Antitrust 101: How to Build Medical Monopolies by Discrediting U.S. Physicians

Recently, there have been a rash of initiatives by unaccountable non-profit physician credentialing organizations (Federation of State Medical Boards, the American Boards of  Internal Medicine, Family Medicine and Pediatrics), and the American Medical Association to come to the public's rescue by de-credentialing U.S. physicians they accuse of spreading misinformation during the COVID-19 pandemic.

Physicians have seen this medical monopoly-building playbook before.

The video below reviews the antitrust, monopoly-making activities of the American Board of Internal Medicine (ABIM). The discrediting of certain U.S. physicians as "cheaters" and disseminators of "misinformation" serve as a smokescreen to their monopoly-building activities. As physicians worked tirelessly to care for patients during the COVID-19 pandemic, the ABIM used U.S. physicians' testing fees to redistribute physician testing fees for their "social justice" initiatives, most significant of which was lobbing Congress so their separate Maintenance of Certification (MOC) continuous testing produt would be a never-ending source of revenue and data metrics used by the Medical Industrial Complex. Sadly, this mandate on younger, more vulnerable ABMS-board certified US physicians has harmed hundreds of physicians and tens of thousands of patients as physicians burn out and leave the profession.

For all patients who wonder why health care prices are so high and access to a board-certified physician has become so difficult, look no further than the organizations above. 

What Entity or Person Serves As ABIM's "Restricted" Contributors?

 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).

Can There Ever Be a "Kinder and Gentler" MOC?

It has been a long time since I have written anything concerning the American Board of Medical Specialties' (ABMS) Maintenance of Certification (MOC) board re-certification program. But when I read pieces in the media, like the one recently published in Medscape that spin the soothing narrative that MOC can become "kinder and gentler," I feel the need to speak out.

Like a child bring groomed by serial molester, the media miss the seriousness of the harms imposed to physicians and patients by the industry-levied Maintenance of Certification mandate begun in 1990, largely because patients and the public really don't understand US physician board certification and the conflicts of interest with industry that exist. The public knows they want a "board certified" physician (thanks to the marking muscle and self-generated congratulatory "research" articles generated over the years by these multimillion-dollar organizations), but they fail to realize that board certification, once little more than a voluntary lifetime marketing accolade before 1990, became time-limited, mandatory, and an economic necessity for physicians to work, have hospital privileges, or be included in insurance panels since then. 

This change from a lifetime accolade to a time-limited necessity for physicians was unilaterally imposed on (only) US physicians by the highly conflicted and highly political ABMS and their member boards in conjunction with their parent organizations (where the ABMS is also a "member organization") from the Accreditation Council of Graduate Medical Education (ACGME), including the American Medical Association (AMA), American Hospital Association (AHA) and the Association of American Medical Colleges (AAMC). Thanks in large part to the nuances of often-delayed non-profit tax filings, all of these organizations enjoy their tax-exempt status and multi-million dollar budgets on the backs of working US physicians who are the major source of their funding.

The seemingly impenetrable nature of medical journal pay-walls has served to perpetuate the ruse of the scientific validity of time-limited US board certification. There is simply no scientifically valid proof that "longitudinal assessment" questions pushed to physician cell phones or taking day-long tests every 10 years improves patient care. Could it be these actions distract from patient care just to keep the money flowing?

More importantly, patients suffer as physicians become burned out or quit. Patients suffer as the boards  sell all the physician data they reap from that testing to Group Purchase Organizations (like Premier, Inc) and hospital organizations (like Kaiser) that increasingly consolidate and limit access in the name of lucrative health care "efficiencies."

The monopoly stranglehold on US board Certification (and specifically time-limited "Maintenance" of Certification, or MOC) and the vast conflicts of interest and millions of dollars it generates, is why the ABMS member boards are being sued right now. Their actions, I (and thousands of others) believe, violate anti-trust and unjust enrichment laws. It is not okay that a physician with years of dedicated service to his or her patients can lose their job or ability to care for their patients based on an unproven testing mandate. Nowhere does a physician's years of experience count to these AMBS member boards; only their money.

This is why I, along with many other men and women, help co-found Practicing Physicians of America, a non-profit 501(c)(6) organization, in part so we can work collectively to attempt to end the monopoly status of the American Board of Medical Specialties and their member boards on US Physician board certification. We hope that justice can be served to the hundreds (and perhaps thousands) of physicians  harmed by this discriminatory mandate imposed on us since 1990.

Physicians wanting to learn more or want to help can e-mail me at wes - at - practicingphysicians dot org. Donations for our work can be made at http://www.gofundme.com/practicing-physicians-of-america or (if you don't want to use GoFundMe, mailed to our organization at the following address:

Practicing Physicians of America
876 Loop 337 Bldg 101
New Braunfels, TX 78130

-Wes