Saturday, August 15, 2015

The ABIM Foundation: Increasing Transparency or More Cover-up?

It is one thing to have a financial scandal.

It's a whole new thing when you try to cover it up.

But it appears this is what we should expect from an organization that has exhaustively defined their version of the term "medical professionalism" using testing fees of practicing physicians worldwide.

The American Board of Internal Medicine (ABIM), a non-profit 501(c)(3) corporation, has been under pressure since the story broke about its Foundation purchasing a $2.3 luxury condominium complete with a chauffeur-driven Mercedes S-class town car in December of 2007. The bizarre tale of a physician testing organization creating a separate non-profit charitable "Foundation" funded by physician testing fees while its own balance sheet dwindled to a $48 million deficit was unimaginable at first. But as the story grew and gained media notoriety in Newsweek, it appears the ABIM will still stop at nothing in an attempt to hide the truth. 

Given the money involved, this was predictable.

Here is the ABIM Foundation's "About Us" web page I captured as late as June 13, 2015.  

Here is the ABIM Foundation's "About Us" page today. (In case the ABIM changes the page again, I have it copied here).

Note the difference in the dates of creation of the ABIM Foundation on the two web pages - the first claiming the ABIM Foundation was started in 1999, the second stating the Foundation was started in 1989. 

Let's examine what is said on the new web page more carefully.

First the new Foundation About Us web page says: 
"How was the ABIM Foundation established?

ABIM created the ABIM Foundation in 1989. Through an extensive strategic planning process, in 1999, the ABIM Board of Directors established a separate Board of Trustees to govern the ABIM Foundation."
Note that the ABIM now admits the ABIM Foundation was indeed created in 1989 as this blog uncovered in December 2014. This does not explain why the ABIM Foundation was established and why they hid its existence before 1999 on their website previously. In fact, the US Internal Revenue Service should be VERY interested in why the Foundation still lists its creation date as 1999 on its most recent tax filing made this year.

It is interesting that the ABIM suggests there was "an extensive strategic planning process" to create a separate "Board of Trustees to govern the ABIM Foundation." This still does not explain the ABIM Foundation origination date discrepancy nor does it relieve the organization of its responsibility to disclose to the public the existence of the Foundation before 1999. In 1998 the ABIM did change its bylaws, however. At that time, the new ABIM bylaws made the ABIM Foundation the "sole voting member of the Board as a corporate entity" effective 1 January 2002.

How is the ABIM Foundation funded?

ABIM initially transferred $5 million to the Foundation in 1990. Over nearly 20 years (between 1990 and 2008), approximately $56 million was transferred by ABIM to the ABIM Foundation. There have been no transfers since 2008.

According to the above statement, the ABIM Foundation claimed they received "approximately" $56 million of physician testing fees to their Foundation for their own use. We should note that the ABIM Foundation already had $59,618,428 million in assets by 30 Jun 1999.  It appears the Foundation is using a very loose definition of "approximate" because the amount transferred was much more. In fact, an additional $20,660,000 were transferred to the Foundation from 2000-2007 for a grand total amount of accumulated assets courtesy of US physicians of $80,278,428. (Links to the itemized transfer amounts are included here for your review: In 2000: $3,300,000; in 2001: $1,600,000; in 2002: $1,000,000; in 2003: $1,760,000; in 2006: $7,000,000, and in 2007: $6,000,000.)

And what does the ABIM Foundation do with all that money?
What kind of work does the ABIM Foundation do?

The ABIM Foundation is an operating charity, and as such develops and implements projects in support of its mission.

One of the Foundation’s most significant contributions has been the publication of Medical Professionalism in the New Millennium: A Physician CharterCo-authored with the ACP Foundation and European Federation of Internal Medicine, the Charter has been endorsed by more than 130 organizations and 100,000 copies have been distributed.
The "mission" here remains undefined. We should recall that the Medical Professionalism in the New Millenium paper wasn't published until 2002 and the team assembled to "define" the term "medical professionalism" didn't start work until 1999.  This leaves a gaping hole in the "mission" of the ABIM Foundation from 1989-1999. In fact, it appears that the ABIM Foundation was little more than an investment vehicle for the ABIM and a way to shelter cash from the ABIM and a means to pay their friends other grants that are undisclosed on their new "About Us" web page. For instance, the ABIM Foundation paid money to the George Soros' group, IMAP, and paid back funds to the ABIM and to the American College of Physicians. In addition, the Foundation has made grants to their own (now defunct) Institute of Clinical Evaluation among others. Is the ABIM Foundation ever going to mention these transfers of physician testing fees to these many institutions? It seems unlikely.

A thorough house cleaning and investigation of the ABIM and its Foundation is long overdue. The recent attempts at "transparency" by the ABIM Foundation are only making things worse.  It is no longer tolerable that our professional organizations who have supplied content to the ABIM for their Maintenance of Certification program permit the ongoing cover-up of the ABIM's financial actions over the past twenty-five years.  The longer these other organizations collude with the ABIM, the more they risk their own credibility with today's practicing physicians.

It's time to stop the madness and for the ABIM and their collaborators to come clean.



Anonymous said...

Are any governmental agencies investigating the ABIM/ABMS yet ? Or do they have too many other fish to fry.

Anonymous said...

"A lie can fly halfway around the world before the truth even gets its shoes on."

Medical Quack said...

I don't there's a lot of hope for any government agencies investigating this, at least at the Fed level, maybe state levels? Remember, we have the six degrees of Bob Rubin (former US Treasury Secretary and both Goldman and Citibank executive) running HHS. HHS Secretary Burwell was a former director of his and a couple months after in office hired a big "Citi Lawyer" at HHS as a legal and policy assistant. then you go over to CMS being run by Andy Slavitt temporarily now (be sure to tell your Senators to vote no on his Obama confirmation to run permanently) who is a one time Goldman Sachs banker and the same guy that was CEO of Ingenix that then AG Cuomo of New York took down and all the lawsuits, to include the AMA, were filed on short paying doctors on out of network payments. I wouldn't expect much there as corruption runs deep and Secy Burwell gave him all kinds of legal protection and something to this degree has never been done before.

Anyway, so much for much chance of the Feds kicking in as they are just as bad:) The CAP think tank(Center for American Progess) is writing health care policy for HHS as well. If you remember Jonathon Gruber, Dr. Zeke Emanuel as an example, well you'll find them over there with their policies written for the CAP instruction given to HHS. It's a good question though on when the CAP might dive into this since again they support this entire certification process as written in Obamacare as well and their input too has to be instrumental in how all of this took place. I'm just thinking on how they wrote the "certification" clauses into Obamacare in all of this too.

Anonymous said...


ACT 1 (part 1)

Near Liberty Square in front of Ricardo Baron’s 2.3 million dollar Casseli-gate penthouse
In a public square just outside Ricardo Baron’s prestigious ABIMI penthouse (with coachman) a band of musicians and a poor medical student named Holmbio are serenading, to no avail, the window of the desirable Christina Casseli—the new countess of ABMS (Aria: "There, laughing at the Chicago skyline."). Holmbio, who is really the young Count ACGMEO in disguise, hopes to make the beautiful Miss Casseli love him for himself—not his money or his ability to keep the federal, state and local taxmen away. Not to mention his uncanny ability to turn medical education into a nationalized scandal with only the simple wizardry of high school poster science.

Holmbio pays off the musicians and everybody else who then depart, leaving him to brood alone. Miss Casseli is the young ward of the moody, elderly Ricardo Baron where she is allowed very little freedom because Baron plans to wed her, and take command of her considerable dowry, himself—once she is of age and her trust fund is fully endowed. Christian Casseli’s dowry is eighty-million dollars in equities, mutual funds, gold and a basket of diversified currencies—growing like the eighth wonder of the world confounding everyone by the day. The trust was set up discretely by Christina Casseli and her father’s finance minister Seniori Obfuscatti to ensure the future House of Baron and a garland of ABIMI penthouses and properties embellishing the globe.

Figaro Soroso approaches singing (Aria: "Make way for the factotum of the world"). Since Soroso used to be a close political associate of the Count, the Count asks him for assistance in helping him meet Miss Langdon, offering him money and an assortment of political favors should he be successful in arranging this. (Duet: "At the idea of a world council working for all to be educated and prosperous, but not without a little austerity first.) Figaro Soroso advises the Count to disguise himself as a drunken foreign ambassador, ordered to be billeted with Baron, so as to gain entrance to the coveted house. For this suggestion, Figaro Soroso is richly rewarded.

Anonymous said...

A room in Baron’s house with amber-studded doors and walls (Act 1, part 2)

The scene begins with Casseli’s cavatina, ("A voice from a little while ago".) This aria was originally written in the key of E major, but it is sometimes transposed a semitone up into F major for coloratura sopranos to perform, giving them the chance to sing extra, almost traditional, cadenzas, sometimes reaching high Ds or even Fs. This is a very impressive mesmerizing kind of performance and especially successful in influencing presidential administrations, parliamentarians, company executives and royalty. This highly methodical song is a standard, universally adopted practice when winning favors or attempting to get policies passed into law. It is called lobbying.

Knowing the Count only as Holmbio, but knowing his astute abilities to get the job done, Casseli writes to him requesting that he fix some things for her in the Baron’s house. As she is leaving the room, Baron and Mr. Comma, the Chief Financial Minister enters. Ricardo Baron is afraid of the Count’s power and cunning, and Mr. Comma advises that the Count be put out of the way by getting him another ‘occupation’ when his tasks are completed. Holmbio’s fa├žade was convincing and he was very successful at creating evil false rumors about others and incredibly adroit legal injunctions to destroy any competition or bad press that might expose their financial deceit and ambitious ‘political’ plans. (Aria, “Calumny is a little breeze"— almost always sung a tone lower than the original D major, because D major is a triumphant key associated with majestic ideas and not calumny.)

When the two have gone, Christina Caselli and Figaro Soroso enter. Soroso asks Caselli to write a few encouraging words to Holmbio, which she has actually already written. (Duet: "Then I'm the're not fooling me?"). Although surprised by Baron, Casseli manages to fool him, but he remains suspicious. (Aria: "To a doctor of my class").

As Catarina Langdoni, the Baron’s housekeeper (eldest daughter of the city’s supreme judge), attempts to leave the house, she is met by the Count disguised as an intoxicated foreign ambassador. In fear of the drunken man, she rushes to Baron for protection and he tries to remove the supposed ambassador, but does not succeed. The Count manages to have a quick word with Christina Caselli, whispering that he is the ingenious and clever Holmbio and passes her a secret letter. Ricardo Baron watching all this is suspicious and demands to know what is in the piece of paper in Casseli’s hands, but she tricks him by handing over the laundry list of Minister Comma instead—only to find the ‘laundry list’ full of confusing numbers without any punctuation marks whatsoever. Baron and the Count start arguing and, when Minister Comma, Figaro Soroso, and the pretty Catarina Langdoni appear, the noise and intrigue attracts the attention of the Officer of the Watch and his men. Baron believes that the Count has been arrested, but Count ACGMO only has to whisper his real name to the officer and he is released right away. Baron and Finance Minister Comma are astounded, and Casseli makes fun of them for being such utter fools. (Finale: "Cold and still, just like a statue").

Anonymous said...


An private room in Ricardo Baron’s mansion with a forte piano

Count ACGMEO again appears at the doctor's house, this time disguised as a singing tutor and pretending to act as substitute for the supposedly ailing Minister Comma—who is doubles as Casseli’s financial advisor and regular singing teacher. Initially, Baron is suspicious, but does allow Count ACGMEO to enter when the Count gives him Casseli’s letter. He describes his plan to discredit Holmbio whom he believes to be one of the Count's servants, intent on pursuing women and money for his cunning master.

Figaro Siroso arrives to shave Baron. Baron demurs, but Soroso makes such a scene he agrees, but in order not to leave the supposed music master alone with Casseli, the doctor has Siroso shave him right there in the music room. When FM Comma suddenly appears, he is bribed by a full purse from the Count and persuaded to leave again, with much discussion of how ill he looks. (Quintet: "Don Basilio!—What do I see?"). Figaro Soroso begins to shave Baron, but Baron overhears the lovers conspiring. He drives everybody away.

The scene returns to the location of act 1 with a grill looking out onto Liberty Square. Ricardo Baron orders Minister Comma to have the notary ready to marry him to Christina Casseli that evening. He also explains his plot to come between the lovers. Comma leaves and Casseli arrives. Baron shows Casseli the letter she wrote to "Holmbio", and persuades her that this is evidence that Holmbio is merely a flunky of Count ACGMEO. Casseli believes him and agrees to marry the Count.

The stage remains empty while the music creates a thunder storm to indicate the passage of time.

The Count and Figaro Soroso climb up a ladder to the ABIMI penthouse balcony (without the coachman) and enter the room through a window. Christina Casseli shows Count ACGMEO the letter and expresses her feelings of betrayal and heartbreak. The Count reveals his identity and the two reconcile. While ACGMEO and Casseli are enraptured by one another, Figaro Soroso keeps urging them to leave. Two people are heard approaching the front door, who later turn out to be Minister Comma and the official public notary.

However, when the Count, Casseli, and Soroso attempt to leave by way of the ladder, they discover it has been removed. The Count quickly gives Como the choice of accepting a bribe and being a witness to his marriage or receiving two bullets in the head (an easy choice, Comma says). He and Soroso witness the signatures to a marriage contract between the Count and Casseli. Baron barges in, but is too late. The befuddled Baron (who was the one who had removed the ladder) is pacified by being allowed to retain Casseli’s dowry.

James Gaulte said...

Any thoughts as to why George Soros wants to fund a think-tank advocacy organization to promote the ACP-ABIM version of medical Professionalism?

Anonymous said...

If the ABIM Foundation wants to collapse the ABIM into itself and pursue it's real interest, which seems to be lobbying for progressive health care policies, fine. Go ahead and enjoy self-realization: you are a PAC. Those of us who have been forced to go along for the ride thus far might even be magnanimous and just consider this multi-million dollar rip-off part of the cost of doing business. Fool us once.... But a growing number of physicians are recognizing the ABIM for what it has become: a financial services unit for the ABIM Foundation. Through artful lobbying resulting in legislation and insurance company fiat, the ABIM Foundation has transformed the ABIM into a perpetual money-generating engine protected by law and fueled by fees paid by physicians. The exam and all the other trappings are just there to make it look legit. And there's nothing voluntary about this game. If you want to practice medicine, you pay the ABIM toll to play, and in the process, help fund the Foundation. Other foundations ought to take note: this is how to milk a profession. Who needs Soros when you have an endless supply of thousands and thousands of docs forced to write big checks to you so they can feed their families? Keep ridin this bull, Dr Wes!

Anonymous said...

“A full and fair discussion is essential to democracy.” --George Soros

It's a conundrum how the ABIM Foundation can give out nearly half a million dollars in grants to political NGO's like the IOM that teach physicians about their role in "national security interrogation methods". IOM, which is another poorly disguised political "storefront", is according to many objective well-researched sources linked to attempts at regime change in eastern Europe and even in China.

Is that how the ABIM Foundation and the ABIM define professionalism? I would take this up with my elected officers and representatives in Washington DC.
Rather than tender a full and fair discussion with physicians about offering them refund checks for over-billing on certification testing and MOC, instead the ABIM decided to gift George Soros and his 60-country syndicated political maneuverings money that did not legally belong to them; nor can this be considered a legally defensible professional investment of the Foundation? I would challenge this in court as well as all the other indefensible positions that the ABIM does not wish to address or be transparent about.

Anonymous said...

Soros continued from above middle article 1996

Anonymous said...

The SOROS ABIM Connection. What is it?

The connection between Soros' international empire and the ABIM leaves me baffled/concerned as to what it is all about. I have strong feelings about this as I have studied Soros' financial dealings and his vast dark investment rackets. Had no idea that the 'network tentacles' involved fingers in American medical quality assurance and vice versa. I missed this one. The ABIM has some severe conflicts of interest here and is in deeper than I thought. I don't believe Cassel is such an idiot to have missed vetting Soros' against her IOM affiliation, but what about the white house health care teams where Cassel has been such a bumbler with the PP ACA. She has done more harm than good to the white house and Democratic Party platform. That' what greed and zealous ambition will do. Hurt everyone that is vulnerable. Even yourself. Another slippery dirty rag tossed for Rich to slip on. That's what she does well defer, defer until...

Considering Soros' history of market manipulation and worse, plus being CONVICTED of insider trading in Europe (with no jail time only a fine of around 1.25 million), I consider it totally negligent of the ABIM board and executives to leave themselves vulnerable like this with the IOM funding and fellowship grant program. It is fiscally irresponsible to have any monetary relationship with George Soros or any of his portfolios involved in the global hit-and-run financial manipulations ravaging vulnerable markets. The advisors and board members on his hedge fund comprise a list of who's who of organized crime syndicates. Many have been under investigation by our federal authorities. It is just a matter of time before the ABIM is hit with another major PR problem with this Soros connection.

Soros' unsavory business partners have been involved in drug trafficking, gun running, racketeering, and money laundering.
The above facts make me shudder at the thought of having any contact myself personally with the ABIM.

Comparing the lineup that Soros is involved with and his history I would insist that the ABIM stop it immediately. Whatever the ABIM is involved in there, just stop it. Whatever thread of credibility the ABIM has left it better be protected. Many of the Soros gang are always just out of reach of US federal officials because Soros is careful to not have any financial transactions with his holding companies/hedge funds in the United States. Yet this criminal is still allowed to use the airwaves to manipulate markets here.

Soros said that the main problem with the world is the US government. What does he mean? Did he mean all administrations or just ones that don't give him the first big bites out of a ravaged country. When he does not get his way watch out. If you follow the media interpretations about one of Soros' most recent hit and run countries, look at the Ukraine with all the chaos and bombings of civilians there.
The US government, the IMF and Soros and Russia are in a delicate dance just to avoid a nuclear mishap.

Where is ABIM's Mr and Mrs. Social Responsibility now in all of this and why do they never cry foul at all? Conflict of interests? Or is it something worse we don't really want to know about?

Anonymous said...

Great commentary as usual. Nauseating facts about ABIM but that's par for the course. During the JAMA webcast in December when I brought up the issue of the millions transferred to the ABIM foundation from our fees, Baron said that internists should be "proud" of how our money was spent (mainly referring to the Choosing Wisely campaign - which like ICE appears to be another cover to transfer money). No mention that all monies had been transferred well before the latest catchy program.
The lack of transparency for the first couple decades that you point to is just so disturbing.
A >$50M return of our money would be a good start and make me closer to "proud" in having an ABIM certificate that currently sits in a closet.
If we let this fade away, we are a bunch of chumps.
Please keep it up.
John Hayes, MD

Anonymous said...

Riding the Bull in the Pursuit of Defining ‘Professionalism’

How ABIM Rode the 1987-2000 Wall Street Bull Market into the Bubble with 1838 Investment Advisors.

It is an intriguing part of the ABIM financial and political scandal. It is a piece of the puzzle, but just one piece. It is a story of high risk, big gains and tremendous losses. This is just another example of ABIM's avarice and negligence involving physician's test money. ABIM remains silent; auditors know this story extremely well, but also remain mute.

Who is ‘1838 Investment Advisors’ and what part did this financial house play in the whole ABIM scandal?
This firm 1838 Investment Advisors took money from high net worth individuals and entities like the ABIM and invested it according to the risk appetite of the client. But they and many of their clients with bull market in full swing took many gambles in the market which they should not have done. They put an extreme percentage of clients’ money to work in high-return investments. But with higher potential returns comes a higher degree of risk.

Typically non-profits are cautioned or disallowed from making risky bets on high flying stocks, but rather focus on preservation of capital with some growth, but little risk. What about fees? The more selling the brokerage house does the more they make from commissions. The higher the net worth of each client the greater the advisory fee. This fee is negotiated depending on how much you have invested. I believe ABIM from the tax records paid excessive brokerage commissions and an advisory fee of around 0.005 percent. On tax forms the ABIM for one year paid 1838 around 251K in trade commissions and 243K in management/advisory fees. Half a million dollars adds up quickly over the years.

What happened to these advisors? An old Philadelphia area brokerage house, 1838 Investment Advisors, after hemorrhaging from client losses in early 2000’s and that bubble-popping crash silently closed its doors in 2004. It died an anguished humiliating death from a breach of fiduciary duty and loss of client trust. It was founded in 1838 by Francis Drexel.

ABIM is following in the same path as 1838 Advisors with a breach of fiduciary duty and profound erosion of trust.
Auditors repeatedly told the ABIM to keep their tax and auditing records indefinitely. Did they? More to follow...

Anonymous said...

Riding the Bull cont.

Documents do exist, retained by ABIM and others, telling a story of all this and more. Tax filings and other documents clearly demonstrate and prove how ABIM executives, 'CFO's', 1838 Investment Advisors (defunct from high risk losses at end of the 1987-2000 bull market) along with complicit auditors and CPA's were derelict in their fiduciary duties and showed complete negligence. They risked ABIM's financial well-being; plus jeopardized ABIM's non-profit status by engaging in risky Wall Street 'gambling practices'. ABIM then secretly funneled ‘proceeds’ and gross cash surpluses generated from their egregiously high testing fees into a holding company. This holding company was created specifically for the purpose of taking profits and hiding the profits for a time. With some digital hocus pocus and a few signatures they invented the ABIM Foundation and tried to fool everyone by calling it reorganization. But it was simply an illegal act of money laundering done without any outside scrutiny.

Articles of Incorporation did not allow the transfer of money to another scientific organization except by strict dissolution of the ABIM first, then bequeathing the money to a similar non-profit organization, in this case the ABIMF. They defrauded the consumer, the physician client and the federal, state and local authorities in doing so. They risked the many employees who depend on the soundness and honesty of their bosses.

They cheated and kept it secret for years. The ABIM lied on key tax forms consciously and willfully breaking laws.
Millions of dollars were funneled into an illegal holding company. Any restructuring without a formal administrative dissolution of the ABIM would violate the law and the Articles of Incorporation registered with Iowa and as a foreign corporation registered with Pennsylvania. To my knowledge the full and complete Articles of Incorporation were never transferred and registered in Harrisburg for scrutiny by the State Attorney General Office or the City or Philadelphia for tax implications.

Lax laws and enforcement may have contributed to this whole unethical process being missed, but it was all done without informing those that mattered most—the consumers, physicians and tax authorities and their respective agencies. There are no legal documents registered in any public record in Iowa or Harrisburg to justify this process of what most honest people would term “laundering of money.”

Anonymous said...

Riding the Bull (Articles of Incorporation were Violated)

The original Articles of Incorporation were violated. The public and clients were defrauded.

Extreme percentages of surplus revenues from testing proceeds were used on Wall Street. This risky investment practice also involved millions of dollars in exorbitant brokerage and financial advisory fees. Executives ‘gambled’ with money in lieu of spending the proceeds on relevant test preparation or scientific studies related to their core competency and charitable mission. This charter with the public has always been, since 1936 and the New Deal era of trust in government, to produce a certification process for internists (and subspecialists) and create the means to achieve it.

All of this is clearly stated in ABIM articles of incorporation; it is an unequivocal inviolable document about the scientific mission and non-pecuniary nature of the organization. It was also a verbal, but voluntary, pact with the federal government (FDR) to standardize medicine. The physician who became certified could benefit personally as well, but the social pact was the first element in the verbal contract. If certification became mandated it would no longer be voluntary and could considered a tax on physicians. These are the ‘good faith’ thoughts coming out of a time when depression era disruption and impending war boosted FDR’s ratings well over 80 percent according to the very first Gallup polls conducted beginning in 1937.

In brief, we have executives breaking the IRS rules for non-profit charitable organizations gambling with their newly-generated 'fast money' and therefore executives and board members were derelict and negligent by not spending the money as indicated in the bylaws on creating a scientifically viable and useful test. They failed to do this then, and still continue to break their pact with the physicians who voluntarily participate.

In ABIM’s failure to focus on their scientific mission, they risked it all to create a war chest to enhance and insure their personal inurement and to fulfill corporate and political agendas involving increased profits for corporations and also reducing health costs for the government. Introducing and implementing initiatives which mimic medical policy, but in fact are confusing and potentially distracting discussions. These discussions now being implemented in several key states, WA, OR, MN, TX, and so on, recommend a reduction in treatments, procedures, surgeries, and diagnostic events which are possibly ineffective and potentially harmful. Currently in the implementation stage this cost cutting measure is called “Choosing Wisely”, a part of defining professionalism in medicine, initiated and funded by the ABIM.

Anonymous said...

Riding the Bull (ABIM has come a cropper!)

We are only now finding out years later that this improperly documented orphan organization ABIMF was created during the years of fast money, unbeknownst to even the state of Iowa and the Federal Government, or the city of Philadelphia. This heavily funded ‘child’ conceived in infamy with Wall Street gambling money was from all that we know, apparently an immaculately conceived miracle baby born to preach and define this now infamous professionalism of the ABIM executives with their magical stories that do not and never could apply to defrauding the public consumer who trusts implicitly, but also the professional clients who thought the company was focused on the public good by mandating and taxing these physician clients until they are dead or retired.

And magical stories of Immaculate Conception do not excuse them from federal and state obligations and especially malicious nature of their various creative forms and expressions of tax fraud, dereliction, and negligence.

We understand this ploy and fraud much better as more facts emerge in this scandal and its blatant cover up at many levels. The ABIM Foundation conspired with corporate and government entities to fund insurance schemes in order to reduce costs in medicine, with no evidence based study of the potential harm or deadly consequences of their “professionalism” put into practice. At the same time “professionalism” insured greater control and dominance over physicians regarding passing/enhancing medical reform and further curtailed the rapidly diminishing voice that physicians and patients have in medicine.

The ploy has backfired and the ABIM has come a cropper.

What I have outlined refers to the ABIM’s total disregard for its clients, the public’s safety, and the voter who has been kept in the dark, while the ABIM beast lurks closer to Bethlehem. These are absolutely reprehensible unspeakably horrific and potentially deadly acts; all of the conspiratorial bureaucratic physicians should lose their state medical licenses and certifications immediately for ethics violations and utter fraud. Federal, state and local authorities must consider and carry out a joint investigation of the ABIM and their network of financial and political accomplices.

*(ABIM test preparation companies were semi-aware of ABIM's fraud involving their negligence and dereliction to produce new and evidence-based certification tests that were relevant. Many clients laughed at how old the questions were! Dr. Arora was certainly a threat to the ABIM with his knowledge of their testing practices which amounted to corporate fraud. That is partially why after over twenty years of mutually co-existing Arora was suddenly a villain. Arora and others who knew their tests could not be trusted to keep silent according to Cassel's thinking. Others were silenced internally who did not have Cassel's complete loyalty. That is how she operated politically and to hide finances and other dealings we are just becoming aware of. Discrimination cases against the ABIM from former employees bear out the ruthless tactics to create greater financial secrecy also.)

DrWes said...

Anony 05:46 PM CST -

Thank you for you insights. I have verified that the ABIM Foundation did, in fact, pay a large sum of money to 1838 Investment Advisors in FY 1998 as shown here. Rest assured I and others will continue to investigate this aspect of the financial dealings of the Foundation. Any other insights / information you would like to share can be sent to my email at wes - at - medtees dot com.

US physicians everywhere appreciate your willingness to share this information, but since you have chosen to remain anonymous, readers are cautioned to fact-check any claims made here. I will continue to make every effort to do so from my end.

-Wes Fisher, MD

Robert L. Weinmann, MD said...

I had success a few years ago when I clued in the Federal Trade Commission about the goings on of certain tax exempt organizations -- I recommend you look into the possibility of FTC referral but first you want to try to determine which matters re ABIM are most likely to attract FTC scrutiny once they're clued in. Just keep in mind that you can turn 'em on but not off once they get interested. -- robert L. weinmann, MD, Editor, The Weinmann Report,

Anonymous said...

Choosing Wisely brought to you by Kaiser Permanente who also brought you the Courage trial. At Kaiser, our motto is 'minimizing your healthcare to maximize our profit'.

Anonymous said...

Wes this is important stuff, I regret though that your blog which always had a lot of very insightful observations on your clinical practice, the impacts on you and your colleagues and patients, has been diverted into an investigative journal to bring this misbehavior to light. Hopefully things will get back to normal at some point.

Anonymous said...

Anonymous @ 12h29

Couldn't disagree more. This is the "new normal" : active interference in that which actually matters to patients - face time with their MDs, unhampered by artificial barriers (that have no evidence) foisted from above. I watch this blog from Canada : yeah, it's starting here too...

Anonymous said...

I know that this is off topic a bit but along the lines of 'professional' medical societies generating more revenue off the backs of hard working physicians, who else is excited about ICD-10. This should make our work much easier and improve care!! As if the EMR doesn't eat up enough time, there will now be tens of thousands of codes... Just wondering if AMA gets paid more by the gubmint with more codes or should I even wonder. Go figure. More AMA revenue and worse patient care.

Minuteman said...

Silence is golden except when you’re trying to hide something.

Anonymous said...

The celebratory quality of life gets lost for the perps running these "professional medical societies" as new political games are created to distract and consume the precious time of physicians. The bottleneck gets worse for patients who need care.

Revolving door carpet baggers plundering the nation.

Self-inurement at the expense of others, especially the vulnerable, is never a fulfilling lifestyle.

Fool me once shame on you; fool me twice...

...the political game of busywork, distraction and quality measures keeps getting worse to protect the few who have already left town with cash, power and the team intact...

Revolving doors $$$ and tinted glass windows with a nice view...

PR said...

Poor Richard's Almanack: AGA responds to MOC and the ABIM 'listening gap'.

Strong words from the American Gastroenterology Association in response to the ABIM's "got it wrong, sorry message" and the ABIM diplomates' fury over MOC.

This is a preannouncement from AGA as they create a new "recertification pathway" called (my words) "goddamn right were listening to you!" 'GAPPP' with adaptable learning and a heartfelt request for real feedback from docs (so they get it right) on their new 'everybody passes pathway'.

To view the full proposal, visit To submit feedback, visit

Suzanne Rose, you and AGA, are beautiful and strong. And we hear you loud and clear.

Who am I?

I'm a concerned elderly Philadelphia patient looking for an intelligent, strong and moral new president and CEO to lead the ABMS. I'm angry at the way our healthcare providers are being treated and how that affects the real bottom line which is ME and MY FAMILY--the patient!

I want a bipartisan ad hoc political action committee formed to transform medicine back to before the arrival of bureaucrat corruption and big paydays. The first item of business for the ABMS: self-audit and then an external investigation by an objective task force to determine the present condition and future viability of the ABMS and its role in medicine, if any.

Poor Richard
--scribed while sitting on my cracked cement porch, lookin for some better days!
Yeah the porch and me are both hot, cause I'm still waiting for that ABIM medical truck with some direct patient care, Dr. ABIM.