In late 2018 through 2020, The American Board of Internal Medicine (ABIM) was involved in a class action antitrust lawsuit for claims of illegal creation and maintenance of their monopoly power in the market for maintenance of certification (MOC). Even though there was an outpouring of physician support for the lawsuit from working physicians, the case did not survive massive legal efforts to kill the case on technical grounds before it went to trial.
Now, physicians are left with little choice but to cough up more money to pay the exorbitant salaries of the non-clinical academic elite who run the organization or risk losing their jobs. It is the tie that binds ABIM's their proprietary MOC continuing education product to physicians' initial subspecialty board certification that allows ABIM to raise their costs without any oversight because physicians require their initial board certification credential to maintain their hospital privileges or place on insurance companies' rosters.
It is particularly concerning that ABIM decided to raise their MOC fees 25% in 2022 when their own assets mushroomed 18% in 2021 alone to more than $168 million:
ABIM has constantly billed itself as a "physician-led" non-profit 501(c)(3) organization. From their About ABIM webpage:
"ABIM is a physician-led, non-profit, independent evaluation organization driven by doctors who want to achieve higher standards for better care in a rapidly changing world."
But are they really? Who is really pulling the strings at ABIM?
We have already seen that the former CEO and President of ABIM, Christine Cassel, MD was serving as a board member of one of the largest Group Purchase Organizations, Premier, Inc, and serving on the Board of Kaisier Hospital and Health Systems while also serving as President and CEO of the ABIM - conflict that was never disclosed to physician-diplomates of the ABIM.
But now we see another concerning potential conflict that needs explanation, especially with the rate hike in fees physician must endure. Who are ABIM's "RESTRICTED" contributor(s) found buried on their latest IRS Form 990?
Might it be George Soros (since ABIM contributed to his Institute for Medical Professionalism in 2003 and 2008)?
Or might it be other members of the Accreditation Council of Graduate Medical Education (ACGME), like the American Medical Association (AMA) or American Hospital Association (AHA)? Who stands to profit from the control of physicians this way?
Physicians have a right to know what the heck is going on at ABIM and why are fees have gone up 25% in 2022 at a time when ABIM is more than flush with cash. We also deserve to know who their contributors are that are supporting his racket.
Unless, of course, the US is running the physician regulatory system like the mob.
-Wes
PS: For those interested in staying abreast of our ongoing investigation, consider joining Practicing Physicians of America (it's free and allows us to know who wants further work in this arena).
this is somewhat reminiscent of the Clinton-Lewinsky scandal insofar as behavior inappropriate for the circumstances was revealed, and shared as widely as possible. Outrage ensued from certain sections, little was done, and the cabal was unshaken by the revelation(s), pretty much business as usual, raking in the cash.
ReplyDeleteClearly, this will be a long haul endeavor, and will be won at the individual hospital level, first by gaining acceptance of NBPAS, then perhaps one day, removing the need for initial ABMS board certification in the minds of Physicians, and perhaps even administrators. And we can ride off over the rainbow on our trusty unicorn steeds.
This issue is past relevant now. Do you needed specialty CME and go with NBPAS if your organization still needs a gilded certificate. Honesty who cares about all this if you are in practice? As ABIM itself says, it's certification is optional
ReplyDeleteMore disturbing revelations about the ABIM/ABMS and their partners/associates.
ReplyDeleteWes,
ReplyDeleteMore than a mouthful when you said, "cash rich". Look at all the ABIM/ABMS tax forms over the past several years. ABIM holding 75 million dollars in cash!!!!!!! Who holds that much cash relative to total assets consistently and why?
What is ABIM hiding from physicians and the IRS with their hocus pocus tax filings?
Follow the money it may lead to offshore hedge funds or un-reported private partnerships. Or payouts of some kind. What is keeping the flagship float with their bloated expenses. It does not add up. That is perhaps why they are raising fees.
In short, the staggering amount held in cash on their tax forms does not justify a raise in fees unless they are clandestinely fully invested like the ABPN, or broke. Either way they may be misreporting their financial condition to physicians and more alarmingly to the federal government. Btw, the IRS has never scrutinized this "grandfathered" organization that is run by a handful of opportunistic kleptocrats.
Compare ABIM to the asset rich ABPN. (Psych. and Neruo) $2 million in cash (1.3%) versus ABIM's $75 million (45%). That raises serious red flags. CEO/Executive compensation already through the roof (millions they take home) will increase, not what they give to the public. (Nil)
https://projects.propublica.org/nonprofits/display_990/410654864/06_2021_prefixes_38-41%2F410654864_201912_990O_2021060718281411
I think we need to care as the ABIM "continuum" controls many aspects of medicine. They undermine how physicians practice and harm patients' rights. If one does not care about that then one does not truly understand the nasty consequences. It is vitally important to have an active participation in this fight to end MOC, otherwise the next phases of their control and intimidating demands will be to put you out of practice/you will lose even more autonomy.
ReplyDeleteLies abound at the ABMS. If we become numb to the lies in life and just go along, where does that leave us? Pysicians need to take back control of these organizations and make them true and clean. Right now, they are dirty corporations exerting control and raking in the money.
More money equals more power and money for these elite and menacing politicians.
ABIM's tax forms reflect a decades-long campaign against the profession of medicine.
ReplyDeleteWith executive profiting from it. Follow the war chest money.
Ballard Spahr legal expenses: top expenditure under contractors. Prosecuting their war against physicians with a vengeance, even when they know they have no case. Going to appeals court to protract the harms -- terrorization and fear mongering.
Getting court cases against ABIM dismissed, which have a high degree of merit. Lobbying the higher court with conflicted third-party legal firms in the appeals process.
Unbelievable: the captured judicial system.
Unbelievable that Ballard is claimed as their number one contractor. They pay millions of dollars to Pearson Vue. Not even a peep about them under contractors. Must be partners utilizing ABIM's tax advantaged scheme. Keeping the testing prices inflated for Pearson rather than passing the tax savings on to the client - physicians.
ABIM tax forms read like a map and guide to kleptocratic conquest
ReplyDeleteThe ABIM war chest is huge. Look who the recipients are and how much their executives make. We should rephrase that into how much they take. The amounts paid to execs (literally stolen money, not earned) are staggering.
One must understand the plunder of physicians started over thirty years ago.
Hiding huge chunks of money stolen from physicians over thirty years, with ever increasing testing fees and requirements. On could safely say, thanks to crowdsourced investigative journalism and forensic auditing, the ABIM got caught lying on tax forms and engaging in obfuscation. They were involved in a scam of huge proportions: without mincing words, money laundering and then risky investments. Creating a lucrative Ponzi scheme with double payouts to top executives are the hallmarks of the ABIM.
The investments practices and millions poured in to their piggy bank foundation from 1989 to today - yeah, the foundation with the fake years of formation and bogus domicile in Iowa. The ABIM laundered so much money that the cash flow confused search engines about the nature of the ABIM. During the 1990's/2000's and beyond Google search bots painted the ABIM as an investment company. No joke. Google bots and crawlers track the money/net worth of corporations, individuals and their activities.
There are a lot of bright red flags on ABIM's recent tax map. One wonders who the ABMS as a whole serves. Who are they really? Industry shills, government revolvers and private equity insiders? Asking who they serve provides the answer. They certainly not serve doctors and patients. (Profession and public.)
To many the ABIM's tax forms look like a looter's guide to plunder - mirroring quite profoundly a rentier class campaign against physicians and the patients they serve. Tying up money and/with excruciating time demands. Doctors are manipulated into forced postures, both physical and psychological doing useless endless MOC. This testing adversely affects our healthcare delivery system. Everyone is gaslighted, while a few elites prosper serving the industry they say they take no money from.
Restricted on their tax forms is fitting. In fact, it is not surprising as it fits into a very old pattern of obfuscation and lies. Ironically, the stealing from physicians still gets swept under the rug. No one has properly studied what the underlying stress created by ABIM's MOC scheme actually does to physicians and how it harms patients. The fear and propaganda campaigns have been intense. "A kinder and gentler MOC", is just the tip of the spear of an even worse MOC to come.
Watch out for the new 24/7 longitudinal surveillance and assessment assault on physicians.
Truth at the ABIM has always been concealed, but now it is official with the designation "restricted". "Kinder and gentler", or whatever phrase the PR team comes up with, is a ploy and at the same time an admission of culpability of harms done and the customary insults yet to come. At an ever higher price tag, increasing demands.
What a racket. Pay up or you can't work.
ReplyDeleteABIM's Money, Power and Profit (Not caring who it harms.)
ReplyDeleteLongitudinal assessment/MOC is an obvious attack against physicians and patients. An affront to the profession of medicine. Coercion/strong-arming the ABIM's tools. MOC propaganda (aka lies) and physician gaslighting keep the executive largess going.
A 25% fee increase insures that the power and largess grows for the ABMS and their sock puppets. MOC's resultant physician burnout and apathy plays into the hands of the ABMS' "perpetual cash machine."
ABIM's fee fro "sorry, we got it wrong" just increased by 25%
ReplyDeleteMOC (Longitudinal Assessment) is wrong no matter how you express it.
"Sorry, we go it wrong." - ABIM
That ABMS/ABIM MOC 'wrongness' extends to the ABIM Foundation as well. (ABIM's big piggy bank for executive bonuses and padded paychecks.)
"Sorry, we go it wrong." - ABIM
ABIM Foundation
MEDICAL PROFESSIONALISM
(Propaganda "Sorry, we go it wrong." - ABIM)
THE PHYSICIAN CHARTER
(Propaganda "Sorry, we go it wrong." - ABIM)
TRUST IN HEALTH CARE
(Propaganda "Sorry, we go it wrong." - ABIM)
TRUST PRACTICE CHALLENGE
(Propaganda "Sorry, we go it wrong." - ABIM)
2021 ABIM FOUNDATION FORUM: PURSUING TRUST STRIVING FOR EQUITABLE HEALTH CARE
(Propaganda "Sorry, we go it wrong." - ABIM)
2020 ABIM FOUNDATION FORUM: BUILDING TRUST & HEALTH EQUITY
(Propaganda "Sorry, we go it wrong." - ABIM)
2019 ABIM FOUNDATION FORUM: [RE]BUILDING TRUST – A PATH FORWARD
(Propaganda "Sorry, we go it wrong." - ABIM)
2018 ABIM FOUNDATION FORUM: [RE]BUILDING TRUST
(Propaganda "Sorry, we go it wrong." - ABIM)
CHOOSING WISELY®
(Propaganda "Sorry, we go it wrong." - ABIM)
INITIATIVES
(Propaganda "Sorry, we go it wrong." - ABIM)
GRANTS
(Restricted "Sorry, we go it wrong." - ABIM)
Will physicians get their day in court?
ReplyDeleteABR Attorney:
"Your honor, it is the ABR's position that we have the absolute right to beat physicians over the head with our baseball bats and decertify them if they don't buy our batty MOC products.
"ABR can choose whatever add-on certification requirements we want including requiring physicians to buy only our tacky brands of baseball bats." (ABMS MOC.)
Oral Arguments 7th Circuit Court of Appeals
products."https://www.youtube.com/watch?v=2J5aZ-QBdNE&t=7023s
"'MOC' happens" because ABMS maintains monopoly power with zero accountability.
ReplyDeleteABMS MOC - a track to a nowhere
ReplyDeleteIt's difficult to imagine a more stupid and cynical situation. Doctors in America are forced to take the heat of MOC, sweating feverishly to pay an annual work tax to monopolists at the ABMS. I.e. doctors are ironically forced to pay for their own useless suffering and political demise. Coerced and brainwashed into paying for unproven ever-pricier products. Forced to jump through an ever-changing number of absurd experimental hoops.
Longitudinal assessment is a scientifically unproven theory of testing. Look at it. It is absurd. Just another coercive tied product - just as much as the two-year, seven-year or ten-year MOC testing regimens. MOC, no matter what it is called, or how much lip gloss ABMS puts on it, it is all forced hogwash.
Why should physicians be marched down 'MOC Lane' and forced to comply with such onerous, wasteful and distracting mandates? Laying down a track to nowhere for ABMS elites to profit by. Creating conditions for the subjugation and possibly the annihilation of their jobs. AI and mid-level providers replacing physicians are on the corporate and political agenda at the ABIM/ABMS, without doubt. Look at the history of the ABMS executives. Corporate lawyers not head some of the positions with strong ties to private equity.
Objectively, MOC is nothing more than expensive brainwashing where doctors have become transformed by hook and crook into highly conditioned captured clients of the ABMS. They are literally monopolists by any reasonable definition. Do or die, say the monopolist profiteers. On some legal documents they have been accused of racketeering. A reasonable assumption obvious to most physicians who toil as subordinates in a corporate matrix.
This do or die situation of forced MOC translates into physicians losing their ability to work or receive compensated from insurance. Do or else! And patients lose their doctors. Do or die? Patients suffer and may literally die, especially the severely ill and chronically ill. Senior citizens bear the brunt of MOC's diminishing returns with their frail health and comorbidities. Who benefits from this!
It's hard to fathom - even harder to swallow - that the most highly educated corpus of professionals in America are suppliant enough to enable MOC - slavishly and even fearfully accepting ABMS' illegal and unethical "do or die" mandates. Harsh orders and policies coming from ivory tower elites. Elites who comprise a powerful syndicate of propagandists working from panoramic offices and luxury suites shilling for corporate, political and special interests.
Only in the United States. No where else in the world do they force march their physicians through a system of torturous proprietary hoops. ABMS MOC® is internationally recognized as a torturous bridge too far.
When are American physicians going to wake up and do something together to end MOC.
Time to rethink or a time to end it?
https://www.kevinmd.com/2022/01/its-time-to-rethink-board-recertification.html
It appears that ABIM, being a 501(c)(3) and having answered "yes" on Section IV, line 2 they should have filled out who the contributor is (name of person) and the exact amount of the contribution (in dollars, euros, yuan, rubles, etc. depending on the source and offer the exchange rate at the time).
ReplyDeleteSee who must file and general rules with the specific instructions for a 501(c)(3)
https://www.irs.gov/pub/irs-pdf/f990ezb.pdf
Btw, on the IRS website, schedule B is not included in the filing for 2020. (2019). Per law, the ABIM must make their books available to the public upon request. I would think that if the CFO were asked about the restricted entry in question, he would be obliged to reveal it. (who and how much)
Under Part VIII line 1 there is an amount of $37,149 stated under other revenue referenced under 2(f) "all other contributions." Who does that refer to? Nothing is mentioned under schedule O with an explanation.
Given the "platinum transparency rating" ABIM has touted on its website, I'm sure the CFO would be delighted to take a diplomates call and answer any questions openly. (Or not. Many have emailed or called the ABIM with questions in the past only to be ignored or accused of being shrill in the case of a reputable investigative journalist.)
Why doesn't the CFO just offer an explanation in response to this posting? Right here!.
Anony- Practicing Physicians of America is fully aware that the ABIM has not published their Form 990 Schedule B. But that schedule B (which we have access to) has also restricted access to the name and amounts of their contributors to the public. A clever scheme to hide the facts. We are also aware that the ABIM’s Chief Medical Office came from PwC. We would appreciate a comment from him on these activities, too.
DeleteTake a look at Gustave Courbet's "The Origin of the World" hanging in the Musee d'Orsay. Hers is a crew cut.
ReplyDeleteRedacted/Restricted/Reduced Access
ReplyDeleteWhen public or private companies redact, restrict, or reduce access to what should be a matter of public record, what does that say to the public? It says volumes!
This results in an organization/company being stained with real and perceived conflicts of interest.
We logically ask, are they even operating within the margins of the law?
Critical misstatements on tax filings in the past indicate this. Huge transfers of millions of dollars in profits to a newly created 'foundation' gives more than a cause for pause. Critical misstatements relating to huge deposits of money that ends up creating a war chest and surfeit funds to boost or support the bulk of the egregious amounts of executive compensation doled out every year at the ABMS/ABIM.
Such questioning leads one to ask. Who owns and controls the ABIM/ABMS? Who profits from its existence?
It is certainly not the public. The patients are actually harmed by reduced access to care. (Think MOC and MOC money!) It certainly is not the "self-governing" in-the- trench physicians who are in charge or profiting. They are poorer in time and money as a result of this "big business" of quality measures and the policing/surveillance/data collection of physicians".
Who controls the ABMS organizations and profits then?
Is it big pharma? The insurers? Wall Street? The PwC's of the world. (Think ABIM's CMO!) Is it private equity? (Think ABMS' conflicted CEOs.) Is it the government? (Think Medicare, social security, MIC, Baron, Cassel, et al) What about global corporate structures and elite private interests? (Think Soros, et al with his front orgs 'Open This' and Open That' Societies. How about Gates Family Trust/Investments with their pharmacological global wonder machine. What about Klaus Schwab's of the world with their mantras "you will own nothing and be happy".
Or is it all of the above? (Think the PwC's of the world. They are indeed all over the globe in every place you can think of. And they have representation within the ABMS/ABIM, via the ABIM's CMO and past ABMS contributions/payments to Pwc for unspecified/obfuscated services.
Certainly the ABMS/ABIM has been steered in the direction of big corporations and Wall Street profits.
History shows this. The past relationships of the ABMS/ABIM with big tobacco was a fiasco, a public relations nightmare. A so-called "physician-led" organization/franchise supporting carcinogens in order to prop up corporate profits and Wall Street stock holdings. The ABMS/ABIM remain silent on their past transgressions. Obvious lies and mistruths concerning their active and passive support of cigarette addiction and cancer/heart disease. And they are silent on it even to this day. No apologies.
What about ABMS/ABIM's longstanding relationships with the NIH and its affiliates? Leadership at the ABIM/ABMS has always been extremely cozy in appointing revolving door corporates and political advocates. (Think all four past CEO/Presidents of the ABIM, the largest medical board in the ABMS. From Benson to Baron.)
Is the ABIM with its "restricted access" to contributions and names taking more than a few 'play action pages' and obfuscating cues from one of its large unofficial partners/affiliates, the NIH.
The NIH has been under fire for their vigilant obstruction and lack of transparency about contracts and contributions made to NIH scientists (including leadership) to the tune of $350,000,000.
https://www.openthebooks.com/substack-investigation-faucis-royalties-and-the-350-million-royalty-payment-stream-hidden-by-nih/
https://www.openthebooks.com/the-national-desk-nih-has-taxpayers-in-the-dark-as-scientists-receive-millions-in-royalties/
https://www.openthebooks.com/epoch-times-exclusive-nih-provides-brief-fauci-job-description-but-withholds-all-contracts/
ReplyDelete"ABIM is a physician-led, non-profit, independent evaluation organization driven by doctors who want to achieve higher standards for better care in a rapidly changing world."
Is there anything true in ABIM's statement? Not a word.
Mark Twain could have been speaking about prevailing physician attitudes toward the ABMS when he cynically said, "we have the best government that money can buy."
The only thing changing at the ABIM is the price they demand from physicians. It is always going up! It's bonus time again at the ABIM.