS cronies reveals a patent pattern of the abuse of position and authority.

Question: who are these people that use the same kind of errant techniques of disinformation as Bob Wachter, Cees van der Vleuten, and Christine Cassel when they inappropriately call those opposed to MOC as being fringe elements in the medical community. Now these same "authors" employ the word "activists" with a pejorative connotation to try to isolate the problem of a big shining sword looming over their heads revealing like a crystal mirror revealing that they have abused their power/positions and have lost the support and trust of almost everyone.

Anonymous said...

MOC is abusive, illegal and immoral and has no place in 21st century medicine. To ascribe noble origins to MOC is to turn a blind eye on all the underlying corruption with all the obscene paychecks, money laundering, self-dealing finance and politics, clandestine lobbying, offshore investments, condos, real estate, foundations used to pad incomes, and the general malaise they have created through deception to undermine physician and patient rights. The fundamental ones being the right to work and the right to care. All the propaganda in the world does not remove the sword above one's head. Continuous streams of newspeak and doublespeak do not wipe the sword, or clean-up of all the bloody mess they have created and continue to propagate. The double down on MOC with new approaches, under new banners, inventing new slogans and sickening arrays of expensive advertising commercials, which the ABMS dares to call medical science. Look at all the other forms of waste of physician fees and taxpayer dollars that is occurring. All the money spent on endless forms of PR stunts, like the farcical and facetious TRUST CAMPAIGN. And now we have this obsequious publication on "being and nothingness" in the MAYO proceedings to confuse the issue.

The Essence of Law is Conscience said...

Why do the ABMS appointed authors avoid the words racketeering and fraud? They mention lawsuits but avoid the content of the complaints.

All this is just more disinformation and propaganda to throw off the scent (one barrage after another) Calculated disinformation with carefully chosen words and myths from those who appear more than willing to shoot their colleagues who wish to end MOC in the proverbial head. Their word craft betrays the lower ranked physicians working in the trenches for a living, just for thinking clearly and independently. Stating that MOC is not just equivalent to a racketeering scheme, it is a massive racketeering slash conspiracy scheme used by the ABMS and their partners to defraud the profession and the public. It is pure unadulterated graft in one of its most virulent forms created consciously to control physicians, creating fear, burnout and job insecurity. It is all that and more without mixing any words.

Novel MOC said...

Rather than researching attitudes about MOC and making apologies for the ABMS, it would seem more fitting if some of those billions of federal tax dollars in grant money could be used investigating the ABMS, et al and their conspiracy to defraud the public and the profession of medicine.

All the references are ABMS cronies or employees.
All behind a pay wall. This one submitted 3 years ago.

Unknown said...

"We've all heard of the Golden Rule, which goes something like this: Do unto others as you would have them do to you. In other words, treat other people--in business and in life--the way you yourself would want to be treated." Coined by a no name author of a contemporary self help book. More weasel words from weasel ABMS stooges.

Let me propose the Iron Rule therefore, namely that all ABMS racketeers and fraudsters like Dr Ellenbogen shall be liable severally or individually for restitution of their ill gotten gains to their many MOC victims. Re-read Eichenwald's book on Enron and his Newsweek trilogy on MOC and understand that when the stinking, rotting ABMS edifice finally collapses, perps like Dr Ellenbogen will be in jail. ABMS crimes are on a par with those of Enron.

Unknown said...

More extraordinary and shameless sleaze from another gaggle of ABMS hacks. What is this if not an embarrassingly self exculpatory ABMS lovefest designed by PR professionals paid for by money stolen through MOC racketeering and fraud from legions of hard working doctors. Webs of lies and deception are the sole defense of ABMS fraudsters, soon to be torn away in courtrooms from coast to coast.

Unknown said...

Since Dr Ellenbogen himself is no stranger to fraud (just google him for more) he is the perfect poster child for all ABMS directors.

Real Change said...

Several Standard Deviations from the Norm

The ABMS/ABIM has a history of egregious conflicts of interests, which shows who they are and what they serve.

From big tobacco to big data, they support special interests and their own financial interests rather than acting out of fidelity to physicians and patients needs and safety.

From Chicago's billion-dollar skyline to the Cayman Islands golden parachute investment accounts, it's fair to say that the ABMS member boards and their cronies' actions are out-of-bounds "several standard deviations from the norm."

MOC: The Evidence of Harm said...

The Name of the Game - Become and Activist - Get the Media, DOJ and Legislators Involved

MOC causes burnout and depersonalization in physicians as well as personal trauma to one's life and livelihood. All these and more negative blows are shocks and traumas to the brain and neurological centers.

The ABMS keeps saying, "get back out there on the field. Tough through it." The insurance companies say if you don't have an ABMS certification we will not pay you. The ABMS takes your certification if you don't do MOC/pay up, which means you won't be able to find work or get any reimbursement without further trauma and hardship. Trauma to one's patients results.

Where is the real research on the negative effects of MOC and why do the ABMS coaches and their partners keep insisting that physicians keep getting back out there on the field - only to experience repeated traumas to the brain and nervous system. Plus. Carpal tunnel syndrome from being data clerks. Stress and overload from being monitored to death and tested to death. The trauma from being trapped like a precocial young wild bird locked in a cage.

The ABIM Foundation advocates for cost savings in healthcare and cutting down on inappropriate invasive procedures, but what about saving those they are personally harming through enforcing the regime of mandatory MOC? What about the invasive policies that have destroyed fundamental constitutional rights and privacy?

All physicians musts become activists and take back the profession from the obscenely paid "coaches" who keep saying to their traumatized "labor force, "get back out there on the field. Tough through it."

How many trillions of dollars are speaking through their mouths when they say, "get back out there on the field" when there is repeated daily brain trauma, emotional debilitation and personal injury?

Where are the neurological studies of the brain to prove otherwise. Where is the NIH funding to prove MOC is safe, that physicians and patients are safe when the ABMS adds the measure of violence and greed into the game for their own profit. This is not rocket science, it is palpable harm and the ABMS and their partners are consciously creating it.

Where are the men and women of pure reason and conscience who will stand up and fight this abusive situation?

There is strength in numbers. All physicians must be vocal and do something to fight back.
Insure that the harms being done by ABMS' mandatory MOC end immediately as the AMA House of Delegates in their wisdom so resolved three years ago.

Ed Rico said...

The tap dancing and smoke show returns, elevated to an art form here by the polished ABNS insiders after the tortured rhetoric of the inarticulate and frequently tongue-tied Dr. Baron led the Walnut St gang to opt for Ostrich Strategy as ABIM’s Main defense against charges of corruption. There is no evidence of #MOC being created with ”the best of public health intentions” The evidence that is available demonstrates that #MOC was never more than a thinly-disguised cash grab based on ABMS and their business partners usurped authority to sell the de facto right to practice medicine in the US. The Straw Man argument is alive and well, summarized here as “Keeping up is good, therefore #MOC is a noble cause”. Exactly the sentiments that Ken Lay, Michael Milken or Bernie Madoff would have expressed when their schemes were exposed.

The true “existential crisis” regarding #MOC is the wild panic among self-appointed Cartel Elites that their perpetual river of tax-advantaged cash forcibly extracted from practicing physicians, involuntarily subsidized by taxpayers, is in serious jeopardy. Once the civil litigation has run it’s course, criminal liability looms on the horizon for the most egregious of the Cartel ringleaders.

Anonymous said...

Jonathin Kravis quit the justice department. Would someone know a way to involve him with the issues of MOC?