Tuesday, March 17, 2020

The "Risk and Distraction" of MOC

From the American Board of Internal Medicine:
We did not come to this decision lightly, but we believe removing the potential risk and distraction of sitting for a spring exam is the right thing to do for our diplomates and for the country at this time. Learn more: https://www.abim.org/media-center/Coronavirus-Updates.aspx
Physicians can help make sure this risky, unproven, and "distracting" ABMS board "maintenance of certification" (MOC) requirement never returns by supporting the plaintiffs working to end this monopolized program here.

-Wes

10 comments:

  1. It was not that difficult of a decision for Rich to make. Maybe we can find some unity now, but especially when we awaken from this crisis later this year and realize clearly together that MOC does more harm than good. The longitudinal racketeering that produces stress, burnout, and suicide must end now.

    Pearson decided for the ABMS . . . all testing was cancelled. Prudent shutdown of the Pearson Vue centers precipitated the decision by the ABMS to cancel spring testing.

    Pearson announcement . . .

    "Important test delivery information pertaining to COVID-19 (coronavirus)
    Starting Tuesday, March 17, we are suspending test delivery at all U.S.- and Canada-based Pearson VUE-owned test centers for 30 days until April 16. Learn more.

    Updated: March 16, 2020"

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  2. Are EHRs the next Covid victims?

    Cerner has closed a large campus and sent folks to work at home due to a quarantine/closure/disinfection at their major campus in Kansas. Only essential personnel needed to run the massive programs/data storage sites are allowed on campus. This latest news comes as employees tested positive and self-quarantining of "Realization patient 1" and all those who came in contact with him is being enforced.

    Large rooms at Cerner's campus with lots of bodies working closely together was a recipe for disaster.

    Epic likewise is having trouble with keeping its 10K employees safe.

    https://madison.com/wsj/business/remote-work-sick-days-and-canceled-travel-madison-area-businesses/article_8b50af26-1916-5124-8a81-a1d631445eee.html

    Better have some paper charts on hand and ready.

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  3. A Survey from October 2001 - from a study conducted between October 2000 and September 2001

    Authorship - On the Front Lines
    https://www.ncbi.nlm.nih.gov/pubmed/?term=Burstin%20H%5BAuthor%5D&cauthor=true&cauthor_uid=12366891

    2002 Bioterrorism - Preparedness of Family Physicians
    https://www.aafp.org/patient-care/nrn/nrn/studies/all/bioterrorism.html

    "Bioterrorism - Preparedness of Family Physicians
    This project was conducted between October 2000 and September 2001, was funded by the Agency for Healthcare Research and Quality (AHRQ) to compare the family physician members of the AAFP National Research Network with U.S. family physicians in general, while examining and promoting the health care system's readiness for a bioterrorist event and other public health emergencies through the development of new evidence, tools, and models. The study consisted of two parts: focus groups and a mail survey. The focus groups, exploring family physicians’ knowledge and attitudes toward bioterrorism readiness, were completed at the March 2001 Annual Network Convocation. A mail survey subsequently was conducted with a random sample of active members of the AAFP and all Network physicians to further explore the issues raised in the focus groups. Data collection was completed in December 2001."

    https://journals.sagepub.com/doi/abs/10.1177/15254402003003003

    History of Quality Measurement
    https://onlinelibrary.wiley.com/doi/full/10.1111/joim.12471

    Helen Burstin
    https://smhs.gwu.edu/news/helen-burstin-md-mph-named-evp-and-ceo-council-medical-specialty-societies

    AHRQ Bioterrorism 2004
    https://www.ncbi.nlm.nih.gov/pubmed/14965073

    Quality Measurement 2007 - Where is it going, who's making decisions - Corrigan and Burstin
    https://www.ncbi.nlm.nih.gov/pubmed/17949597

    Bio T. a Public Health Persepctive 2010
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4921253/

    Bio T. and the Role of Family Physicans 2011
    https://www.aafp.org/afp/2011/0701/p18.html

    Linkedin - Burstin
    https://www.linkedin.com/in/helen-burstin-04063852

    Lobbying Acella Learning, etc
    https://projects.propublica.org/represent/lobbying/r/300980381

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  4. Health Care Priorities For A COVID-19 Stimulus Bill: Recommendations To The Administration, Congress, And Other Federal, State And Local Leaders From Public Health, Medical, Policy And Legal Experts

    Howard P. Forman Elizabeth Fowler Megan L. Ranney Ruth J. Katz Sara Rosenbaum Kavita Patel Timothy Stoltzfus Jost Abbe R. Gluck Christen Linke Young Brendan G. Carr Erica Turret Suhas Gondi Adam L. Beckman

    Additional experts who express support:

    Harlan Krumholz, Harold H. Hines, Jr. Professor of Medicine (Cardiology) and Professor in the Institute for Social and Policy Studies, of Investigative Medicine and of Public Health (Health Policy); Director, Center for Outcomes Research and Evaluation, Yale-New Haven Hospital

    Nirav R. Shah, Former NY State Commissioner of Health; Senior Scholar, Stanford University Clinical Excellence Research Center

    Bob Kocher, Former Special Assistant to the President for Healthcare and Economic Policy; Partner Venrock and Senior Fellow at the Leonard D. Schaeffer Center for Healthcare Policy at USC

    Seth Trueger, Assistant Professor of Emergency Medicine, Northwestern University; Digital Media Editor, JAMA Network Open

    Dave A. Chokshi, Chief Population Health Officer, NYC Health + Hospitals

    Albert Icksang Ko, Professor of Epidemiology and Medicine and Chair, Department of Epidemiology of Microbial Diseases, Yale School of Public Health

    Donald M. Berwick, Former Administrator of the Centers for Medicare and Medicaid Services; President Emeritus and Senior Fellow, Institute for Healthcare Improvement

    Leana S. Wen, Former Health Commissioner for City of Baltimore; Visiting Professor, Health Policy and Management, George Washington University School of Public Health

    Ezekiel J. Emanuel, Former Special Advisor for Health Policy to Director of White House Office of Management and Budget; Vice Provost for Global Initiatives; Chair, Department of Medical Ethics and Health Policy at the University of Pennsylvania

    Benjamin K. Chu, Former President of NYC Health + Hospitals; Former Acting Commissioner of Health for the New York City Department of Health; Senior Advisor, Manatt Health

    Bruce Lesley, Former Senior Health Policy Advisor on the Senate Finance and Health, Education, Labor, and Pensions Committees; President, First Focus

    Alice Chen, Co-Founder and Former Executive Director, Doctors for America

    Aaron Kesselheim, Professor of Medicine and Director, Program On Regulation, Therapeutics, And Law, Division of Pharmacoepidemiology and Pharmacoeconomics of Harvard Medical School and Brigham and Women's Hospital

    Neel Shah, Founder, Costs of Care; Director, Delivery Decisions Initiative at Ariadne Labs; Assistant Professor of Obstetrics and Gynecology, Harvard Medical School

    Abdul El-Sayed, Former Executive Director of the Detroit Health Department and Health Officer for the City of Detroit

    Gretchen Berland, MacArthur Fellow; Associate Professor of Medicine, Yale School of Medicine

    Helen Burstin, Executive Vice President and Chief Executive Officer, Council of Medical Specialty Societies

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  5. Where is the protective gear that is needed to fight COVID-19 or any bio-threat?

    All these quality measures that have been pushed down physicians' throats like MOC are truly put under the bright spotlight in this current crisis. Farcical when you see that the most vital aspects of healthcare delivery have been ignored, devalued and undermined by our ABMS thought leaders and medical societies. The so-called "we have listened" discussions have been invitation only and one way at best.

    They should come out of their ivory towers and get down in the trenches without protective gear with us. Instead of legislating MOC, rationing, and medical homes for their corporate partners, the medical politicians like Baron, Cassel, Weiss, Holmboe and Wachter should have created a real safety net for physicians and patients. A stockpile of masks and testing/disinfectant stations ready to go. These virus strains have been collected and studied to the hilt. John Hopkins even ran the drill for Wall Street and a large private foundation to see how much damage could be done to the financial markets and populace by a similar, if not identical, viral attack last year. http://www.centerforhealthsecurity.org/event201/

    Instead of real support, we got all the useless trivia forced on us. And the next big MOC thing. More lucrative data collection through the latest version of Messr. Ponzi's longitudinal pyramid scheme. Coming down the pike: the new and improved longitudinal graft courtesy of the Anglo-Dutch investment elites who own the mother lode of Wolters Kluwer and Pearson stock. And the global private equity firms, mega-healthcare employers, big pharma and payors who are looking to turn a handsome profit off their demured labor force. And the top heavy federal social financial safety nets that are running out of money. As well as the pension funds that states and corporations are trying to tier down.

    Now it all seems (with Covid 19) like the story of the small boat that overturned in the lake and all the elite passengers drowned because the one thing they really needed to know was how to swim and that is just the thing that they never learned.

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  6. Thank you to the global response teams everywhere.

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  7. The Toughest Triage — Allocating Ventilators in a Pandemic

    New England Journal of MedicineList of authors.
    Robert D. Truog, M.D., Christine Mitchell, R.N., and George Q. Daley, M.D., Ph.D.

    "The Covid-19 pandemic has led to severe shortages of many essential goods and services, from hand sanitizers and N-95 masks to ICU beds and ventilators. Although rationing is not unprecedented, never before has the American public been faced with the prospect of having to ration medical goods and services on this scale.

    Of all the medical care that will have to be rationed, the most problematic will be mechanical ventilation. Several countries, but not the United States, have already experienced a shortage of ventilators. Acute care hospitals in the United States currently have about 62,000 full-function ventilators and about 98,000 basic ventilators, with an additional 8900 in the Office of the Assistant Secretary for Preparedness and Response Strategic National Stockpile.1 The Centers for Disease Control and Prevention estimates that 2.4 million to 21 million Americans will require hospitalization during the pandemic, and the experience in Italy has been that about 10 to 25% of hospitalized patients will require ventilation, in some cases for several weeks.2 On the basis of these estimates, the number of patients needing ventilation could range between 1.4 and 31 patients per ventilator. Whether it will be necessary to ration ventilators will depend on the pace of the pandemic and how many patients need ventilation at the same time, but many analysts warn that the risk is high.3"

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  8. Read the replacement language in the 880 pages of "Stimulus Bill" for healthcare related subjects.
    https://assets.documentcloud.org/documents/20059055/final-final-cares-act.pdf

    ‘‘(I) determining whether a drug
    12 is generally recognized as safe and ef13 fective under section 201(p)(1), ex14 empt from section 503(b)(1), and not
    15 required to be the subject of an ap16 proved application under section 505;
    17 or
    18 ‘‘(II) determining whether a
    19 change to a condition of use of a drug
    20 is generally recognized as safe and ef21 fective under section 201(p)(1), ex22 empt from section 503(b)(1), and not
    23 required to be the subject of an ap24 proved application under section 505,


    (C) by striking ‘‘a physician who’’ and in2 serting ‘‘a physician, nurse practitioner, clinical
    3 nurse specialist, or physician assistant who’’;
    4 (3) in the fourth sentence, by inserting ‘‘, nurse
    5 practitioner, clinical nurse specialist, or physician as6 sistant’’ after ‘‘physician’’; and

    page after page of it . . .

    ‘‘(B) EXCEPTIONS.—When issuing an administrative order under paragraph (1) on the
    426
    O:\HEN\HEN20312.xml [file 1 of 2] S.L.C.
    1 Secretary’s initiative proposing to determine
    2 that a drug described in subsection (a)(3) is not
    3 generally recognized as safe and effective under
    4 section 201(p)(1), the Secretary shall follow the
    5 procedures in subparagraph (A), except that—

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  9. Everyone who pays into the ABMS Ponzi scheme along with every US taxpayer should read this article about the ABIM's scandalous financial self-dealing enterprises and political machinations.

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  10. They already have my MOC 10-year exam money for this year. They may do better than everyone else, while collecting fees and MOC testing charges, they can claim they were shut down, get some Covid-19 stimulus money. Of course without mentioning that they did not refund anyone, just deferred the dates of the test. Another scam?

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