Saturday, April 25, 2015

ACC Issues "Urgent" Message, But To Whom?

The American College of Cardiology (ACC) leadership, troubled by the "complex situation" presented by the changes in re-certification by the American Board of Internal Medicine (ABIM), issued an "urgent message" yesterday on their blog.

This message hinted at the ACC's pathway forward: to create a "second task force" to "aggressively" explore "whether an alternative board should/could be developed by ACC for our members." They then add a cautionary note, stating "while working as rapidly as possible, we want to be cautious, realizing the great complexity of the situation."

So what are cardiologists and cardiac electrophysiologists to think of this latest "urgent message?"

It is clear that the ABIM's MOC program as it exists can no longer be considered legitimate. However, the ripple effects of the scandal of the ABIM and its Foundation are so far reaching that every single member board of the American Board of Medical Specialties' MOC constructs' twenty-four member boards will open themselves to scrutiny once the financial genie leaves the bottle.  It is not easy to unravel a monopoly when it's found to be (1) scientifically unfounded, (2) corrupt, and (3) profitable to the many leaders of these unaccountable non-profit organizations' leadership.

The era of the gilded age of non-profit organizations controlling medicine is coming to an end and every one of the scientific non-profit organizations that have hid behind their secretive walls for so long know it.

That's why this message was so "urgent."



james gajulte said...

The good news is that maybe the ABMS crowd's phoney-baloney jobs and schemes may be unraveling. The bad news is that the NQF is contracted to CMS to assist in writing quality rules with the CEO of that organization being a prime mover in both the Choosing Wisely scam and the MOC disaster.

DrWes said...


Yep, looking more "complicated" all the time, isn't it?

Paul Kempen said...

All the ABMS boards are reeling under the ABIM scandal AND the disclosures that Certification DOESN'T matter in any way. Here is the Urgent email from MY board for all to review. I am especially amazed by the "disclosure text" as follows here:"then destroy this email and refrain from any disclosure, copying, distribution or use of this information."

Dear Dr. Kempen,

In February, I informed you about the Maintenance of Certification in Anesthesiology Program (MOCA) redesign, known as MOCA 2.0. This initiative was inspired by diplomate feedback and technological advances that are allowing us to provide our diplomates with customized learning and assessment. Today, I'm writing to give you an update on our progress.

The ABA's board of directors, which is comprised of 12 practicing anesthesiologists and one public member, has been collaborating with a group of volunteer diplomates since early 2014 to build MOCA 2.0. It is a robust platform that will allow diplomates to participate in activities most relevant to their practices. We are still developing the platform and its program requirements, but wanted to share some of the following highlights:
The ABA will launch the MOCA 2.0 pilot on Jan. 1, 2016.

All diplomates who have certificates that expire in 2016 or later and who are participating in MOCA will be enrolled in the pilot. Non-time limited certificate holders are encouraged and welcome to participate, but will not be automatically enrolled.

The MOCA Minute application, an interactive learning tool that we began piloting in 2014, will replace the MOCA Examination as the Board's MOC Part 3: Assessment of Knowledge, Judgment, and Skills. You may learn more about the MOCA Minute application in the 2015 edition of ABA News.

As of Jan.1, 2016, simulation will become an optional Part 4 activity. We consider simulation a valuable education tool and will continue to strongly encourage it.

We are developing a variety of MOCA Part 4: Improvement in Medical Practice options that will give diplomates greater flexibility to complete activities relevant to their practice. The Board will award points to diplomates completing MOCA Part 4 activities based on the time and effort required to complete them. A minimum number of Part 4 points will be required for all diplomates participating in the MOCA 2.0 pilot.

We will share the details about the point system in the coming months.

There will be an annual $210 fee to participate in MOCA 2.0, which will replace the current $2,100 MOCA fee paid every 10 years.
MOCA 2.0 will eventually feature an online repository that will serve as a single source to store, retrieve and distribute certificates, licenses and other important documentation. These are significant changes that will help the ABA more effectively identify diplomates' knowledge gaps and steer them to targeted educational options that will close these gaps. We believe MOCA 2.0 will enhance patient safety and clinical outcomes.

We have been working on this effort since 2012 when we began exploring the idea of incorporating innovative technology to enhance the MOCA program. We still have some details to work through and will continue to communicate new information as decisions are made. The ABA will produce training materials in the coming months to get participating diplomates acclimated with the pilot program's features prior to its launch.

In the meantime, you may click here for MOCA 2.0 FAQs. If you have questions, please contact the ABA Communications Center at (866) 999-7501 or via email at for assistance Monday through Friday from 8 a.m. to 5 p.m. ET.

Rathmell signature.jpg
James P. Rathmell, M.D.

NOTICE: This message contains information that may be confidential and legally privileged. If you are not an intended recipient, please notify the sender immediately, then destroy this email and refrain from any disclosure, copying, distribution or use of this information. Thank you.

Anonymous said...

Thank you so much for this post. You read my mind!

The over-riding mantra at national ACC is "no margin: no mission". This translates to more missions: more margin.

The ACC sees a prime opportunity to move in on ABIM territory. National ACC gain a plethora of benefits including a captive audience of rich 1% cardiologists who will be dependent on the ACC for certification and an increasing importance in Washington DC where all power in medicine resides.

Within the national ACC, there is a cacophony of useful idiots clamoring for an independent pathway for cardiologists. These geniuses don't realize that this independence is de facto more dependence on an organization which claims to support cardiologists. In all reality, national ACC supports itself.

National ACC collects data on us like a tagged animal released in the wild to track migratory patterns. Remember that these are the Mensa masters who devised 'superior' guidelines in collaboration with ABIM in the form of Choosing Wisely. Sadly, these recommendations harmed patients when they were proven wrong. If this isn't the quintessential example of the danger of guidelines, I am not sure what else is.


Did you notice the claim that ACC is independent from ABMS? How can this be true when a past president of ACC admitted to serving on the ABMS board? This person is now a Trustee at ACC.

The prior CEO of ACC, Jack Lewin, climbed the echelon and moved over to TCT with his seven figure salary. What is his first move at TCT...hire Hillary to make a $300,000 speech.


Anonymous said...

but aren't you at least glad that sheepish doctors are talking about and maybe even devising a way to liberate themselves from the needless shackles of the ABMS/ABIM. Maybe you'd say out of the frying pan into the fire, but with starting afresh I think there's more of a chance for your voice to be heard before entrenched financial interests rule the day

DrWes said...

Don't underestimate the collective power of working US physicians to act effectively. Our voice is being heard and will only grow louder as more and more barriers to efficient, meaningful interactions erode our profession. The ABIM scandal is mobilizing working physicians like never before, and we are discovering that we have an open slate now to create a model that is in the doctor-patient relationship's interest, rather than the policy elite's.

Anonymous said...

Their message appears to be an attempt to stay relevant while the world passes them. Buy some time. Illusion of action. They are scared they are loosing control here.

Anonymous said...

If you falsely believe that the ACC is losing relevance, I invite you to investigate Operation PINNACLE. This will be part of meaningful use (MU-infinity). Sooner than you think, all of your patient records will be downloaded nightly from your EMR to ACC servers which will analyze your clinical performance so CMS can decide how much to penalize you.

The ACC is the de facto 'DOJ' of CMS for cardiologists. The ACC will collect money from the government for turning us in and collect money from your hospital for the privilege.

Sorry doctor, we have to cut your pay because our overhead has gone up (paying ACC) and because your didn't document that Mrs. Smith can't take statins because of muscle pain so CMS has fined you (VBP).

The ACC is the enemy. Do not be fooled into complacency!

Michael Gilbreath said...

You go Wes; a little well deserved recognition.

It will be interesting to see where all this goes. Everyone, including the ABMS and specialty societies, are watching and wondering.

Thanks to guys like you, Charles Cutler, Charles Kroll, and Paul Teirstein we’re closer than ever to meaningful change.

What needs to happen next is easy. We need to see a major hospital accept the NBPAS as a legitimate credential. Make no mistake that day is coming; but the sooner it happens the better. Hospitals are slow turning vessels and it’s going to take a lot of folks pulling on the rudder to get a big one to change directions. Still, I’m optimistic it will happen.

Physicians have wasted way too much money and time on this meaningless “MOC” process and the ABMS in general. We need choice. Its time we got back to real education and professional development. I’m grateful to all you folks for helping to expose this unscrupulous business for what it really is. Education has never been a consideration at the ABIM; it’s always been about the money. It seems the emperor’s wardrobe is sparse indeed.

Congratulations again,

Michael Gilbreath