Wednesday, July 01, 2020

Will the History of US Physician Board Certification Sink MOC?

In the closely followed Siva v American Board of Radiology (ABR) antitrust case (1:19-cv-01407), the Plaintiff recently filed an Opposition to Dismiss the First Amended Complaint (FAC) earlier this week. At issue in this case is whether intial certification and MOC are a single product or two separate tied products. In this newest legal docket entry, the Plaintiff added additional arguments from a recently decided Viamedia, Inc. v. Comcast Corp. antitrust tying opinion recently decided in the Seventh Circuit Court that demonstrates the importance of the history of US Board Certification is to the tying claim made by the Plaintiff:
ABR also virtually ignores the new Sherman Act, Section 2 tying opinion, Viamedia, Inc. v. Comcast Corp., 951 F.3d 429 (7th Cir. 2020), in which the Seventh Circuit reversed summary judgment for defendant, rejecting the same single product arguments ABR makes here. First, Viamedia holds that whether there is separate demand must be assessed before the tie is imposed, and not after. Viamedia, 951 F.3d at 469 (“the market must be ‘assessed at the pre-contract rather than post-contract stage’”) (quoting Philip E. Areeda & Herbert Hovenkamp, Antitrust Law: An Analysis of Antitrust Principles and Their Application, ¶ 1802d6, at 89 (4th Ed. 2018) (“Areeda & Hovenkamp”)).

This guts both premises of ABR’s single product theory: (1) that certifications should be analyzed post-MOC, with MOC viewed as a component of a “multi-stage” process (ABR at 8), rather than before ABR imposed its tie forcing radiologists to buy MOC or have their certifications revoked; and (2) as to MOC, “the relevant inquiry” is whether there currently is conflated demand for a single CPD product (MOC) and certifications as a result of ABR’s tie (id.), rather than inquiring whether there was separate demand by radiologists for CPD products before ABR tied certifications and MOC. See Viamedia, 951 F.3d at 469 (consumers “viewed the services as separate prior into entering into their present [tying] contracts with Comcast”). The Viamedia imperative to assess demand before the tie makes perfect sense because focusing on demand after the tie is forced on consumers inevitably rewards the defendant who has already successfully reduced competition, the very goal of the illegal tie. Viamedia makes clear that a defendant like ABR who forces consumers to purchase a tied product, cannot then parlay its own coercion into evidence of lack of separate demand for a product that the victimized consumers would not otherwise purchase, exactly what ABR argues here. (ABR at 8-9, 11).
Additionally, the new brief suggests the adhesion contract physicians must sign when enrolling in MOC (or one of its Continuous Professional Development (CPD) successors) are irrelevant to the antitrust issues being decided by the court:
ABR argues repeatedly that Dr. Siva “knew” from “the outset” based on a “contract” that MOC was tied to certifications. (ABR at 3-4, 10, 11). In doing so, ABR misrepresents information and documents about MOC that Dr. Siva received “after he purchased his certification.” (¶ 255; emphasis added).7 Dr. Siva alleges that neither his application for certification nor the certificate itself referred to “initial” certification or to MOC. (¶¶ 250, 252- 253). (emphasis mine) The FAC also alleges no contract obligating radiologists to buy MOC; nor does any such contract exist. Radiologists are forced to buy MOC because if they do not, ABR revokes their certifications, without which a successful medical career is impossible.

At any rate, ABR’s argument is a diversion. Awareness that a tie exists when the tying product is bought does not make the tie any less coercive. Radiologists’ knowledge of ABR’s monopoly power and leverage cannot absolve ABR of its illegal tie.
There is no question the heat is being turned up of the American Board of Radiology and this new legal precedent set by Viamedia prioritizes the importance of the history and original intent of board certification (that is, of assuring adequate residency training) is an important factor in establishing the illegal product tie that ABR has leveraged with MOC against its diplomates for their financial benefit.

ABR has approximately three weeks to respond to these latest arguments.

-Wes

PS: Physicians wishing to help the ongoing legal efforts to end MOC for all subspecialties are encouraged to contribute to the GoFundMe page created to support the plaintiffs.

Monday, June 08, 2020

How MOC is Contributing to the Demise of Physicians

Dr. Torie S. Sepah, MD on the KevinMD blog:

Now, one could argue, what’s $500 a year to a physician? Well, it adds up to $5,000 in ten years, at which time I’ll shell out another several grand to take the recertification exam.  Contrary to popular belief, physicians aren’t exactly rolling in the dough. In fact, 8 out of 10 physicians under 40 carry over $150,000 in medical school debt.  It all adds up: the medical license fee, the DEA fee, the specialty association fee.  Is this extra $5,000 really necessary, and if so, what is it for?

Here’s what it is not being used for, to protect what our board certification stands for.

My board certification in psychiatry doesn’t mean much these days because NPs and PAs are also board certified in psychiatry without attending a medical school, completing an ACGME residency program, passing the three-part oral exam in order to become eligible for the written exam in psychiatry, and of course not participating in MOC or taking our rigorous written exam every ten years.

To make sure that the world knows they are board-certified, they often embroider it on their white coats. And now, in 24 states, they can practice medicine independently with board certification in a specialty like psychiatry.

More physicians are waking to multitude of harms caused by Maintenance of Certification (MOC).

This is why multiple antitrust lawsuits have been filed against the ABMS member boards. Right now, the American Board of Radiology has filed a Motion to Dismiss the first amended complaint filed in the lawsuit against them. They argue that MOC and initial certification are all one product (certification) and therefore the anti-trust claim filed has no merit. As physicians, we know better. The detailed 79-page amended complaint explains the differences of initial certification from all other "continuous professional development products" (like CME, MOC, "continuous certification" and NBPAS recertification) and explains why ABR's contention that MOC and initial certification are one product is wrong on many levels. We'll see if the judge in that case feels the physician plaintiff has sufficiently argued his case to move this case to discovery.

The American Board of Internal Medicine also had the original District Court lawsuit dismissed. But that first-pass lawsuit has now been appealed to the Third Appellate Court. That appeal adds lots of new evidence supporting the differences between initial certification and the "continuous professional development" program that is MOC and the ABIM's monopoly control, racketeering, and unjust enrichment that has followed as a result. The ABIM response to that filing is currently due July 6th.  

Our own medical boards have repeatedly poked a sleeping bear with MOC payment and testing requirements. Those requirements have harmed physicians and limited access of care to patients. While this is not an easy path to find justice, the best victories are those that are hard fought with lasting and meaningful results.

-Wes


Tuesday, May 05, 2020

Appeal Filed in Physicians' Ongoing Lawsuit Against ABIM

"ABIM has created a lucrative new revenue source by forcing internists to buy MOC. The new MOC revenue has not been used in the interests of the internist community, but to serve the economic interests of ABIM management, including overly generous compensation, ABIM’s lavish pension plan, and purchase of a $2.3 million condominium used by ABIM management."

- From the Brief of Plaintiffs-Appellants filed yesterday
It was almost six years ago the story of ABIM's $2.3 million condominium was told. It was a tale of corruption, greed, and the laundering of physician testing fees to create the ABIM Foundation using the smokescreen of repeated physician testing called Maintenance of Certification (MOC®) as a mark of a physician's "professionalism." Working physicians, however, knew better. They felt first-hand the financial and emotional toll this ever-changing program caused. MOC® was always about the money, but most physicians were too afraid to speak up lest they lose their jobs. Today MOC® remains a story of adhesion contracts to force payments to the numerous conflicted interests of the medical publishing, credentialing, device, pharmaceutical, and hospital supply line industries in exchange for the physician data it generates.

The irony of Richard Baron, MD, President and CEO of the ABIM and ABIM Foundation discussing disinformation on Fox News from the comfort of his own home is lost on few US physicians. So is the irony that the insurance industry is poised to make a windfall on the unaffordable insurance law they helped author.

These conflicts have come at a very stiff price for many United States physicians, nurses, and medical technicians who toil on the front lines without sufficient personal protective equipment (PPE) today. MOC® and the data entry it required fed Group Purchase Organizations and the insurance industry the data they needed to squeeze the suppliers of materials and the suppliers of care. As Siddhartha Mukherjee, MD, DPhil explained in his recent New Yorker article, its all a game of assuring a sizable profit margins for these the little-known supply line organizations who receive kickbacks in return for their efforts:
“Hospitals typically don’t order masks as individual buyers,” he told me. He spoke deliberately, with the slightest Texan drawl. Instead, they negotiate contracts as members of a Group Purchasing Organization—representing hundreds or thousands of hospitals—and, as Bowen explained, the G.P.O. always “chooses the cheapest bid.”
Yesterday the Brief of Plaintiffs-Appellants was filed in the 3rd Circuit Court of Appeals against the American Board of Internal Medicine (ABIM) regarding MOC®. In that Brief, the physician plaintiffs argue that the earlier District Court erred in dismissing (1) the anti-trust tying claims with prejudice, (2) the monopolization claims, (3) the racketeering claims, and (4) the unjust enrichment claims made by the plaintiffs concerning MOC. The details of the clearly-written 78-page brief argue why.

As health care workers struggle to cope with our current US supply line shortcomings, the US physician MOC® story takes on new meaning. Now more than ever, US physicians deserve their day in court concerning the exploitation they have endured because of MOC®.

If this case finally proceeds to discovery, we might just find the real truth about MOC® after all.

-Wes

P.S.: Working physicians are encouraged to contribute the the GoFundMe page supporting the physician plaintiffs in this ongoing case.

Sunday, April 26, 2020

Two ER Physicians Lend Their Opinion on Reopening the Economy

Addendum: YouTube brought down the videos included in this blog post because they claimed it violated their terms of use. I found that very disturbing that non-anonymous US physicians were silenced during these unprecedented times. I believe we should promote (and not silence) legitimate, respectful, critical debate. Whether right or wrong (and certainly many of the facts delivered have been thoroughly debunked by others) their viewpoint opened peoples' eyes.

Because nothing is erased on the internet, readers will find links to the videos on a different platform below the YouTube video placeholders.
"Typically you quarantine the sick. When someone has measles you quarantine them. We’ve never seen where we quarantine the healthy."

"We’ve tested over 4 million… which gives us a 19.6% positive out of those who are tested for COVID-19. So if this is a typical extrapolation 328 million people times 19.6 is 64 million. That’s a significant amount of people with COVID; it’s similar to the flu. If you study the numbers in 2017 and 2018 we had 50 to 60 million with the flu. And we had a similar death rate in the deaths the United States were 43,545—similar to the flu of 2017-2018. We always have between 37,000 and 60,000 deaths in the United States, every single year. No pandemic talk. No shelter-in-place. No shutting down businesses…"

Dr. Daniel W. Erickson of Bakersfield, California, is a former emergency-room physician who co-owns, with his partner Dr. Artin Massih, Accelerated Urgent Care in Bakersfield, CA north of Los Angeles. They conducted a press conference regarding their opinions about reopening the economy and withstood many challenging questions by a hostile press. I encourage my interested readers to watch the entire hour-long press conference:





Addendum: Links to the above videos can be found here:

Part 1: https://vimeo.com/412698864

Part 2: https://vimeo.com/412699764
In a follow-up ABC news piece it is also interesting to note, "Dr. Erickson also claimed that state health department officials also agreed with his statements about reopening. 23ABC News reached out to the state to see if officials agree with Dr. Erickson about reopening and they have no(t) responded back."

We should acknowledge these physicians test patients and have a vested interest in doing so. Whether testing will ever really clear the way toward reopening the economy is debatable in my opinion, given that every test has false negative and false positive results. Yet testing is the popular narrative now.

As we sit in our living rooms staring at Netflix as the economy begins to creak forward, perhaps we should ask ourselves when we're told our salvation will occur after we test billions of people worldwide (which will never happen, in my opinion), who stands to benefit? Likewise, who benefits by promoting more fear and the isolation/distancing narrative?

-Wes

Saturday, April 18, 2020

Rethinking the COVID-19 "Pandemic"


The front page headline of the Wall Street Journal this morning read: "Stocks Rally in Face of Downturn."

Why?

Perhaps they know something we don't? Or have we been too manipulated by fear to look critically at what has just happened thanks to a little-known RNA virus?

I realize that most of the blog posts here lately have been critical of the American Board of Medical Specialties and their 24 subsidiary medical specialty boards, in large part because they rely on rote memorization of trivial facts as a means of gauging physician "quality" and "professionalism" (as they have deemed to "redefine" the term in their 2002 widely-published self-written white paper). Clinical experience gained only after years of complicated and uncertain patient interactions has always been immaterial to these rent-seeking data-collecting medical specialty member boards. But what I'm focusing on now is something much more important for the practicing physician that can't be measured by a standardized test: the ability to think critically in the face of the unknown. After all, most new patient encounters require the ability to assimilate vast amounts of information and distill it clinically for the benefits of an individual patient that has an infinite number of possible clinical co-founders.

We have to remember that 27-year old journalists and younger brilliant physician sycophants of the computerized test, as much as they may mean well, can be easily manipulated by political, economic, and social agendas that have been engrained in our society for years. As clinical physicians, is our job to listen to politicians and economists and those young physicians, or to think critically about an incredibly complicated non-linear (and non-exponential) biologic event that has just swept the world and resulted in the shuttering of so many economies and left over 22 million unemployed in the United States alone?

In the beginning of this evolving WHO-defined pandemic, the world were enamored with mathematical models from economists and pundits based in complicated assumptions - most of which were (quite frankly) guesses and never truly gauged to existing well-known viral illnesses like seasonal influenza. The World Health Organization (WHO) proclaimed early on that this new coronavirus had an incredibly high 3.4% mortality rate. New phrases were quickly introduced into our daily vernacular by the mainstream and social media like"flattening the curve," and "social distancing" as images of refrigerator trucks to house the dead were pushed to our cell phones. But that mortality statistic, we're now finding, was markedly overblown.

Perhaps more important is the way this virus has managed to seek out and impact the most medically vulnerable of our populations: those in close living environments or the socially disadvantaged with serious preexisting medical conditions like obesity, diabetes, lung disease, heart disease, cancers, and blood dycrasias. The elderly in particular, have been remarkably vulnerable to succumbing to COVID-19, in large part because they carry these preconditions far more frequently than younger patients. Health care workers, too, see a skewed population that can seem overwhelming at such a time since we are subjected to an unknown pathogen with an uncertain transmission, prevalence, and unknown lethality. We see the people dying and our bias is reinforced: this must be something BIG.

So how do we gain perspective and reliable data? Do we turn to mainstream media, or print scientific journals that are slow to react and limited in their scope, or do we turn to each other knowing each of us is struggling with the same unknowns? Or maybe that, too, is complicated.

Fortunately, thanks in large part to the internet, the world is quite literally, our oyster. It is time as one British pathologist John Lee has appropriately suggested, that we begin to examine the evidence with "skepticism and vigorous debate." The COVID-19 death toll, and how it relates to our more typical seasonal flu that often impacts hospitals, is far from clear. There is nuance involved in proclaiming a death rate when those dying from a virus are intermingled with those dying with a virus.

Clinical physicians should begin to critically question our national narrative, given these recently updated facts regarding the COVID-19 pandemic from a Swiss physician, each of which are carefully referenced. Look them over. Carefully. Perhaps putting the current situation in perspective from other parts of the world will be more helpful to our patients and their economic and psychologic strife than  taking remarkably expensive and unproven computerized tests created by unaccountable bureaucrats that mean absolutely nothing.

-Wes

Image above from: Lee, J. "How to understand - and report - figures from "COVID Deaths."

Friday, April 17, 2020

COVID-19: A Way Forward

Since the beginning of the coronavirus pandemic and the ongoing Personal Protective Equipment (PPE) shortages I have quietly wondered, "Where is the American Medical Association (AMA)?" Why weren't health care workers and their patients the FIRST consideration of the AMA rather than the making of CPT codes? Is it because the words "physician" and "patient" do not appear in their mission statement?

With an estimated 22 million people currently unemployed in the United States and with states making plans to reopen their economies, a medically cogent path forward out of this pandemic is desperately needed.

It is with that background that I had the opportunity to read this opinion piece by Paul Kempen, MD, PhD that I took the liberty of republishing here. Admittedly, there are no perfect answers right now, but we all need to do our part to bring some semblance of normalcy to our lives again since this situation is likely to continue for some time (I have taken the liberty of making minor edits and have added a few hyperlinks for clarity):

Personal Health is a Personal Responsibility to Enable National Health

Paul Kempen, MD, PhD

"It really amazes me as a physician and health care expert, that while the government and general population expect doctors, nurses - yes, ALL hospital health care workers (HCW) down to the janitor - to go to work every day to care for severely and clearly infected patients, the expectation that the general population cannot even perform daily tasks in low risk environments seems severely misplaced. Being out of doors has even been declared “illegal” in some places. We have seen the country “closed for business” and production capabilities, lives and personal welfare, decimated. If all HCWs are able to work in clearly infected environments, why are citizens unable to protect themselves in low risk environments? Why are there not clear and effective educational and production mechanisms for ensuring regular daily living activities promoted in all media at this time? I have NEVER seen a public educational clip on HOW to correctly wear a mask but have repeatedly seen “experts” without and improperly wearing masks. Are factories and businesses still (really) unable to provide PPE and distancing between workers? WHY? If we can put a man on the moon, we cannot provide education and PPE?

Of course, the lack of Personal Protective Equipment (PPE) has been the serious issue. Government/CDC/WHO “Expert Action” has been unable to address to date the singular outstanding shortage of N95 masks, gowns, and hand disinfectant, or provided accurate and specific instruction/education on personal protective measures. Instead, concentrating on ventilator production (to treat disease) and “testing” to identify infections remains “the answer”. In medicine, we typically test to identify infection based on symptoms - as a healthy, negative tested individual is not protected by the test (due to false negatives) and can become infected by those providing tests to hundreds per hour.

These deflective and reassuring measures apparently resulted politically from “overstated need” by “hot spot Governors” looking for “quick answers” and sound-bytes. Even our CDC “health care experts” got it wrong (or was this merely political decisions): CDC statements initially recommended that civilians should NOT wear masks (because of the shortage), when clearly, masks are the single most important protection against air-born, respiratory infection dissemination. The first thing I personally did when I heard of COVID in January was to order ten N95 masks. Even today, 4/16/2020, three months after the first diagnosed infections were reported in January, this country still does not have enough N95 masks for every citizen. Why? Sending in Navy Hospital ships to NY and LA flies in the face of “Carnival line contagion” episodes: After admitting only 40 patients, the USNS Comfort was infected. The USS Mercy was similarly infected. Will it be also “quarantined”? The medical personnel would have been better utilized on land based stations - but that big red “X” would have not been able to provide the political statement and reassurance in NY harbor.

We have been through infectious hysteria before: The HIV epidemic in the 1980s, which led to important “universal precautions” for self-protection. The SARS (2003) and MERS (2012) Corona infections occurred and should have led to testing and treatment mechanisms decades ago. Flu epidemics occur every year and kill 30-60,000 people-just like COVID and our lessons here should be applied for all future flu seasons-which are coming. Needed measures now include production and education to enable return to economic stability - the ONE essential of any country “at War”:

Instead of forcibly pulling citizens without masks off of a subway train, the CDC and government experts should have ramped up N95 mask production in January to insure at a minimum, one N95 mask per citizen per week. (Editor's note: To be fair, hind sight is aways 20/20) Make N95 masks universally available at no cost to everyone now, including child sizes. They can be disinfected repeatedly by baking at 180 degrees F for 30 minutes. This should NOT require 30 days for each state to insure production for each member of state’s society. (This is much cheaper than $1,200 checks for every tax payer!) Educational commercials should appear hourly and instruct ALL citizens how to wear masks appropriately, the difference in mask types and identify mask type abilities to protect you. Mandating everyone appearing on television to be wearing appropriate masks correctly, as examples to foster compliance, is as possible as legally forcing everyone on an airplane to undergo instruction on how to fasten a seat belt in 2020.

Surgical and home-made masks catch (only most) personal, exhaled droplets and protect to a limited degree those around you. N95 masks will, when correctly worn, eliminate 95% of particles in your INHALED air from reaching you if worn correctly. HCW are “fitted” for N95 masks when hired under OSHA mandates, that is, specifically instructed in proper use. Civilians need this instruction also.

Cut your beard off, shave daily to maximize N95 mask “fit” and effectiveness. Wear masks at all times when not alone and do not touch your face unless immediately after hand washing. Wash your hands frequently (whenever possible contamination occurs), shower and change clothing daily to reduce personal contamination.

If you show signs of infection, contact your doctor for definitive advice and wear at minimum a surgical mask at all times while avoiding others. DO NOT go to hospitals or drive through testing sites if healthy - these sites are high risk areas and those testing hundreds of civilians per hour may well be a significant vector for transmission from infected to those heathy. The tests require invading your body and with unknown hygiene - i.e. out there on the streets where there is no ability to wash hands between individual tests (and I am sure they do not change PPE between each person, given the shortage).

Testing, currently unavailable and with unknown reliability, should be reserved for those with probable/known infection and done in facilities with hand washing between individual tests, unless self testing kits become readily available and are dropped off/mailed in bio-infection labeled and protective packaging (which seems unlikely or reliably possible for general populations).

In addition, we should be testing ALL deaths for COVID presence, instead of declaring all deaths automatically as COVID, as appears to be the current methodology. This is needed to yield REAL numbers.

Insure production of ALL treatment/prophylaxis drugs in sufficient quantities and allow doctors the ability to practice prevention, prophylaxis and treatment tailored to the individual patient and their wishes with all available products - including “compassionate” and “off label” prescriptions.

Serious COVID infections occur in under 5% of all infections. Healthy children and young adults appear resilient. Release this mostly-healthy “herd” now, or when the “surge” is over and create the “herd immunity”. In any “war” the young and healthy are sent to fight and maintain the economy, but please, also provide the needed weapons to them (masks and sanitizers). They will volunteer! Perhaps this group is resilient because they are self-immunized by yearly non-lethal common cold coronavirus encounters which account for 20% all yearly colds creating crossover immunization/disease mitigation.

It is time we all recognize your health is YOUR responsibility. Quit smoking, overeating, passing “joints” and crack pipes and other high risk behaviors. The “opiate epidemic” suddenly disappeared from the news with the COVID19 emergence but it is not gone! As a nation, we must insure our economy and production to maintain wartime abilities. Not just tanks and jets, but drugs, testing, ventilators and PPE should have national priority for “in-country” self-sustaining production. Most drugs marketed in the USA are made from Chinese imported materials at this time. This must change. We must take charge of ourselves and our national security in war and disease. We must stop the media and government hysteria and work with facts, real facts, and not politically motivated reassurances made in the moment as acts of reassurance. Restart the economy to provide PPE and drugs tomorrow for all who need them.

In 1933, the worst year of the Great Depression, President Franklin Roosevelt stated in his inaugural address: “So first of all, let me assert my belief that the only thing we need to fear is fear itself - nameless, unreasoning, unjustified terror, which paralyzes needed efforts to convert retreat into advance.”

This was great advice then and seems especially pertinent on 4/16/2020 before we create another modern great depression. If we are at war, we need our economy to provide for the common good and protection of life, liberty and the pursuit of happiness. The media must be used to serve the people and not continue to create paralyzing terror."
I welcome thoughtful comments to this piece.

-Wes

Tuesday, April 14, 2020

MOC's Irrelevancy To Public Unmasked In Time of Crisis

With the collapse of testing center availability, travel bans, and growing physician clinical demands, the American Board of Medical Specialties' lucrative Maintenance of Certification® program recently proved how unnecessary it was to the public's wellbeing as each of the member boards followed the ABMS's announcement shuddering its entire Spring examination schedule and many maintenance of certification and continuous certification exercises for all medical subspecialties.

The American Board of Family Medicine, which enjoys the richest balance sheet of any ABMS member board with assets of over $137 million dollars, seems to have a hard time letting go however. The ABFM released this multi-page tortuous statement, portion of which is published below:
Changes to Certification Deadlines

At this time, ABFM has made the following accommodations to the deadlines for your continuous certification participation:

All Diplomates with a three-year stage ending in 2020 will have a one-year extension on completing all stage requirements.

For Diplomates participating in FMCLA, the Quarter 1 deadline has already been extended through June 15, 2020; we anticipate extending completion guidelines further for subsequent quarters. For first year participants, we will adjust the meaningful participation guidelines.

Any Diplomate in Year 10 of their certification cycle who opted for the one-day examination will have an additional year to meet their examination requirement.

Any board-eligible family physician with an eligibility end date in 2020, or anyone participating in the Re-Entry process with an end date in 2020, will have an additional year to obtain their certification.

Any Diplomate who also holds a Certificate of Added Qualification with an examination deadline in 2020 will have the option for an additional year to complete the examination requirement.

For those facing financial hardship as the result of the pandemic, we will establish a method for delaying 2020 payments. This will take a short time to be implemented online, but once available, Diplomates will find information about this in their Physician Portfolio.

These extensions do not prevent anyone with a 2020 deadline from staying on the current timeline. Certification activities will be accessible for anyone who wants to use them.


Certification Stage Activity Requirements

We are continuing our efforts to improve our current Knowledge Self-Assessments (KSA) and will begin to support learning on COVID-19 as evidence becomes more available.

Specifically related to the Performance Improvement (PI) requirement, we will be providing a mechanism to meet the PI requirement by telling us about the unprecedented and rapid changes that you had to make in the ways that you deliver care, regardless of practice type or scope.

An extension has been granted to the first quarter deadline for anyone who is utilizing Continuous Knowledge Self-Assessment (CKSA) as part of their certification activities. The deadline to complete your current quarter 25-question set has been extended from March 31 to June 15, 2020. As the experience of the pandemic evolves, further extensions may be needed.

Any Diplomate who had planned to participate in a Group KSA that has been canceled or postponed can still do the activity online in their ABFM Physician Portfolio. The same certification points and CME credit will be applied as if it was done in a group setting.

Seriously?

Let's keep the magnitude of what frontline doctors are doing today in the care of patients during the COVID-19 pandemic, shall we? The above gibberish should be simplified to the following:

"Any ABFM diplomate caring for patients between 1 Feb 2020 and 1 July 2020 and holding a valid medical license to practice medicine while risking their lives and the lives of their loved ones on behalf of their patients during the COVD-19 pandemic has hereby demonstrated all the skills, professionalism, fortitude, and leadership required to establish themselves as a physician in good standing for a lifetime and will receive lifetime certification from the American Board of Family Medicine without restriction. Self-selected continuing medical education for ongoing education, as required by their respective state licensing boards, will be all that is required of these exceptional physician professionals thereafter.""

Instead, the American Board of Family Medicine seems hellbent on proving just how irrelevant, greedy, insensitive, and distracting they are to the care of our patients in this time of unprecedented physical, psychological, and economic need.

-Wes