Wednesday, December 16, 2015

The ABIM Maintenance of Certification (MOC) Controversy a Year Later

It has been one year since the story of the ABIM Foundation, Choosing Wisely, and the $2.3 million Condominium appeared on this blog. It has been one year without answers to the many financial, conflicts of interest, and likely illegal tax dealings of the American Board of Internal Medicine discussed within this blog's pages.

But as this story has unfolded, it is clear that this story is much more than a story of the purchase of a luxury condominium by a little known non-profit organization. It has been the story of betrayal of the entire practicing physician community in the United States and their patients everywhere in the name of self-serving power and greed by a relatively select few.

The story is also an embarrassing demonstration of the inability of our professional medical societies to deal forthrightly and honestly with all that has transpired. The vast network of the interconnected medical Specialty Board System led by the American Board of Medical Specialties in the United States that earns hundreds of millions of dollars annually from physician testing fees is incredibly wasteful and counterproductive. Instead of honest examination and disclosure of the facts, the ongoing deception, double-speak, and cover-ups of this system continues.

To date this story has also been about the failure of our legal, government, and law enforcement agencies to investigate the secret financial and tax filing discrepancies of the American Board of Internal Medicine and the ABIM Foundation. This has created a colossal erosion of physicians' trust with our US medical regulatory agencies, especially when doctors can't trust these agencies to protect them from fraud and abuse.

Why the lack of governmental investigation into over $70 million of physician testing fees that were secretly funneled from working physicians (preoccupied with the real work of patient care) into a shadow "Foundation" hellbent on making shady investments and enriching its leadership? The wanton disregard of the basic tenets of law and a civil society displayed by the ABIM is an anathema to honest physicians. Most physicians would prefer to believe that we do not work in an environment that rewards deception, theft, and greed. Yet here we are.

Finally, with the notable exception of a veteran Newsweek reporter, Kurt Eichenwald (see here, here, here, and here) and the tireless efforts of a single forensic accountant, Mr. Charles P. Kroll with whom I have had the pleasure to meet, there has been precious little true investigative reporting into the financial and anti-trust activities of the ABMS and their member boards by major outlets of main stream media. "It's a doctor problem" or "it's too complicated," I've been told. Is that the reason?

We'll see.

One thing's for sure: there's a lot of money at stake in the testing and control of practicing physicians and it is increasingly clear that these organizations (and even some segments of government for which they now work) won't open up willingly or relinquish their lucrative MOC re-certification program without a fight. They know they simply can't afford to maintain their current ways without it.

Getting It Wrong Again

Because of this reality of cover-up and backed by remarkable hubris and ego, the ABIM leadership appears to have made a more recent critical error - another little thing it appears they got "wrong." The ABIM decided to track down and hunt a young physician attendee of the Arora Board Review course attended in 2009 using an email that was found on the server at the residence of Dr. Arora and sued him almost five years later. These guys are serious.  It seems maintaining monopoly control of the lucrative board re-certification process using threats and intimidation (aka, The Chicago Way) was just too important to the ABIM.  But what the ABIM didn't expect is that this young man had at least one parent who was a lawyer,  and he sued back. Time wil tell if this brave man dealt the ABIM (already in the midst of their own financial and ethical mess) a potentially mortal blow.

This case is about to get interesting. So interesting, in fact, that it appears the ABIM's legal team will stop at nothing to try confuse and deceive the judge or magistrate who will soon hear oral arguments in late January 2016 about the case.

Perhaps then the truth will come out: all of the facts of the business of testing physicians; all of the tactics used to bully physicians into compliance with the ABIM MOC program; everything laid bare.

For this story is similar to the disturbing story of a subcontracting security firm that works with Pearson (a company reviewed earlier on this blog) and paid by the state of New Jersey that has been spying on children to protect their monopoly interest in the content of the national Common Core test. For physicians, it is no coincidence that a different division of Pearson, PearsonVue, is the professional testing division of Pearson that the ABIM uses to secure its examinations and cherished test questions.

When the facts come to light about the spying, the tracking, the hunting of physicians by an organization profiting handsomely from intimidation and thuggery, it will be hard for the ABIM and its Foundation to survive. So, too, the basic construct of the ABMS and our entire professional specialty board system.

It is increasingly clear that the ABMS MOC program is about threats and intimidation so people can enrich themselves selling unproven quality data to unwitting customers, and little more.  Physician education, if it happens, is really secondary. Is this what the physicians need from these sheltered and unaccountable non-profit organizations? How much time, energy, and money have we already wasted and turned from the delivery of health care with this program?  How many physicians' lives has the current system in its perverted construct ruined?

When all of the facts of the MOC program become known, maybe, just maybe, the ongoing fleecing of US physicians by the corrupt and misguided ABMS MOC progam and the irresponsible Code of Silence held by their subordinate member boards will end and our profession can get back to doing what its meant to do: treat patients.

One can only hope.


PS: By the way, today in history on December 16, 1773, the Boston Tea Party took place.
Seems apropos, doesn't it?


Lisa said...

Other PearsonVue tests bring up results immediately--they're digging up whatever they can to screw you extra. Can you not tell the DOJ that disparaging remarks are being made against terrorists? That's not tolerated.

By the way, Dec 16th was also Beethoven's birthday...dadadadahhh

Sound-tracks for Whack-a-Mole


Anonymous said...

Great blogpost.

You know they read this.

They just stall..and stall...and stall.

I was willing to give Baron the benefit of the doubt. Not anymore.

He is shameless.

End MOC said...

How about that lobbying, Wes? Doesn't the ABMS make billions of dollars for its "real clients" from all of its regulatory capture, not just millions for themselves at the top of the bureaucratic ladder.

By "real clients" I'm referring to the nefarious "stakeholders" the big recipients of the money written into almost every healthcare reform bill for decades.

The PP ACA is a prime example of power brokering and has nothing to do with caring for the public or organizing medicine into a harmonious socially equitable enterprise.

More empty words like usual.

Note the very careful wording in their request for funding for "new committees" that can better serve those already involved in the "entwined commitments" to healthcare quality GME and lifelong learning.

What a damn buzz the ABMS makes in my head with their "ethical commitments" to cleverly increase their own investment accounts and humongous salaries by proffering more bureaucratic red tape and lifelong educational opportunities for our gullible governmental representatives to consider and bite into.

If I were to rewrite history I would put the ABMS in the central garden winding around a pivotal tree--a tree not of life or health but pure evil.

We contribute to this corruption of the good by throwing money at the root of that bad tree. We water it with strained conciliatory words that never speak directly or honestly about the horrendous situation we are in.

We fertilize 'it' with lies and pretense. It is time to stop 'it'.

Anonymous said...

Great blog and to the point, Wes! We need to sue them individually and collectively.
Money is the only thing that matters to them. Take it away. It is our money.

Anonymous said...

The ABMS keeps encouraging more funding for select committees and commissions, while underscoring the need not to cut their other lucrative power grabs resulting from earlier lobbying successes among their many governmental $$$ requests.

When a state or federal representative of the people shrugs off his duty to provide oversight regarding these corrupt tax-exempt organizations it is a totally wrong and uniformed response. The moment they started grabbing money and power from the people and the government they ceased being non-profit organizations.

All docs have been cheated out of money and time. We need the IRS (or any physician or patient) to sue for breaches of our federal and state laws. The ABMS has committed acts of fraud against every physician and John/Jane Doe or Mary/Joe public.

The ABMS is comprised of 24 specialty boards, but it gets financial support through the associate member organizations like the ACGME and the rest of their unscrupulous gang...

Further reading


Anonymous said...

Is there anything we can do to help with Dr. Salas Rushford's legal fund?

He's got guts to stand up against the corruption and fraud of Rich Baron, Lynn Langdon and the ABIM hit men. I was outraged when I heard about his case and the details.

DrWes said...

Anony 06:04PM -

I believe Dr. Salas Rushford will be posting a request for funds soon via a website he is creating. I will provide a link to the sight when/if it is announced.

Anonymous said...

We are getting closer to the truth of ABIM and ABMS culpability. ABIM needs to be exposed, not just feathered out a few details at a time. We need to read about it all in the main stream media.

The ABMS, not just the ABIM, had a large role in the persecution of physicians and board review companies that were competed for only a small share of the money pie. How greedy and petty can they get to sue Dr. Salas Rushford five years later.

I believe it is a political and personal vendetta by the executives and key players as well.

I will chip in to his defense fund. Keep us informed.

Anonymous said...

Regarding the ABIM survey "Share Your Thoughts on MOC".

Dear Richard G Battaglia, MD, ABIM CMO:

I called the ABIM in November to welcome you, Dr. Battaglia, to the ABIM in your new appointment as of Chief Medical Officer. I understood that you would act as a liaison between physicians and the ABIM in order to make the organization more transparent and responsive for physicians.

When I called, I was trying to reach you in order to applaud this move by the ABIM.

Unfortunately, when I called they would not put me through to you, your voicemail or provide me with an extension. So, I asked for your email and the response was, "No, e-mails cannot be given out either." So, instead of relating my best wishes personally, I requested that the phone receptionist convey my best wishes to you.

Dr. Battaglia, I am not a physician but a patient. But as a recipient of medical care by ABIM/ABMS's certified physicians, and non-certified US docs, I am certainly an interested party in the discussion and the survey. I share the concern about the need for greater transparency and responsiveness regarding the ABIM and ABMS. Issues of certification and MOC do not just affect physicians, but it affects patients even more so.

I am blogging about this here to let you know that I am disappointed that my thoughts, feelings, and input were apparently not needed or wanted. I was barred from sharing even the simple sentiment of, "Welcome to the ABIM." This is troubling, because the ABMS was founded on the premise that the organization was at one time "for the patient."

The ABIM announced they have included non-physicians on the council, because it was important to have a broad-based objective understanding of the complex issues which the ABIM faces in meeting the "ever-changing challenges of certification and continuing medical education in the 21st century."

The ABMS includes non-physicians on their board in some capacity as well.

So why not create a patient council also as a liaison between the ones that matter the most in medicine, the patient and physician--their relationship. We as patients would like to really listen deeply to the physicians' concerns in order to help resolve severe problems that if not dealt with properly and thoroughly, will totally shatter all trust in the ABMS in a very short time.

That will certainly be the result of ABIM's incessant closed attitudes and shut-door-policy toward physician and patient input. This continues to be the reality, unfortunately while you claim to hold out an open hand; yet no one can ever get through. Nor do you wish to truly listen. That is my invariable impression.

In light of the importance of your survey containing views and experiences about MOC from physicians, I would like to submit the need for an additional survey of responses about the experiences and views of the ABMS and MOC from the patients' point of view, in order that the patient/public can really be informed and involved about issues of the ABIM today, and how relevant MOC is (if it really is) for the ones that really matter--the patient and physician.

Page Two ABIM CMO said...

It is wrong that this conversation is kept between physicians and the ABIM leadership only, because it is ultimately a conversation between doctor/provider and patient.

It should be a shared decision process where the patient is instrumental in the decision-making process as they are deeply involved.

Here is a question for you.

If after careful deliberation of facts the patient population, me included, decided they wanted more time with their physicians. What if we wanted to see less stress and burnout in their physicians partly a result of useless/questionable bureaucratic oversight like the ABMS metes out. What if we wanted to trust our physicians to choose the right continuing medical education that was right for them (and us) and not allow universal medical science to be packaged, monetized, and forced on physicians by the ABIM.

IF this were the truth, would you listen? I'm afraid to tell you, Dr. Battaglia, it is already the conclusion of many patients and this view is growing everyday.

Put the survey out to the public. You will quickly discover that "the patient" which the ABIM speaks of in their previous "scientific surveys" has never heard of the ABMS or the ABIM. The patient would quickly inform you in "real time" the ABMS has nothing to do with the patient/physician exchange and very little influence at all in choosing or keeping a physician.

As a matter of fact if my physician were not transparent and responsive toward me and had a tendency toward arrogance, I would drop that physician immediately.
Why is it that the ABIM only makes people increasingly angry. PR will not help this deep response.

When you break trust with the people that matter to you most, the relationship is broken. The kind of trust needed to get physicians to keep dishing out money to you is lost forever. You must think of another plan. Give all the money back that you and others at the ABIM have stolen and amassed in the ABIM Foundation. That would be a better plan of gaining trust back.

Thank you.

When I call I always give my name. Please take my call and discuss openly with me next time I call. Without your input, Dr. Battaglia, I'm afraid that my mind will stay with what I experience. I am the vital part of the questioning process and I do have many valuable questions and things to say. I was hoping to learn something from you that would challenge my views and broaden my perspective, but instead I am blogging with great concern about the whole organization and the way it strong-arms physicians instead of really listening and changing.

I suspect even your letter to Dr. Accad is nothing more than window dressing. After all you have serious ethical and legal issues. Let's address those first, before we have any more nice words written in the shifting sand.

Anonymous said...

If ABIM is really smart, they need to apologize publicly to Arora and compensate him out of court. He did nothing wrong, nothing that Harvard or mayo review courses or even our poor quality specialty societies don't do year after year. Arora needs to get on SERMO and get the huge body of doctors to be present at the court.

Anonymous said...

Well...The ABIM has spoken.

" Diplomates still need to take and pass an examination every 10 years and earn 100 MOC points every five years as well as complete some MOC activity every two years to participate in the program."

Dr. Baron.... You're not listening to spit.

Goodbye ABIM... Hello NBPAS.

You Sir are shameless.

Anonymous said...

"In a policy retreat LONGER than Napoleon's march from Moscow, the American Board of Internal Medicine (ABIM) once again has relaxed its controversial requirements for maintenance of certification (MOC).

ABIM announced today that it is lifting the requirement that physicians earn MOC credits for improving patient care and safety and incorporating their preferences in medical decision-making for an additional 2 years. The three MOC activities in question go by the name of Practice Assessment, Patient Safety, and Patient Voice. The organization told diplomates in February that they won't have to complete these requirements, widely lambasted as busywork, for at least the next 2 years. The latest decision extends the suspension through the end of 2018.

In a news release, ABIM stated that it based its decision on feedback from internists and internal medicine subspecialists and the organization's commitment to "recognizing meaningful activities physicians are already doing in practice." To make its requirements less burdensome to diplomates, ABIM has been approving more continuing medical education activities undertaken apart from recertification as counting toward MOC credit.

"ABIM has heard from many STAKEHOLERS good for patients when physicians regularly evaluate and improve the quality of their care, so we need to do a better job recognizing the meaningful quality improvement activities you are already doing," Richard J. Baron, MD, MACP, president of ABIM, wrote on the organization's blog. "We all share the values articulated by the [American Board of Medical Specialties] that embody a commitment to professionalism and the importance of physicians staying current, increasing patient safety and reducing harm and improving patient care."





Backbone connected to the Jawbone said...

The DOJ and IRS are asleep at the switch.

They are not protecting the public from testing company fraud. They turn a blind eye at blatant tax omission, misstatements and other irregularities at the ABIM.

The ABMS is a for-profit alliance of membership organization! Each member pays the head Chicago organization in order to belong.

How much does each member specialty board pay and what do physicians get for it?

Where is the oversight and ethical lead going to come from. Will it come from the CEO of the ABMS? Everything indicates the CEO is controlled by others with out any power.

It appears even the CEO pays membership dues.

The media is afraid to report the truth. What does that say about our free press?
Money flows with more abundance and power than the rain, snow and wind under the ABMS' dark umbrella.

Can some reporter speak about this story other than that award winning, NY Times best selling author, who screams out to physicians that they need to grow a spine?

Maybe it is a contingent story where more physicians need to look at the facts and grow a spine before others will come in and investigate.

If true, why is that?

Straight-Up Dope said...

If physicians/we want a sick dysfunctional relationship keep paying the ABIM/ABMS.

If you want to be normal life, get a lawyer and "sue the pledge off these bastards!"

They are cleverly 'playing us' for ever new ways to collect money. Even the 10 year MOC test, if that is discontinued, will not be because we want it; it will be because there are new ways to get even more money in more reliable/continuous revenue streams. Beware. This for-profit corporation puts more time into money propagation over 700% more energy and time into the financial schemes.

Warning the ABMS and ABIM have contingency plans not unlike our department of defense, with financial plans that will be even more lucrative for the ABIM/ABMS. It will be more time consuming and legally invasive for physicians.

These bureaucrats have bosses/partners too that will not let the money go.

Physicians, wake up!

Do you want to be controlled and keep paying these frauds? The ABIM is a for-profit testing/testing security company. The ABIM has massive debt. It is operating on revolving credit. The ABIM is totally broke and they lie about it.

The ABIM Foundation is a straight-up WALLNUT STREET "hedge fund".
The money was stolen from us. Let's get it back.

Anonymous said...

AGA supports ABIM's extended suspension of practice assessment for MOC

“Throughout 2015, AGA has pushed ABIM to reconsider the burdensome recertification process. Gastroenterologists need a recertification system that fosters active learning, not high-stakes testing,” the AGA wrote in the statement.

AGA will continue to work with other societies to establish the best MOC approach based on principles it released earlier this year. These principles focused on a “simpler, less intrusive and less expensive” MOC process; ending the 10-year exam, out-of-date closed-book assessments and unnecessary assessments in specialty areas in which physicians do not practice; and replacing lifelong testing with ongoing CME.

“We hear you that MOC is a burden and we will continue to push for the principles of individualization, specialization and dropping the high-stakes exam — sooner rather than later,” the statement said.

MOC requirements that are still in effect include the 10-year exam, earning 100 MOC points every 5 years and completion of some MOC activity every 2 years. Because requirements vary based on year of certification or recertification, AGA encouraged physicians to visit the ABIM Physician Portal in its statement.

Dogtroep said...

I wondered why my MOC test results weren't back yet (the exam was 10/16/15)--it's because the ABIM is still prepping for their day in court.

Anonymous said...

ABMS MOC steals money and time.

Ed Rico said...

Biotech executive Martin Shkreli arrested and charged with securities fraud conspiracy, securities fraud, and wire fraud conspiracy. Can the ABIM principals be next?

Piccolo said...

Kurt Eichenwald called for an investigation of Martin Shkreli some time ago and predicted (tweeted) almost before anyone that he would be indicted.
Here we go. But, surprise it is on "something unrelated."

Kurt also called for an investigation of the ABIM months ago encouraging several government agencies to do so.

Eichenwald has the instincts of a bloodhound when it comes to financial/criminal fraud. And his track record is close to perfect.

Who knows the way in to the ABIM for the Fed may come through something we would not have suspected. I'd place a bet that there probably is an investigation even now. The ABMS, an equally dark organization, if not more so, work in tandem with the ABIM and the member boards. They do not contrary to what they say have a "hands off" style of governance.

It is the opposite, the corporate headquarters in Chicago actually plots with (makes financial plans) and protects (with risk managers)the whole umbrella. (They used to call it a violin in the old days as well as an umbrella.)

Maybe it will be a smart young Federal prosecutor or a clever investigative reporter that will crack the case open and shine a light where they are most vulnerable. They got Al Capone on tax evasion. Not sexy, but maybe it will be something like that which we could not predict.

There's plenty there, we know that; but it's hard work to get at facts that you can document and prove. Maybe it's just as simple as connecting the dots on legal/financial documents and coming up with the key to the scheme.

Anybody who knows Philly (and Chicago) like I do knows it's a damn dominoes game. Nobody wants to be the first in line to fall. But what goes up must come...

Anonymous said...

The ABMS is very much like that "terror organization" the UN pledged to join forces against today in an attempt to cut off their funding. The UN declared economic war on an "artificial state" in the Levant where everyone must work and live under the conditions of fear and coercion. Everyone must remit and submit. Of course they say it is voluntary.
They suddenly recognized it was a vast bureaucratic network that depended heavily on huge cash streams. Most of its operations are funded from stolen money that runs the operations or it goes into the pockets of wealthy leaders who spend it on themselves. The criminals also put the money to work for themselves into high risk investments.

New Sons and Daughters of Liberty said...

I researched what you said in this blog post about the spying and privacy issues in the testing industry. I'm doing my own fact checking. What you write is disturbing but true.

What the hell is a British company Pearson/Pearson Vue doing spying on US citizens! It is despicable to spy on children like that. They create the testing market with regulatory capture, lobby to broaden the copyright protection laws, and then push to get legal protections relaxed to have Americans spy on Americans.

That is pathetic and a sickness that needs to be cured. All the test companies invariably are taking advantage gullible people like this to create fear and enhance their products and services.

And the ABIM connections to this "spy ring" is doubly concerning. Aren't you sick and tired of this?

And they seem to selectively pick the soft targets like green card/visa holders who are too afraid to speak out. There is no place for such violations of our constitution and bill of rights.

There is no place in America for discrimination against FMG's or any resident of the United States!

I'd like to see the "New Sons and Daughters of Liberty" toss those company's products into the Boston Harbor! Or the Delaware River and Lake Michigan.

Or toss everything in the river that borders Valley Forge National Monument near Philadelphia along the Ben Franklin Freeway. How about a symbolic encampment in honor of the two thousand physicians who have signed up with the NBPS. And the 20,000+ petition signers. The hundreds of thousands of physicians and millions of patriots who oppose the tyranny of the ABMS.

Valley Forge where two thousand freedom fighters did not survive the cold winter.

Boston Tea Party, John Adams and the destruction of the heavily taxed tea in the Boston estuary. Some of the Sons of Liberty wore traditional native American regalia.

The Cost of Keeping Up said...

We are not looking for regime change, but MOC must go.

Anonymous said...

It is also time to stike at Pearson Vue! Those that can should think about having their children "opt out" of their state's Pearson Vue school testing. IE: the common core PARCC tests etc. Stop feeding the ABIM and their cronies. Come at the battle from multiple directions just as they are trying to flank physicians! I am sure that there are other indirect angles of attack that can be thought up and applied!

Anonymous said...

A good read on how opting out is disrupting Pearson Vue's school testing. It has an impact! It also may give some insight as to the trajectory and consequences of a physician testing opt out movement.

Anonymous said...

"No teacher left behind"
was just replaced on Dec 10 2015 by the "Every student succeeds act"

This new law gives more power to the states. Read about it. The new bill was possible only with Republican sponsorship and backed by a strong teachers' union.

Teachers were civilly punished or going to prison for testing irregularities created by the impossible federal mandates. Pearson/Pearson Vue's and other test companies' unvetted "security partners" were involved in many of the security investigations. The testing security campaigns with their expanded powers involves almost all testing corporations. We can't just look at one and point the finger.

In Atlanta teachers went to prison over "irregular erasures."

Physicians may be the next ones to go to prison for taking ABMS mandated MOC tests.
The testing cartels and their security gangsters and scheisters are recommending that their "clients" UPDATE their protection clauses to include civil and criminal prosecution, etc.

New on-site or home-based online proctored MOC exams, where unvetted third party security proctors will take control of your computer and ABMS will/may entrap you with attempts to get you to commit to an even more punitive "take it or leave it" condition in their "legal contract."

My strong opinion is that MOC is not just onerous, it is an illegal fee, plus itcauses great harm to the medical profession. It harms patients. It was created to monetarily benefit testing cartels like the ABMS and their partners. The benefit is unproven. The harms are obvious.

The legality of the ABMS' MOC needs to be challenged in a courts across the nation. Physicians should sue for monetary and punitive damages.

Physicians need to create a strong union and lobby.

Cassel-gate, spy-gate scandal of 2008- said...

What else did the ABIM and their co-partners at the ABMS do wrong?

They used highly questionable and tainted investigative practices and unethical legal tactics that brought shame to their company brands. They used shock and awe terror to produce ultimate levels of fear. Clear rational thinking was not encouraged by ABIM officials. Only moralism and hypocritical chastisement by the CEO Christine K. Cassel.

It was McCarthyism in its political power and prejudicial methods including the use of threats and intimidation. They sanctioned and sued and in so doing they actually began blackballing physicians.

The ABIM created a mock panel to adjudicate.

Let’s backtrack a moment in time.

Just try to remember all the statements from Christine Cassel and Bob Wachter about these events. All the 'stage play' while Christine Cassel the CEO/President of the ABIM was amassing millions of dollars ‘playing the field’ in an unprecedented display of egregious conflicts of interest.

ProPublica exposed Cassel's follies a few years later. But nothing happened to her. She stepped down to let things cool off politically. This was wrong and it should have been investigated by government officials thoroughly and fairly punished.

Today, less than a couple years later, we find Dr. Cassel will soon be ‘aided and abetted’ again by the same organization that helped cause the 'furor' in the first place--Kaiser Permanente and its Foundations.

Now, Cassel, the Quality Czar, will get more millions of dollars for advantaging further one of the largest hospital/insurance organizations in the country. She will be working to help start a Kaiser sponsored physician training/educational program with a focus on primary and internal medicine.

At the heart of the non-profit organization is a for profit body of Kaiser partners who profit handsomely. This is not advertised, but is clearly stated in documents and in the formal company structure.

Not so odd or hard to uncover, the fact that the current CEO/President of Kaiser Permanente was even, in part, groomed and pushed into the top position by Dr. Cassel.

When will this kind of 'conflicted servicing' between government/regulatory body and corporation be punished for the egregiously conflicted crime that it is?

We can't sustain the image of fair business and democratic principles abroad when we have such hypocritical action and double speak at home. I am speaking of the corruption that we find everywhere. This corruption is condoned and rewarded in the medical bureaucracy with its revolving-door practices and ever-increasing payouts.

The healthcare system suffers under its heavy weight and siphoning of finite resources and money to enrich a few elites.

Wes, when will it stop?

x said...

dr wes , i m with you. i have decided not to renew my MOC. it is a online scam, i agree. if i loose my hospital privileges due to abim, i will sue it. thank you for exposing ABIM.

Anonymous said...

Dear Dr. Wes,
I find it interesting that so many of those leaving comments are choosing (like myself) to remain anonymous. I have been certified by ABOG since 1993, and I have seen ever more costly and time-consuming methods of re-certification in the past 20+ years. First, diplomates had to pass a closed-book written exam every 10 years. Then the Board shortened the exam interval to every 6 years. Then came a change to opt for annual re-certification, instead of the written exam, by reading journal articles and answering questions on these articles 3 times a year. I really didn't mind the open-book option of annual re-certification, even though it obviously cost a lot more than taking the closed-book exam every 6 years. Without giving a reasonable explanation, several years ago ABOG re-instituted the closed-book exam every 6 years. This move was made in conjunction with similar changes to MOC by almost all the ABMS-affiliated specialty boards. At the time, I saw it for what I'm sure it actually was--a move to get more money out of the diplomates. Last week, I received an email from ABOG that said they were starting a "pilot program" over the next 2 years, so that diplomates who pass the annual open-book questions with at least an 86% average can opt out of the 6-year exam. Pardon my cynicism, but I believe that ABOG may be anticipating some un-wanted scrutiny of their own MOC program (and finances), as a result of the ABIM MOC controversy. I see this pilot program as a way for ABOG to ultimately remove the 6-year exam requirement to avoid closer scrutiny, but to do it in a way that makes them look like the good guys. In my opinion, all the ABMS-affiliated boards are knee-deep in greed and corruption. We need to get rid of all of them, and deep-six MOC in the process.

Anonymous said...

People remain anonymous because the ABMS has unvetted employees and contractors spying on us. They keep secret files on physicians and websites. This should be understood that they operate outside decency and outside the law. Privacy is not an issue for them. Money and copyright; monopoly are all they care about.

They are in a tower well protected, exempt from the law, or so they think. No one can get through to even talk with these elites.

It won't be long before some disgruntled insider posts their internal emails like in the Sony scandal; or they get hacked by some political activist who can readily understand how corrupt they are. That's how damn corrupt the ABMS is and many of their employees know it. The world at large knows it.

By the way, physicians in other countries don't want the ABMS and MOC in their lives. MOC should be dissolved along with these quasi-governmental organizations whose executives compensate themselves with $$$$$$$ galore making the US president's salary look like a fellowship stipend in comparison.

ABMS spies' and security thugs' search many keywords: anything to do with initial certification and MOC. They will have federal marshals batter your doors down and seize your personal property to protect their bogus copyrights. That's how connected this testing syndicate is. The security companies they use have proprietary forensic methods to keep track of you. They track you by your IP address. They read your Facebook, Twitter, anything they can get on you is fair game they say.

Shocked? You better be. More reason to end this whole tangled nightmarish cartel of corporate security thugs. Corrupt individuals make the rules for you.

The ABMS thinks and acts always with money in mind pretending to be GOVERNMENT REGULATORS. The whole ABMS membership and associate members should also be brought in line. Who populates the top echelons and how much they get paid needs to be completely rethought/restructured. Some honest, but powerful politicians and a strong physicians union is perhaps the only way. Physicians have to create their own political muscle again. The membership societies are in their pocket and vice versa--everyone sucking somebody's hind tit on the corrupt phantom of the opera carousel.

Wake up and organize. Sue all these bastards. You will own them. Right now they own you.

Anonymous said...

Anonymous, Mon Dec 21, 05:27:00 PM CST
You wrote, "Pardon my cynicism, but I believe that ABOG may be anticipating some un-wanted scrutiny of their own MOC program (and finances), as a result of the ABIM MOC controversy."

We should be suspicious and critical thinkers; we should become doers and not just passive cynics. You/we are right to break out of that mode of passivity and snap into action. This movement to change what is broken and harmful in this malignant bureaucracy has grown like a cancer and needs immediate attention.

Read Wes' blog below and comments to: "Why the history of the specialty boards is important." Table 1 is enlightening how far 'out of bounds' the play has become at the ABMS. They groom the linesman to adjudicate their activities to be always on in bounds or "on the line" when clearly the ball keeps hitting the patients and phycians right in the face. The foul play has gotten to the point of black eyes and bloody noses. Medicine is being carried out of the stadium in a stretcher.

It is time for action to restore fair play for the physicians and patients.

Anonymous said...

The ABMS, including all member boards, has/have institutionalized themselves into the exact opposite(s). This once non-profit organization or goodwill society and relationship drifted and deviated far over time. It is a broken relationship.

ABMS is now a monetized and a brutally coercive institution. It is not voluntary any longer. It produces negative results. No one trusts the motives. And rightfully so, even with the most basic of facts we understand the whole organization has become a protection racket for the elite stakeholders.

The ABMS now serves the greed of individuals and corporations which control the executives and thereby the whole "umbrella" of organizations. Typically, we find many examples of this deviation and theory of drift in history. In politics we see fascist mechanisms of control instituted in Italy under Mussolini, under Stalin, and others. We see bullying and blackballing of good people in the US under McCarthyism as mentioned already.

Incidentally, an ABIM spokesperson--when claiming that his moral sensibilities were shocked by physicians when waking up and expressing the facts about how the corrupt ABMS cartel has become and how it operates outside the margins--suggested incorrectly that the dissenters somehow created an atmosphere of McCarthyism. He was wrong on this issue and most other points, but rightfully raised the issue of McCarthyism. This is psychological projection on the part of ABIM spokesperson. We can see clearly that the ABIM itself has engaged in McCarthy era tactics on physicians. Such ABIM/ABMS individuals, who speak out on behalf the silent executives and corrupt enablers are the real moral pretenders. They speak from the fringe of a corrupt institution that can no longer speak for itself.

These spokespersons, where silence reigns, live in a moral vacuum filling it with dreams and respectable images of their own concoction. They too have sadly become their own opposites. It is a psychological phenomenon and inexplicable to me how a man or woman so intelligent could become little more than a mouthpiece for such corruption. Any good angel that once sat on their right shoulder has certainly flown away long ago.

Corporate Angels said...

It is doubly inexplicable when you see the pile of money such spokespersons and others have made off these lucrative and powerful positions, whether serving as a highly paid executive or handsomely rewarded board member of the ABMS cartel. They tell us/remind us how they are there to serve and protect the public; yet the facts and reality indicate otherwise.

They profiteer and serve on corporate boards as well where they receive hundreds of thousands of dollars per year in stock and cash; or become executives in the corporate world of power and money with all the many revolving doors open to them.

What can we believe in a world of such lies and professional liars?

It is as though we can believe the opposite of what these elites tell us--especially when such spokespersons tell us how ludicrous it is that the ABIM created a "piggy bank" called the ABIM Foundation to financially benefit the executives. In the context of this statement we must no forget the corporate and political agenda served by executives such as Christine K. Cassel who were given all the time in the world while working at the ABIM/ABMS to lobby/work for their pet medical corporations like Kaiser and Premier, Inc., and related healthcare reform projects.

Egregious conflicts of interest never punished.

Analogous in our study of the ABMS, when we see religious organizations turn away from voluntary acts of goodness, they turn into mechanisms of inquisition, hate, control, political oppression, even organized murder. At this point all would agree such an organization needs to be reformed or revitalized.

In the case of the ABMS it was a time-limited voluntary pact with physicians to create order and to benefit the patient and physician. (Or so we were told.) Now it is all about the money and political power and nothing else. It is divisive to the extent that only a corrupt organization can be. The original purposes were already achieved decades ago. The ABMS served as an aid to organize and to systematize education in medicine. That' all. The phycians who founded the organizations knew it was to be need only for a limited time. Articles of incorporation reflect this and the other non-pecuniary values.

Now the ABMS serves nothing except greed and politics. The ABMS corruption undermines the health of the healthcare delivery system in the United States. The ABMS harms the patient. It harms the physician. It harms the integrity of the United States of America. It is time to shudder the doors and dissolve the organizations. The money needs to be returned to the phycians with interest and penalties.

Anonymous said...

Dear Dr Wes,

Thank you for another excellent post exposing ABIM.

I suffered significantly after I disobeyed ABIM and did not re-certify.

Please post if you hear of any class action, I visit you blog often.

wish you and your family Happy Holidays.

best regards

Anonymous said...

Is the ABIM Foundation supporting the destruction of the Brazilian rainforest?

Unwanted said...

I'm considering signing up for nurse practitioner school. Their organization seems to want to promote them.