Sunday, October 25, 2020
Thanks to All!
As treasurer of Practicing Physicians of America, it gives me great pleasure to announce that we hit our goal of raising $400,000 in support of the Plaintiff-physicians who filed class action antitrust lawsuits against the American Board of Internal Medicine, American Board of Radiology, and the American Board of Psychiatry and Neurology.
Over 1,800 individuals, the vast majority of whom are working US physicians from a diverse range of subspecialties, contributed to this effort. These contributions were truly voluntary and made by people who felt strongly that the monopoly power these organizations unjustifiably enjoy over us needed to be held accountable for the harms (economically, emotionally, and professionally) they are causing to working physicians and our profession. This milestone proves that physicians can still do incredible things when they put aside their differences and work together.
While the results of the multi-year legal effort remain uncertain, many beneficial results have already occurred. But we should acknowledge that nearly 40% of our contributions were anonymous donations owing to the threat many physicians still feel from these organizations at their workplace. Simply put: our work is not done.
While there is still much to do in this David vs. Goliath effort, on behalf of all of us at Practicing Physicians of America, thanks to all of our contributors for a job well done.
Westby G. Fisher, MD
Treasurer, Practicing Physicians of America and
Organizer of this legal-support GoFundMe campaign
P.S. Further updates regarding the status of these class action anti-trust cases will continue. Physicians still wanting to contribute are encouraged to do so.
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Longitudinal Assessment: the ABMSLA(®) Program from Hell
"Longitudinal Assessment" is not a benign new testing regimen. It is far worse than anything one could imagine.
A twilight zone program with mandate after mandate. Process after process with data collected in real time every time you turn on your computer, laptop or tablet.
A cornucopia of data collection/data sales for the ABIM/ABMS with endless adhesion contracts destroying the rights of physicians forever.
It is not "more choice". It will be no more choice. It is coercion and control with a capital C..
Long. Assessment is even more onerous. It does more harm. LA is a captive MOC market for captive ABMS MOC® clients, more lethal for doctor and patient than the current MOC Ponzi scheme. Far more pernicious and demanding. Cleverly designed over the past thirty years.
The Knowledge-Check-In is already history. A miserable failure being phased out.
The ABMS has intended to institute more onerous MOC in the form of longitudinal assessment for years.
Everything the ABMS core does is vile. Better watch your backs. LA is the "long arms" ABMS money/data grab from which physicians will never recover from.
It is their propaganda that it give more flexibility and puts the physician in the driver seat. Yes, with them in control of the car and the other vehicles on the road.
Med students, residents and fellows are already being conditioned to accept endless MOC misery through fear. This is wrong.
Longitudinal assessment means being forced to pay a quarterly MOC tax
MOC dulls the mind. It produces stress, burnout and mediocrity. MOC can never lead to excellence. Coerced regimented education produces substandard results, invariably.
Regimentation typically produces unhappy people. Every school child knows this. Excellence comes from within; it cannot be mandated from without. Intelligence, inspiration and joy should be the aim of education, not useless repetitive exercises that result in dullness of mind, resistance of spirit and burnout. This creates despair, a key contributor to the high rate of physician suicide.
What was described above is infra-education. Repressive aggressive measures. Not practicable or even palatable in a prison or detention center. A totally absurd approach to education and continuing education. Violent approaches beget negative results and often create violent upheavals in the soul.
The ABMS/ACGME starts with passionate sharp students and professionals and through base theories and ad hoc practice requirements, coupled with bizarre financial schemes, end up dulling sharp minds. Quelling passion.
Debasing and humiliating human beings who start out bright and caring is a backward approach. The ABIM and other medical boards do not understand how the human mind and heart work separately and in concert. They appear to care mostly about fattening their banks accounts rather than finding the harmonious double sine wave that gives force/energy and brings education to life. Fortunately the human spirit is somewhat resilient and people find ways to renew passion and intelligence. There is healing through meeting.
What a pity that the ABMS/ACGME make a mockery of the profession, our lives and the core principles we live by. The oath we take. If you draw back the curtain on these phony non-profits and out of touch executives, you will see they are not educators at all. Many of them have a pseudo-scientific air and false pulse on trust that only distorts reality and repulses the intelligence within.
The ABMS executives do not inspire; far from it. They can only spin a web of financial schemes around us. Why is this? They are business men, government revolvers, attorneys, lobbyists, psycho-measurers, propagandists, Wall Street bankers, escapees from advertising, hospital spokes, reporters, insurance actuaries, and professional politicians. Their primary goals are to force products and services on physicians for a living. These rentiers end up harming the profession and the public.
The ABMS/ABIM/ACGME used to be comprised of actual working clinicians and academics. That all changed in the early 1960s. Now the volunteer clinicians and academics who once administered the organizations have been relegated to the back of the bus writing contorted copyrightable test questions to support the largess of the execs. And many rather than revolting and reforming the organization defend MOC, which is a form of modern day slavery imposed on us. Without healthy rebellion and a solidarity of purpose to end MOC we will continue to be the dollar harvest for ivory tower elites.
These basic truths about human beings and what inspires excellence and true professionality in us are clear. They serve as examples of how the ABMS/ACGME has gotten it wrong in so many ways. They have deviated, becoming self-possessed with greedy psyches - transforming themselves into "hoofed red demons with horns and tails." They have morphed by adapting dystopic Machiavellian practices adding Orwellian doublespeak and newspeak to their war chest for good measure.
Has anyone read original bylaws of the ABIM from 1936? Written by 9 board members, it is simple and pure in its content and non-pecuniary statement of purpose. ABMS/ABIM executives today are interlopers in the business of taking and deceiving rather than giving and telling the truth.
What is longitudinal assessment
Longitudinal assessment, is a plagiarized pseudo-scientific adaptation of Dutch educational/assessment theory. It is being promoted by the ABMS/ACGM certification/accreditation monopoly as a way of padding their bank accounts. Not just every ten years, every two years or annually, but now with longitudinal MOC they will mandate testing, assessment participation and payment every three months.
They will demand quarterly testing, reports, surveys, payments and assessments from physicians ad nauseum. Longitudinal means for these rentiers, live streaming cash rather than deferred revenues.
Lucrative troves of data will be extracted from doctors and patients. It is entirely useless testing/assessment and will only dull the profession of medicine further. Even more stress, burnout and a higher rate of suicided doctors, early exit from the profession. Doctors will be subjugated by even more onerous online platforms and keep-up-or-else dashboards meant to condition rather than educate. In this next installment of Orwellian dystopia, the big-brother ABMS/big-money corporations decide medical science and care not the physician scientist in a process of shared decision making with the patient.
The coerced quarterly payments and assessments will involve tracking, surveys, improvement modules, peer review and population health exercises and covert analysis and probably experiments. Those who do quarterly taxes for the IRS will understand immediately what longitudinal assessment really is. It is a shrewd method of pre-paying the ABMS MOC tax every three months.
Only the sheepish mind will think it is new sweet grass before they actually experience what its like to be forced to chew the ABMS' bad longitudinal grass, contracted to pay up forever. With surveillance by both live and artificial online proctors.
Longitudinal assessment is a clever new word for continuous MOC. This new mandate will not sharpen the profession, but only blunt the fine edge of science and intelligence. The ABMS/ACGME keeps trying to catch a falling knife. Instead of weeding out a bad apple they will instead produce a barrel full. Longitudinal assessment has the potential to sour and ruin the whole cart. Why? Because the ABMS/ACGME are rotten to the core, comprised of pseudo-scientists and doctors in name only.
These are all verifiable facts. These are unaccountable corporations feigning to be providing a public service. The tax forms show otherwise. They show that the ABMS/ACGME have their priorities backwards. Dollars before education/public/profession.
In true voluntary self-regulation a professional certification would mean something, because it would be for life. Instead of providing meaning and pride that sustains the ABMS/ACGME brokers in illicitly tied products and services to maintain a rentier society that does not wish to work. The ABMS medical boards keep making tender offers of physician's hard earned money with bonuses made out to themselves. They keep issuing shares of doctors' sweat equity with obscene compensation packages. They seek to grab all they can while they can for themselves, rather than focusing on something of real value.
Every one of the executives and CEOs at the ABMS/ACGME has without exception only polluted these "not-for-profits" with foul mediocrity and substandard educational offerings. Offerings they cannot sell based on value or merit, but only by mandating them. They coerce by "deceiving" their powerful associate corporations to make sure that the deception is not only local but nationwide. Certification and it's tied product MOC is thus mandated by every insurer and hospital almost without exception.
Ummmm, I’m retired rand I can say whatever I want. Primary care sucks no matter what. Used to be good as long as outside bastids didn’t hold us to whatever patients behaviors went. ABFM/ABMS/ACGME I don’t give a f#ck, they can all go to H#ll!. So-called certification is a bunch of bull-hockey and I hope all the bastids in the so called certifying G-damnd bastids go to Hades. I am so glad I am out of this crap..
Anyone who tells med students to go into primary care should be castrated to the n’th degree. Sorry, I survived for 30 years and looking back, it sucks primarily. I did some good but, damn I suffered.
Too bad we can't just vote the ABIM executives and board members out and nominate competent non-conflicted physicians. Turn the corrupt self-appointed elites out of their expensive Walnut Street offices and penthouse suites.
There's no excuse for the obscene fees and payouts. No excuse for the ABIM's political machinations and financial self-dealing. There is no place for the harms that MOC imposes on physicians and patients.
There is no reason for MOC to be required/mandated. No benefit except to pad ABIM executives' personal investment accounts, fund/disseminate propaganda, and lubricate collusive business relationships.
How did the ABIM make out this quarter?
Clorox sales are up 27% according to recent company reports. Not quite as good as the historic GDP quarterly spike of 31.4% reported by the government just days ago.
With low demand for MOC this year, how did the ABIM do? [They get paid whether physicians decide to test or not.]
The ABIM has not released any financial information concerning any stimulus money they received. If so, how does it appear on their books, and how will it appear on their invariably late IRS tax filings?
Certification, MOC, and other? Given their size, I would estimate that they would be eligible for about 3 million dollars to make payroll.
How will any stimulus money be spent? More retention bonuses? Or more undocumented tax boons to partners WolternKluwer, Pearson Vue, and others.
What about the ABIM Foundation with their staff and board? Any stimulus money going to them.
Will the money appear on Schedule R?
I believe the ABIM should be transparent about any stimulus money they may have received.
Christine Cassel claimed that the ABIM took no money from "the industry". Yet Cassel received cash/stock/board positions from healthcare companies, while she was the CEO of ABIM and PCAST advisor to the White House. Cassel and others were in the middle of quickly enacting healthcare reform legislation. Legislation which benefited the ABIM/ABMS, Cassel's bank accounts, and the companies/cronies she represented. One of the greatest healthcare scandals, yet it was not investigated in its broader context except superficially by ProPublica and the Senate.
Christine Cassel, in speaking about MOC while CEO of the ABIM in 2010. [Christine Cassel does not currently participate in MOC
"The Journal [NEJM] posed the question — should a 55- year old physician – board certified in endocrinology – and practicing for the last 24 years – participate in ABIM’s MOC program? In an online vote 63% voted against the physician recertifying. MSNBC, in response to the AP story issued its own web survey. A large majority – 80% said yes, all doctors should be required to take tests to renew their certifications.
How do you explain the difference? Well, the respondents in the Journal poll were primarily doctors; the majority in the MSNBC poll, were the general public and non-physicians. Of course, neither poll is scientific, but the results reflect a challenge that those of us at the certifying boards face on a daily basis: while we are of the profession, we are for the public. Board certification and MOC is a marker for the public to know that their physician has met a standard in a particular subspecialty of care. And it is this process that allows the profession to self-regulate – rather than having an outside governmental body determine physician standards, as is the case in many countries."
Not only were the polls unscientific, they underestimated the number of physicians who would not participate in MOC if given a choice. The MSNBC poll overestimated the number of patients who value MOC, because none of those polled knew what MOC was. None of those polled knew what the ABMS or ABIM actually did or who they were. For Cassel to say that the polls were unscientific is an understatement.
Richard Baron was appointed to the ABIM board in 2001. Board members receive compensation due to changes in the bylaws. It is no longer a non-pecuniary organization. It is a political and financial juggernaut forcing physians to pay into a MOC Ponzi scheme.
Baron's most recent compensation put him in the million dollar 1% club. Well over the threshold. He received a retention bonus of over 350,000 dollars.
Federal Election Commission has this to report on the CEO of the ABIM and ABIM Foundation's political contribution history. Running the search by ABIM had zero entries. You have to type in American Board of Internal Medicine and ABIM to get a full picture. Then you have to add years and other employers such as CMS, Greenhouse Internists and ACP to get a full picture. Christine Cassel appears as currently contributing from the ABIM in 2020 and for the past several election cycles.
Here's some of what that elite status can buy.
Federal Election Commission Report on Political Contributions for Richard Baron as of 2020 going back to his appointment to the ABIM board of directors. The dollars to political interests increases with his power and paycheck.
Under the Cover of Covid
ABIM Campaign Contributions (Take a deep breath before you click the link below.)
Scroll through page after page of totally one-sided "political donations" on the FEC site.
Questions come to mind immediately.
Is ABIM involved in political racketeering and influence pedaling? Sure looks like it.
Are the ABIM and ABIM Foundation channeling secret money again? (1989-2007 ABIM Foundation secret money transfers.) Sure appears that way.
Are we looking at surfeit money garnered from overpriced certification tests and illegally tied MOC money? Ditto on the previous response.
Is that big money being funneled into big politics in order to gain political favors/ financial boons? That's what we've seen all along with the undisclosed lobbying.
If it all sounds like conspiracy theories that's good, because there is no better way to peak an interest than to call something a conspiracy theory. I have to offer a disclaimer. It is not really sensational news that we are pointing out. It has been standard practice for years at the ABIM. Business as usual.
The more money the ABIM/ABMS get from physicians, the more powerful and audacious they become. From docs being certified for life to time-limited certifications, with every year it gets worse. Now docs will soon be wed to the ABIM online 24/7 longitudinally forever.
It is a lot of contribution money when you look at the FEC reports and add it up? The head explodes in disbelief. This year there have been more contributions than one could imagine from this small testing company and its piggy-bank foundation! It's an important election year.
Federal Election Commission campaign reporting shows that the ABIM is increasingly becoming a political organization revealing a staggering rise in total political contributions. 100% of their campaign contributions are going to only one party. Where is the money coming from? We see that executive compensation is increasingly being funneled into pockets, personal politics and not testing development.
MOC is contributing to a large degree and one can only think that creating such revenues from MOC was designed to fulfill desires for personal enrichment and political agendas. It is no conspiracy theory just fact that MOC was intentionally designed for these purposes. Moreover that fact that clinicians and academics, who used to volunteer for free to write questions and administer the tests, no longer run this certification company. One can only concluded that the ABIM is suborned to big money and big politics. Unfortunately Pearson Vue and Wolters Kluwer and other foreign interests are pushing the MOC agenda and their own politics on the US.
If you are on the receiving end of the (campaign) money one would probably be gleeful. But only if you had no shame, when you see how such political games and activities harm others. One should say not so fast and see how such one-sided politically motivated arrangements may sour a larger number of other parties on the ABIM. This would be a dumb political move on their part and one that will always come back to haunt the perpetrator.
Who helped pay for that highly efficient political machine that "suppressed the other side from voting" and "kept them from seeing what was happening." Maybe that bright government agent will look up on his smart phone who works at 510 Walnut Street and see how much they get paid for working from those expensive upper floors.
Maybe he or she will read about the condo and Christine Cassel and Judi Cassel (no relation) and look up how the city got those voting machines recommended, purchased and installed. Where the money came from for such marvelous innovations that can cheat the other side in the blink of an eye.
But I'm a democrat and I'm not going to be talking any time soon. Let's keep it on the low down and let 'em figure it out, if they can.
But just maybe the ABIM could at least get an honorable mention in the FBI's final report for helping to fund in no small way such a massive "bring out the vote" campaign. Let's hear it for the ABIM penchant for bullying too, if that was the case at the polls. That's one of their strong suits if they suggested it.
And let's give a big honorable mention to "the Chinese" who helped create the perfect storm (Covid-19) for not letting Republican poll watchers get too close and see what was really going on.
FEC Reports on the ABIM, ABIM Foundation [and harder to type] "American Board of Internal Medicine":
Wes, I'm a post 1992 internal medicine graduate. Unfortunately, to continue being able to work, I had to take another round of maintenance MOC just recently. This is and has never been about ABIM's 'right to determine what their product covers'. This is about the abject extortion of doctors who if they don't have the 'Board Certified' comment after their credentials, they aren't working, getting reimbursed, all of it.
I got real frustrated with a staff position I had as a doctor when a colleague was forced out of the program because he had difficulty passing the re-cert exam. When I addressed this politely with the organization, and inquired about changing the MEC bylaws, I subsequently found myself out of a job with this institution. For anyone to claim MOC or ABIM certified status isn't necessary to practice medicine is a fool
In the end, it's just too complicated a legal issue to allow a judge to summarily toss the case without a proper vetting including depositions, and a jury trial.
"Without truth there can be no trust."
What is the purpose of this for-profit subsidiary of the American Board of Medical Specialties?
See the data sales/revenues for ABMS Solutions in IRS forms Schedule R -- $5,406,000
ABMS Solutions was a private equity acquisition of a global employment agency.
ABMS data registries
These lucrative physician data (on certification and MOC status) are used to illegally represent to employers and insurers/payors who is employable and/or eligible for reimbursement.
The ABMS, through its alter-ego registry ABMS Solutions, sells private information acting like an online physician broker and quasi-employment agency.
If you take a look at Schedule R it is plain that the ABMS is still a global employment registry/broker through its dark ego, ABMS-International. This for-profit global enterprise violates countless US and international laws and standards regarding labor and property theft (recalling certifications without reimbursement). They do all this profiteering mischief along with the perpetual trammeling a physician's right to work, and invasion of privacy.
Schedule R also lists the for-profit subsidiary ABMS-Singapore. This Asian company shows 0 revenues. Don't be fooled by the big goose-egg. This is a false submission to the IRS. They do make money from their offshore operations in Singapore. Millions in fact.
Because ABMS-S is a for-profit company the tax filings are not available to the public.
Is this another example of ABMS money laundering/kickback schemes perpetrated with the ABIM and other medical specialty boards? The answer to this question lies in studying the past 8 years of available tax filings and pdf program files for the 24 specialty boards and its umbrella. In doing so we see a financial schematic of how these shell corporations operate.
It is appalling to me and others the level of fraud and obfuscation we find on the tax filings of so-called non-profits.
Even more appalling when we hear stories of doctors who find themselves suddenly unemployed/seeking new opportunities after being harmed financially and psychologically by ABMS/ABIM MOCSTERS, their cabal of unaccountable, self-appointed "thought leaders", their associates, and affiliated "labor contractors" and "pursers".
MOC is one of the biggest educational Ponzi schemes in the history of the world. It's time to call it what is is end it.
Regarding the court recording, is there a written transcript?
Searching on Pacer.gov. . .
There is a transcript of the oral arguments in Kenny. et al, v. ABIM, but for some reason there is a lock on that particular document. Many of us would like to be able to read it as well. Does anyone have a pdf copy of it? Or is it off limits to us?
The time for the plaintiffs and defendants to present oral arguments was too short imo. 15 minutes. The SCOTUS allows 30 minutes per side. And that is a brisk sprint through constitutional law.
Oral arguments transcript locked!
56. Open Restricted Document COURT MINUTES OF ARGUED/SUBMITTED CASES.
[20-1007, 20-1567, 18-2181, 20-1413, 20-1425, 20-2200] (PM)
[Entered: 10/22/2020 11:15 AM]"
It's worth mentioning that the senior judge R F Kelly assigned to Kenney et al v. ABIM, was suddenly removed from the district court case before completion. Kelly was removed from five other active cases as well. The removals started in the fall of 2019 shortly after Kelly dismissed this case.
Six Robert F Kelly cases were reassigned: the first one to Judge Diamond on 10-22-19, DuBois on 11-6-19, Beetlestone on 11-9-19, another case to Beetlestone on 11-26-19, then McHugh 12-17-19, and Pappert 1-29-20.
The case against ABIM is an important case that affects countless lives of physician and patients rights. It's also an interesting case from a legal standpoint. I believe the court made egregious errors by parroting ABIM talking points and failing to look more deeply into the real world human aspects of the complaints.
Judge Kelly is no longer listed in the federal court's directory and no staff assigned to him based on the official federal website. The court has not made any announcements to the public why he was suddenly removed from all his cases. The five other cases were in various stages. All six cases, including Kenny et al v. ABIM, were reassigned to other judges.
The anti-trust case against the ABIM was reassigned to Wendy Beetlestone on 11/26/19 for further proceedings. It was appealed to the 3rd Circuit.
We need to have more transparency from the court about the status of judges. The US Supreme Court has a fairly good track record when it comes to this.
Best wishes to the Honorable Judge Kelly and his family.
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