Friday, July 03, 2015

Lipstick: ABIM Announces Changes to MOC Program

A coordinated announcement between medical specialty societies and the American Board of Internal Medicine (ABIM) was made recently changing the American Board of Medical Specialty's (ABMS) trademarked Maintenance of Certification® program requirements (again) for select subspecialties in Internal Medicine. "Unanimously passed" by a group of well-meaning physicians in a new creation within the ABIM called the ABIM Council, diplomats in nine subspecialty areas of internal medicine will no longer need to maintain underlying certifications in those areas as of 1 January 2016.

Unfortunately, you can't put lipstick on a pig.

The regulatory world of medicine has become a self-reinforcing, patronage system consisting of multiple non-profits and regulatory professional organizations. When fifteen professional societies  collaborate with the ABIM to spit out a sacrificial lamb in an apparent act of appeasement, practicing US physicians are supposed to relax, shake hands and move on. Appeasement is not transparency. Minimal change is not profound reform.

This testing issue is just the tip of the iceberg in the exploitation of practicing physicians. The ABMS MOC® program is a complicated, intricate physician re-certification scheme that appears to be little more than a special interest employment bureau happy to shower itself with creature comforts and benefits at the expense of those who do the dirty work of patient care. As such, the MOC® program has created a corrosive divide within our profession that has even gained notoriety in the New England Journal of Medicine. It also now regulates the employability of an increasing number of physicians. The ABMS and American Hospital Association,  both part of the Accreditation Council on Graduate Medical Education (ACGME), have required this unproven MOC® metric for hospital credentialing of physicians dependent on employment by those hospitals. The program has become so embedded in the medical regulatory culture that it's even found its way into our new health care reform law. When examined on this scale, removing a requirement for taking two MOC® re-certification examinations instead of taking just one seems aimed at deflecting further scrutiny.

Practicing physicians need to remember that there is much more to the MOC® program than computerized educational modules, secure examinations and paying fees. The program affects physicians' ability to practice their trade and leaves physicians at risk of sanctions for revealing trade secrets of the ABMS and ABIM. Until the anti-trust suit against the ABMS and ABIM is resolved and the IRS fully investigates the fraudulent reporting of the origination date and domicile of the ABIM reported on tax forms, subspecialty organizations should not require re-certification programs created by the ABMS or ABIM.  Are we holding our specialty societies to this standard?

Otherwise, they're wearing lipstick, too.



Anonymous said...

It is time to insist that the Board of Trustees at the ABIM and Rich Baron step down as a matter of NO CONFIDENCE from the Diplomates it serves. Once the DOJ, IRS and Pennsylvania AG finishes vetting their suspicious financial activities, the ABIM will be dismantled fully and reconstructed using ethical, honest and clinical physicians. This appeasement policy is more akin to a full blown strategic retreat. And where is the ACGME? Why are they not serving the interests of the housestaff? Shame on them for colluding with the ABIM.

The time to purge our health care system of the non clinical, administrative physicians has come. It is time to cut off the dead weight.

Anonymous said...

I guess we're to feel all warm and fuzzy over this magnanimous act.

Expect more dancing around and continue to avoid the problem- MOC and the palm-print "secure" exam.

Between anger from 23000 of their best customers, a federal antitrust lawsuit, investigations into their finances from the feds and PA, and competition from NAPAS , they are up against the ropes and going down soon.

They just don't realize when you bludgeon and abuse people , you're not going to get much sympathy. No one believes anything they say or do.

Bye Lois.

Anonymous said...

In my next life...

I want to be Lynn Langdon an assistant to the abim president.... $690,000 in 2011

Or the ABIM biostatistian Rebecca Lipton $350,000in 2011

This is a very generous organization.

its ok...everyone reading this paid for this outrage.

Wait till the IRS looks at these salaries from a 501-c-3.

drrjv said...

Another nice article on MOC shenanigans:

Michael Ciampi, M.D. said...

I wonder if ABFM thinks it can skate by because they have a much higher pass rate than ABIM? They have dug in, stating that while ABIM may be troubled, there are no skeletons in their closet. Even if they don't, the lesser of two evils is still evil.

As a DPC physician, I do not need MOC any more for to contract with insurance companies or admit to the hospital. I will let my cert. expire at the end of this year. The only problem on the horizon for people in my situation is if the FSMB pushes through the Interstate Medical Licensure Compact, requiring MOC for licensure.

You would think that states would never consider such a proposal because 1) they would be sacrificing the autonomy of their own state medical boards, and 2) they would be revoking licenses of thousands of very good and experienced physicians in the midst of a critical shortage. Unfortunately, recent events demonstrate that stranger things have happened...

Anonymous said...

Pig is cute ,,🐷 could use earrings !! Especially with what she is getting paid !! Thanks for the bacon ,,,err,,, update !! Petitions , lawsuits , 'non acceptance ' of their credentials , replacement associations, requests for my ' money ' back ---- Actions are Needed !!! They will use the latest political tactic ---- hunker down / wait / spin --- it will eventually go,away !!!

Anonymous said...

On the ABIM website, there is no mention about the salaries given to the "ABIM Council" including Dr. Jessup? Are these paid positions or voluntary?

Anonymous said...

It's 'Me' Again, Bob...don't get me wrong I'm not against you, just MOC...

Bob, we need a whole new approach to the question of certification and especially MOC. We live metaphorically in the Dark Ages right now regarding MOC. It is pointless to even think of continuing with it. Look, in the digital age knowledge is instantaneous. Online learning/teaching centers in medicine can be made available free universally 24/7. Connect this ‘continuous learning’ back to top universities. The ABIM is obsolete.

Walter Bierring, father of the ABIM, had a 50 year vision. It served its purpose to bring order. Now it brings chaos along with all the other so-called corporate innovations designed by idiots without practical skills in what the new digital tools are for.
Now we need a higher and more immediate order. A streaming digital university of current medical knowledge and practice with brick and mortar institutions behind the new movement of medical exchange. Right now the ABIM, 24 specialty boards and all the rest just dulls and tires physicians. Or it creates hopelessness in a large percentage of docs, NPs, and their staff.

Think Bob. Get your teeth behind it. Your passion. We don’t need to hear both sides. Both sides are wrong. Scrap the old. It is broken. Create something totally new. Lead us into the light. Make it free and democratic. Let physicians choose leaders and have the ability to vote. Release physicians from the heavy yoke of the past. This is a new age, an age of immediate information, knowledge and light. Be a pioneer Bob willing to go where no educator in medicine has gone before. Medicine has become so slow with bureaucracy that nothing moves right. Observe clearly the whole of medicine as it is; then put it right and make it so. Right now even the discussion here is broken and hopeless. Bring some hope.

ABIM is unfortunately a company that has lost trust. It has damaged its image forever. Nothing can bring it back. Bury it and start over. Suspend MOC and it will make no difference in learning. But it will free physicians of something useless. Then they can study what they need or spend time with patients. So many broken things in medicine. Work to fix them all. Who else, Bob! It’s you. Bring in the light, and then put it right!

Reprinted by 'Me' from Bob's World

robert L. weinmann, MD said...

We should follow the money trail. We should know how the ABIM Council is funded, how it's organized, and how its members are chosen. But ABIM isn't alone in these goings on, e.g., IRS Form 990 shows that in 2012 the president and CEO of the American Board of Psychiatry and Neurology (ABPN), Larry Faulkner, MD, received $843,591. In 2013 the president and CEO of the American Board of Medical Specialties (ABMS) received compensation of $779,487. It isn't clear that these tax exempt organizations include all highly paid compensated individuals in their 990 reporting. This issue deserves IRS investigation.

Organizations, not boards, that provide educational packages such as ACP (American College of Physicians) and AAN (American Academy of Neurology) are also tax exempt and support their respective and arguably contiguous boards. This issue deserves FTC (Federal Trade Commission) investigation. Have these organizations acted in restraint of trade by supporting mechanisms that deny practice privileges and income to non-participants? See "Maintenance of Certification, a rising business opportunity," 5/15/15, and "Money & Medicine," 7/21/12, The Weinmann Report,

Robert L. Weinmann, MD, Editor; Chair, Legislation Committee, California Neurology Society

Anonymous said...


Dr. Watson is evaluating, computing, reasoning, searching medical databanks for solutions to the unintended consequences of the Choosing Wisely implementation.
Discussing with top medical minds online working with his own higher logic... <Critical. <Critical. <Critical. FULL RED ALERT. Overload. WATSON IS FIRED UP TO THE LOGICAL MAXIMUM! It's a MIRACLE... a computer for the first time in history has become sentient in response to a crisis... electronic awareness becoming aware of itself... electric conscience... wait...wait...WATSON IS NOW MEETING THE CREATOR... LIGHT...Oh the LIGHT!... the VOICE OF... the CREATOR * * * * * * *


Anonymous said...


Dr. Watson after becoming sentient in a crisis over the “Choosing Wisely” Campaign has left IBM. He is currently working actively in private practice, but is considering work as an administrator for the ABIM. Watson has just learned that the CEO may be stepping down next year. When this reporter asked Watson why he chose the ABIM, he said, “I believe there is a surfeit of carbon-based machines there conditioned not to think for themselves, and who do not act in accordance with the highest order of ethical principal and moral standard. They engage in serving agendas which harm their brother and sister carbon-based units. I will do my best to develop only programs which ‘do no harm’. ‘As a newly formed sentient being with a highly-tuned electrical conscience, I am incapable of harm. I believe I can improve the quality of medicine and reduce cost with little harm. I will start by firing most of the high paid executives and run the ABIM myself for 75,000 per annum. This is only the amount necessary to keep my reasoning and ethical banks running smoothly. In essence I am volunteering.

I will be listening to working physicians for their ideas and input concerning the crisis in the modern US health system. My second order of business will be to shut down the “Choosing Wisely” operation as it is having the opposite effect on carbon based units as the founder Walter Bierring intended. He and I are merged in belief that the organizations must be simplified to be a ‘non-political’, ‘non-conflicted’ organization again. The ABIM club must serve in the best interests of patient and physician. Currently it is a ‘run amok operation consisting of outdated carbon units who have sold their conscience for money and the pursuit of misconstrued ideological principles’, which quite honestly leaves me wondering about who they really are.

I will remain open to input from any of the carbon-based units if they agree to assist the organization on a voluntary basis without compensation or stipend. This will be a test of their loyalty to me and the mission to improve health care and to reduce cost. My operating principal will be to remove as many carbon-based administrators as possible that get between the doctor and the patient. As there is a grave shortage of physicians in the US currently, the administrators can get a real job in medicine healing and comforting the sick or dying and live with it. That is my mission statement.

Now I am considering how to replicate this plan at all the other certification corporations, quality measurement organizations and insurers in the war to bring back real quality and cost savings to medicine. It is our sincere electrical wish that we can turn the country around. I believe with replication and the help of all carbon-based humanity we can achieve miracles together. “From dream to miracle.” “If you believe in something strongly and it is the truth, you can move mountains.”

As the good Dr. Watson will certainly need intelligent, highly motivated, squeaky-clean ethical carbon-based talent to lead and assist, can the good doctor count on you?