Monday, November 02, 2015

Part III: Why Washington?

I woke early to review my notes; who was attending the gathering that day, the itinerary, the location.  Suit, tie, briefcase, cell phone, charger. Check.

Soon I stood in line with familiar faces at the Rayburn building waiting to pass through security, remembering my wife's comments about the DMV.  "Bags on the conveyor, folks.  Jackets, too. Sir, you can leave your suit coat on." Of course. What was I thinking? What about my coffee cup? Passing the bag check, the halls widened. Shiny grey linoleum, fluorescent lights, just as promised. Just like the Hart and Dirksen buildings.

We made our way upstairs to the Judiciary Hearing Room, Room 2226. An early-morning confab of the members of the GOP Doctors Caucus was in the hearing room, discussions underway. Microphones on. All of us listening. Real issues, real bills, sausage making at its finest. An urgency to their voice.  Meaningful Use Part III. Crazy. Not ready. What can we do?  Can we kill it? No? Push for a delay. H.R. 2603/S.1475: "The Saving Lives, Saving Costs Act" to permit safe harbor for physicians who follow guidelines. Add this, what do you think of that? Need to get things done by the 11th of December. A real-life physician-politician show and tell. Then when things concluded, the brief pitch: physician ranks were getting thin. You're needed. (It was not a younger crowd.) Then, off to more meetings before the debt ceiling vote. Got to go. Cynically to me it looked more like doctors were  being taste-tested for the menu rather than really being at the table.

But then a break for coffee and continental breakfast in Representative Sessions' office across the hall. Nice office, four-room suite. Spacious, with lots of Texas memorabilia on the wall. More time to mingle, connect. So many people to meet, so little time.  People circulating for a quick photo shoot with the Congressman. Graciously he invited all to pose. "Off with the name tag," he'd prompt. "Now, this is a good place to stand." Then a photo:

It was fun.  A very polite way to say "thanks for coming." Reminded me of my Navy days, just more casual. Then he was on to the next attendee. On and on, until most people that wanted to have a chance for a photo did so.

Then the main event.

We shuffled back to the Judiciary Room. Congressman Sessions made some introductory remarks.  Very likable guy. Top salesman for AT&T for years, he said. He could sell anything to anyone, he boasted while smiling. Admitted the didn't know a thing about being a doctor, but seemed well-informed on many of the issues doctors face and that our patients are facing right now: high deductibles, co-pays, co-insurance, especially for those just above the poverty brackets. You could see why people like him on the Hill. He explained be was working on a bill. Obamacare is going to collapse - too expensive, he said. Maybe it was designed that way. Not touching Obamacare or Medicare, just an alternative for Medicaid. Hasn't been filed yet. Preliminary, getting ideas. He realized more work is needed. He turned things over to this his legislative aide to explain. Wanted our input, ideas.

A doctor focus group of sorts...

The idea seemed realistic, not far-fetched. Practical option that sounded like a way to make health care sustainable for everyone, with much less gaming of the system. But was it going to be understandable? For some, maybe. For others, it would take some education. Eleven key points, detailed, spelled out with examples.  But I was interested that most doctors in attendance were independents or retired. There were few employed physicians there like me. After the seventh point in the midst of the explanation, a break.  We rose and stretched, I approached the Congressman with a thought.

"Representative Sessions?"


"Wes Fisher from Chicago, sir, interesting plan - very innovative alternative - like the concept - but I wondered if you were aware..." and bent his ear very briefly during our break....

"Are you kidding me? John, get over here." He waved to trusted orthopedic physician-colleague from his home state. "Have you heard about this?"

John listened.  "Not nearly as big a problem for orthopedists," he told him, but he'd heard something about it...

"Give me your cell phone...", Congressman Sessions said.

"Excuse me?"

"Give me your cell phone so I can put my contact information there. Here's mine.  Enter your contact information into mine."

Surprised by his response, I fumbled to enter my contact information.

"Send me the details."


Anonymous said...

Great news, Wes!

I hope Washington is serious about helping with the healthcare crisis, and really assist to improve things on behalf of the patient and physician.

My Grandfather is from Texas and we appreciate the intelligence and sincere salesmanship of Congressman Sessions.

We hope to hear from him on the ABIM issues and relevant parties that are connected to this scandal soon.


The abuses of power and position at the ABIM and their excesses hurt all Americans.

I'm not sure what political party they belong to but they are certainly active politically. Maybe it is a shadow party, I'm not sure, but ABIM and its umbrella organization the ABMS need to be reigned in.

Too much money, too much time to harm others, and too much power to abuse.
ABIM, the ABMS and the NQF must be part of a dark financial corporation funding their politics and healthcare policy:
THE EVERYHTING FOR ME PARTY. Yes they operate under the radar getting rich as the "ME PARTY."

That's it an organization created in their own image to push their "personal" and corporate politics and agendas. Is there a difference?

ME PARTY! Getting rich from their own political storms, while public health declines. Professional medical bureaucrats get rich in the process through conflicts of interests and revolving-door cronyism.

Anonymous said...

Great photo of Dr. Westby Fisher and Representative Sessions!

A Jesuit Priest said...

Perhaps the ABIM/ABMS officers and executives could abstain from money and refuse the use of the condo! That would root out most of the evil. Dante's "Inferno" is filled with such types. Bosch has depicted them in his "Garden of Earthly Delights."

If the ABMS focused on one certification test for life administered near the end of residency and fellowship that would take care of the certification minutiae. MOC the heart of the money scandal.

I am speaking of MOC that nearly irrelevant molehill of medicine which the ABMS causes everone to pray in front of religiously, for some unproven or untested reason.

Furthermore, certification, if the public "demands it," should be free and a part of residency and fellowship paid for out of stipend money. Let others write the test not the ABMS. They have fallen from grace.

As a priest serving God, I question every assertion and right that the specialty boards claim regarding US patent laws and copyright.

They have no right to claim as theirs the medical science paid for primarily by taxpayers and funded originally by the churches, monasteries and humanitarian scholars.

This speaks to the heart of the problem and the abuse of ABIM power, that is, to illegally possess medical science which the ABMS/MOC partners turn into a mountain of profit.

I am appalled at the ABMS and what I can see of the ABIM's lack of true humanity and non-conciliatory nature. They are an enigma wrapped in shroud of greed!


Anonymous said...

"Surprised by his response, I fumbled to enter my contact information.
'Send me the details.'"

This is fantastic news.

MR MUDA said...

"But I was interested that most doctors in attendance were independents or retired. There were few employed physicians there like me."

Representative Sessions is especially lucky that he chose you. Have him talk to the ex Kaiser crowd, Group Health, the ex Virginia Mason docs who fled such radical new political/corporate machinations--the leaders making such a horrible mess out of medicine and health. Physicians lives don't matter.

Unfortunately the docs soon discovered that these institutions were to become also the new model of the future, and their new found jobs would soon mirror the Toyota Assembly line of VM's "kaisen-coached approach" under the rigid and subtly authoritarian tutelage of corporate cronies like Kaplan, Cassel and Baron.

What we have witnessed in medicine over the last five to ten years is undoubtedly a real conspiracy.

Anonymous said...

When the sun goes down tonight, deep within the bowels of the NQF basement, a coffin will open. If you listen closely, the loud squeaky hinges will ring out across the city. The creature will unfurl her wings and exit the satin lined vault to be briefed by her carefully appointed minions. They will inform her that Dr. Wes has communicated directly with Rep. Sessions. Dr. Cassell will instinctively hiss and spit, ritualistically.
Be safe, Dr. Wes...

Really ought to get some natural light in Room 2226 said...

"Meaningful Use Part III. Crazy. Not ready. What can we do? Can we kill it?"

Kill all meaningful use before MU cognizes that it is already dead and useless.
Do not support such electronic self-realization and the resultant agony.

End all data gathering and monitoring that does not have a "reciprocity agreement" with the corporation or government agency sponsoring or supporting it.

Data mining, gathering and monitoring are a monstrosity without a parallel reciprocity agreement.

Don't get it?

Here: If it's not a two-way call hang up the phone!

Anonymous said...

Rich, who has the Ayer Building condo keys tonight? I was wondering if I could stay there? My friend's apartment is being painted. Put me down for today, or call me, and I'm on my way.

I don't mind staying in the third bedroom.
I've actually grown accustomed to sharing kitchen and bathroom space at the WWCA.

You think I'm joking, don't you!

Since I didn't pass the recertification test, that's one of the places I've been staying. And with friends who care.

I paid for that place! Actually, we are all collective owners of that Philadelphia time share.

So, could you please put us all down on the calendar who did not pass the test, please?
Could you bring the keys to the downtown library? It's just for one night.
And the building here's about to close.

Unemployed internist

Anonymous said...

Representative Sessions:
My father lives in Texas between Dallas and Fort Worth. He got out early cause of the useless testing. That's one more physician that can't treat. Who did it?
It's the ABIM. It's the greed they represent. The don't represent the people.
For God's sake become a Senator if you are powerless, but something needs to happen to bring the physicians missing in action back to help with the doctor shortage. If you won't or can't help or don't understand talk with Wes Fisher.

Wes, send my post card pig to the good Representative and let him know how many of us are not able to work as we should. Tell him how the people are underserved.
Tell him how the veterans are getting the shaft and the seniors.

What else have I got right now except to wright about it! Send my message along.
There are physicians driving taxi in New York and Austin!

Unemployed Physician. (do it for my dad in Texas!) It's real! Look around. Dad's too damn proud, but I'm not too ashamed to shout!

Anonymous said...

The ABIM is not protecting anybody but themselves.
They are vengeful and vindictive. Do you understand that clearly, Wes!
I can't tell you how many people they have harmed.
America needs someone with a heart to tell this story.

the death of specialty boards through breach of trust and greed said...

American Board of Internal Medicine: Over 50 Years of Seized Party Control.

But which party? I thought the ABIM was a non-profit humanitarian organization and testing company. It is not either. It is a defunct venture of the depression era that served a purpose and that purpose was completed. Physicians must stop fighting the ABMS and instead treat patients and study on your own. The ABMS is corrupt and offers nothing of value.

Let's examine what is. The ABIM is a closed political society. It harms and destabilizes medicine. It destroys physicians lives and happiness. It preaches austerity in the name of quality. This is a lie. Lies destroy trust. Lies create harm to patients and phycians. Stop this lie now.

Only the few who have actually created these secretive political society, inside the offices and hallways, would be able understand or to describe its purported functions - the lack in fulfilling that original function, and extracurricular political activities. Now executives are parasites of the organization. The vital nutrient or ingredient of the educational component has been strangled from full development. Funds have been diverted for executive bank accounts instead.

There is proof of over 50 Years of excessive inurement for executives who got away from the boards - spinning independently out of control. Executives created an existential parasitic relationship with the specialty boards. Symbiosis was destroyed by political ambition and greed.

Look at what all the specialty boards have become. Their brands are worthless, devoid of trust. They have breached their trust with the public. When that trust dies the organization is dead.

Turn certifications over to third party trustees, evaluate future needs and the efficacies of an outdated multiple choice testing system. Improve it or move on to live knowledge and data banks available all the time. Make access to all knowledge and journals free to physicians as compensation for suffering for so long at inadequate leadership at the board and government levels.

Move on. Give all testing to university programs with the actual ability to create a valid lifetime test in the various specialties and subspecialties. Make CME the standard of continuing excellence, not the ego or libido or political ambitions or authoritarian regimes that pound the love of learning out of people with their offerings of useless gray left over pudding.

Make the tests free as part graduate medical education curriculum. Free the test of conflicts of interest. The ABMS has spun out of control. It is a useless money engine that does not ensure safety for the public. They support corrupt foundations that pretend to spread greater quality of care through reduced costs.

The myth of inverse ratios of quality to cost must be shot in the head for good.
Only quality produces quality. If the money for medicine is not there. Then stop killing our armed forces personnel, wasting lives and equipment in stupid useless interventions that fragment societies and implode security in the world.

Do they know what they have done? Have they no decency? Have they no humanity?
The ABIM is an extension of corporate greed and supports killing abroad by introducing austerity to pay for it.

Stop it. Republicans must stop this madness. Democrats must stop this murder.
Independents must recognize the insanity of war. We must stop exporting death to the world and killing and maiming our own men and women in conflicts that we often create or generate.

Stop it. Or it will mean the end of civilization. The end of humanity. The end of the planet's resources. The slow or quick suffocation of all living creatures on the planet.

The battle to end MOC just ended with pettiness. The ABMS is corrupt and petty.
Go home and find meaningful lives doing something useful. Go home!

The battle is declared over. Pick up the pieces of humanity that remain and move on rebuilding a newer better society where corruption is not known.

Spy Bears. Grizzly and Little said...

Coming soon! The Adventures of the "Spy Bears" to "Wes' World."

The harrowing stories of "Uncle Grizzly" and "Little Bear" who risk their lives in service to their country. Sniffing out and stopping riff raff in the medical bureaucracy is a big part of their current assignment and personal mission.

Working as private investigators after years of "qualifying domestic and international service to their country" they will destroy the dark forces that come between the physician/patient relationship.

If your are dirty they will put their nose to the air and they will discover you.
So keen at tracking and discovering the truth, there is no where for the dark forces within humanity to hide. They will "cast out the demons walking among us."

They work like lightning in the night. They reveal everything that is there.

The series is based on evidence which readers and blogger/authors provide here on this site "Wes' World."

Uncle Grizzly and Little Bear's three year mission: to identify and stamp out corrupt practices in the medical industrial complex and send the lazy bureaucrat riff raff packing.

First Episode: "No Longer Suitable for Use." The Mystery of Why the ABIM Wrote Down 3 Million Dollars on Computer Equipment Purchased in 2013.

The mystery takes us inside the ABIM offices for an in depth look at their operations. Of course as seen through the astute experienced eyes of our heroic investigators 'Uncle Grizzly' and 'Little Bear'.

There is no telling what our team will uncover quite by accident as UG and LB bumble and stumble their way through the ABIM's obfuscated financial and ethical mess.

Remember they work for the "righteous and the holy" so you better put on your clean underwear. They have x-ray vision, the power to see through walls and ceilings.
They have worms that will follow your trail everywhere, even if you delete.

Our bears existed before anyone was born. The fill the night with light. So beware.
If you are good they are beneficent, but if you are guilty and unholy they are beasts from hell.

"We'll be seeing you, but for now we've gotta scat!" - UG&LB

Send the bears your questions in care of "Wes' World." Our investigative heroes will get to the bottom of it all.

©Hypnotic Companions 2015

God Child said...

I have two question for Uncle Grizzly and Little Bear.

Why did Christine hurt so many physicians? I'm glad she is gone, but why did she do it. I was almost starting to think that the ABIM was good and kind back in 2008 and 2009, but geez was I wrong. She hit my family hard and our whole house fell apart when mommy and daddy had to take that recertification test. And they were so distraught losing all hope and all confidence in themselves that they just could never take it again.

Stupid what happened really. I don't understand. They claimed they missed some of the pretest questions that they thought should have been thrown out. But ABIM would never show them the test. They appealed but lost the lengthy and costly ever-changing appeals process. Lynn and Chris kept changing their minds about what they said and kept giving mommy and daddy new policies that they said were subject to change at any time too. And on and on. Around and around the mulberry bush. Ouch!

So here we are still, left to beg in the street. I hope Cassel is gone for good. I hate her and will never forgive her for what she did to my mommy and daddy who used to both be physicians. And good ones that everyone loved. Not fake physicians like her and Rich. You know I read something Lynn wrote about certification test back in 1993. She's been there too long. Not qualified and never could be a doctor. Could not make it into medical school. And I read all the things justifying multiple choice questions to grade a doctor. Lynn and her friends wrote them all. What a lie and sham.

Before I go, just one more frustrating complaint and my rambling question for the cute Little Bear to investigate? I'll take my answers offline. Please write to me by snail mail. I'll leave my address with Sir Wes of the Round Blog.

Why does Lynn continue on there? Why does she persist at being nasty and like an evil spy. Why does she want to injure so many more...and especially the little ones that can't fight so well? Why does she keep insisting on hurting, hurting? That just haunts me everyday till I cry. I ache inside to understand why. I thought she wanted everyone to have a nice day and be good physicians--not without means to even pay for the retake of the test.

She hurt my mommy and daddy and then she hurt my uncle too. She used some naughty people to hurt my uncle because he tried to fight for mommy and daddy. She put on ugly bad people's clothes and came out of the darkness with bad men that like to hurt people. I don't like those scary people she knows and uses. They hurt me too when I tried to stop them. They hurt my uncle's face when he tried to make things right. I saw it all. That bad woman and her bad people should go.

It seems like she is pretending to be a COO turning into a COP when it pleases her or like my mommy and daddy say she howls like a demon when the moon is full.

Is that how she wants to be remembered? Please help us Uncle Grizzly and Little Bear. Investigate them and make them stop hurting doctors. I want them to stop hurting the patients who find it impossible in many places to receive care.

It hurts to be alone and poor in the world. Ouch! I wonder if Lynn ever had to struggle like she's made my family struggle. I probably should not confess about our hard luck life because Lynn might just smile and gloat. Ouch!

Well, good kind bears, those are my questions. I don't expect you to answer me right away, because I know you have lots on your plate to take care of. It seems the whole world is filled to the brim with corrupt people on top that don't care enough to change things.

Lisa said...

Wow, "There are physicians driving taxi in New York and Austin!" from Anonymous. This is demographic targeting. A crisis was created by ACA where there would not be enough doctors--concurrent with that, they make it harder for a physician to stay in business. How is this not strategic? Almost all the presidential candidates have an 'Open Borders' policy, or are at least lenient about H-1B VISAs. MOC is to replace actual quality, because 'being covered' and paying a premium is to be the new definition of healthcare--regardless of whether a doctor helps the patient ("Less is More" or "Stockholder First")

Meanwhile, we have scholarships that go to "minorities" (the 90% of global population that is not white) but the others are stuck with loans. So when even greater crisis is created (e.g. giving healthcare coverage to illegal immigrants at government expense) then on top of a greater crushing national debt, there will be an emergency shortage of physicians. At this point, the crisis that's been strategically created will put the country in a position to push for as many H-1B VISA physicians that we can get. They will make for a cheaper alternative also. So those left with loans to pay will enter the world of the STEM/IT worker. This will become the young white doctor song:

I realize some people will be offended because I mentioned race and 'we're not allowed to say that' but if it's true, I'm allowed to say it. That should be everyone's policy and the country would be a better place. Anyway, thankful to Wes for making the trip out to Washington DC: folks like you make the world a better place. All the best to you as you fight the good fight: do it for your country.

I'm with Lisa and all physicians who have been cheated said...

Yes, Lisa, these are real physician horror stories and thanks for speaking up too.

There is pain across every demographic in our country. I've discovered many people like my own family who have been harmed by ABIM and those who profited financially and politically over the years from working there unethically enriching themselves and growing their investments and retirement accounts.

We understand now that we were duped; and unless we learn more of what is really going on and speak up about our evolving understanding and reasonably thought out convictions we will be fooled again.

It is now time to weaken the ABIM and ABMS. Too much power has corrupted them. They spun away from their humanity and are out of control. They have failed to protect the public through negligence and lack of focus on their core mission, but instead unconscionably harm physicians.

I hope everone understands that physicians' fees went to fund this debacle called healthcare reform, while Chris Cassel was on the job at the ABIM, ABMS, Kaiser, Premier, RWJF, and on the hill!

Cassel was almost everywhere else except...where Cassel was supposed to be - protecting patients,focusing on what she was hired to do. On the job in her office @abim

Cassel's ABIM contract clearly stated she was to work on the creation of viable testing. Cassel chose to work on her several other projects. When a small percentage of revenue goes toward the certification, and almost all read

She failed as has Rich Baron today and the others before them.

The same clear 'mission statement' of humanitarian non-profit organization is written on every ABIM tax return. The organization failed, because the energy went to lobby and play politics. Almost all of the executives either lobbied or protected the organization from being seen for what it really is and has been for decades. The honest truth is the ABIM is secretive about its financials and activities because there is fraud and lies everywhere. It is not hard to pick up any fact about the ABIM and it all leads back to a central lie or deceit.

The ABIM became a secret voting booth decades ago, but over the past 20 years no one got to vote except Chris and her financial/political partners.

We must understand and not forget the lessons we have learned after piecing together the truth.

Cassel and ABIM personnel orchestrated a coup of medicine starting in 2007. It was a very well-timed persecution of review boards, all certification organizations other than the ABMS, but especially the "highly intended consequences," to weakened the one knowledgeable voice in American. I mean the intelligent and moral voice of physicians beaten down with busy work, exhausted and afraid of the ABIM/ABMS. The lawsuits and sanction, letters of concern was intentional to bring about the demise of physicians' rights and voices suppressed opposition. Fear is what we all must fear.

I think every thinking physician, and that would be all, understands or feels the monstrous deceit played on everyone with the fake organizations who usurped our vote and created the myth of universal comprehensive health care. Whatever it is, it does not work and now we will have to take years fixing the mess they greedy ones created like Chris Cassel. I know she is getting on in years, but she should be tried for not just being a lying fraud, but she should be tried for treason.

Thank you for shouting, Lisa!

Lisa said...

Fascinating that Wes' world includes Spy Bears. Dang! That's what I missed doing--life could have been easier with personal bodyguards like this. Hindsight is 20-20 after all.

Cassel's foundation is PHILOSOPHY. Her main purpose is to deconstruct. Another commentator cites her purpose as "protecting patients" LMAO. A handful of rich people with global agendas are calling the shots; ergo healthcare is the traded commodity that the government forces people to purchase--so market forces that would drive quality are absent, as is choice that controls price. Instead, executives are in place to punish dissenters. It is the Stalingrad model of Medicine. Yes, also your medical records are easily modified not just data-mined.

At some point, after people start trying to kill you, you get used to it, and it emboldens one somewhat to just go ahead and really piss people off extra with the truth. It's not really a first choice in how to do life, but you know, you get used to it. Now I find out I might have had bears to protect me and could have led a normal life.

When Doctors without Borders was bombed, a news story went out that this coincidentally was right after peeving the government about their TPP opposition over skyrocketing costs of medicines. So giggles every other news story where they asked for a transparent investigation.

Go Slay the Beast, Wes! An encouragement to the suffering: once you have nothing, what can be taken from you? Always examine whether you have actually done something wrong that you need to make right and do it. Special thanks going out to Principle & Assistant of my Elementary school for teaching me that through behaviors that led to it's closing in disgrace that no one was to ever speak of again. If your conscience is clean then never take the rest of the nonsense as personal failure. People in power will shout you down and shame you--but if you know you're not to blame you can laugh it off--carefully though, because they WILL kick your ass.

Anonymous said...

ASH tells ABIM to stick it.


and now Hematology

All telling Abim to stick it.

Anonymous said...

Who else noticed that our elected representatives vote themselves perks and legal protections, such as exemption from prosecution from insider trading laws--as many got rich on ACA stocks while sticking it to the nation. And that they get paid handsomely to maintain two-households even if it's just a cheap motel room in their state. They get all the surf & turf meals they can eat.

Meanwhile, our homeboy Wes travels at his own expense to Washington DC as a good citizen and they feed him noodles.