Tuesday, April 07, 2015

Newsweek Takes on MOC: A Certified Medical Controversy

Mr. Kurt Eichenwald, a veteran Newsweek reporter who was chastized by the American Board of Internal Medicine (ABIM) for not mentioning his wife was an internal medicince physician in his first exploration of the medical re-certification controvery in medicine, launched a full-scale investigation into the covert financial practices of the organization:
What I found suggests that the primary reason ABIM attempted to expand its recertification process—which set off the uprising—is that the organization has been crippled by accounting games and needs a lot more revenue, fast, to avoid a fiscal train wreck. I also found misleading or false statements in government filings, attempts to withhold public information, damage inflicted on federal science programs and more. ABIM now even appears to be trying to trick Congress into passing laws that would force doctors to cough up cash to cover the organization’s financial follies. It even benefited from something slipped into Obamacare that seems to have been written by ABIM or its lobbyists.
Read the whole thing.

Methinks that both the ABIM and the American Board of Medical Specialties (ABMS) have plenty of explaining to do.  Sure sounds like a lucrative kickback scheme to me.


My initial story behind the MOC controversy.
The latest update on the magnitude of the controversy.
A critical review of one year's MOC "science" base
Which non-profit medical society pays themselves the most from MOC?
The Business of Testing Physicians


W.O.R.M. said...

Once upon a time, a physician could achieve life long board certification as a testament to having acquired the requisite knowledge and skills following a long, arduous training program. Implicit in this process was a demonstration of possessing the self-motivating qualities necessary to engage in lifelong learning. Upon passing a difficult written examination, one would be bestowed with the title of ‘Diplomate’ in their respective specialty. Worn as a badge of pride, it properly symbolized a pinnacle achievement, namely the Doctor as learned professional. It was earned, not unlike a formal academic degree, with no expiration date on its label.

In 1990, something happened. “Goodfellas” was released in the theaters coincident with the rise of a new mob mentality at the ABIM. Life imitating art. There was money to be made by a new generation of extortion sophisticates. Lots of money. Instead of guns and brass knuckles, these genteel wiseguys aggressively advocated for additional “voluntary” educational actvities for physicians wrapped around overbearing and career threatening intimidations. Nevermind that they were of no proven value. It started with board recertification. Intoxicated by money and power, these Dr. “Tommy’s” and Dr. “Pauli’s” pushed even harder with MOC requirements and political lobbying, effecting a codification of their schemes into the ACA. They moved beyond paying off the local judge and beat cop. So now, we are left with this:

Internal medicine/subspecialty physicians now have the ABIM as their certifying partner. Any hospital credentialing requirement problems, go to the ABIM. Trouble with an insurance panel, call the ABIM. Convincing patients of your qualifications, let them check you out at the ABIM. But to stay certified, he/she now has to pay the ABIM every couple of years no matter what. “Business bad? F**k you, pay me. MOC requirements taking you away from patients and your own family? F**k you, pay me. Insurance company reimbursements falling? F**k you, pay me.” It’s time we raise our voices and say “F**k you, we won’t!”

Anonymous said...

Seeing the ABIM complain about someone else's conflict of interest is the quintessential example of the pot calling the kettle black. Pure comedy.

Someone needs to do a study extrapolating the number of patients that were harmed by the erroneous Choose Wisely campaign stating the patients should not be revascularized after acute MI. Do you think that JACC would publish an article describing the lives lost because of their incompetence?

Michael G. Katz, M.D. said...

W.O.R.M., you need your own blog, or at the least a twitter account.

Anonymous said...

From the Newsweek article:

"That unnecessary first paragraph is necessary because ABIM apparently considers itself the enemy of doctors, since it believes a journalist with ties to physicians (me) must be biased against the organization."


“It is just shocking,’’ Charles P. Kroll, a certified public accountant who specializes in health care, says of the consolidated financial statements of ABIM and a related entity, the American Board of Internal Medicine Foundation. “I have never seen anything like it in my 35 years of accounting and auditing experience.”

Maybe Dr. Sinsky, Treasurer of the ABIM Foundation (and AMA Vice President for Physician Satisfaction) will make a comment?

Anonymous said...

Just got a letter from my alma mater saying that my BS in engineering would be revoked if I didn't come back to college and prove proficiency in calculus and heat transfer. They are charging me a large sum for this remediation and claim that it is best for society. The dean said that my diploma was 'rented' and not granted unconditionally.

Funny, my medical school said the same thing. I need to enroll in a weekend course to brush up on anatomy and biochemistry. The dean said that the Krebs cycle is making a come back.

Finally, if this wasn't bad enough. My residency program and fellowship directors left messages on my phone saying that I will have to round one weekend every six months or I will no longer be certified by their programs.

I am very thankful, though. It could always be worse with the elementary school, junior high and high school requiring proficiency. Wait, the phone is ringing...