Tuesday, January 26, 2016

Love, Ethics, and the Quality Assessment Industry

"I think that commercialization of care is a big mistake. Health care is a sacred mission. It is a moral enterprise and a scientific enterprise but not fundamentally a commercial one. We are not selling a product. We don’t have a consumer who understands everything and makes rational choices — and I include myself here. Doctors and nurses are stewards of something precious. Their work is a kind of vocation rather than simply a job; commercial values don’t really capture what they do for patients and for society as a whole.

Systems awareness and systems design are important for health professionals but are not enough. They are enabling mechanisms only. It is the ethical dimension of individuals that is essential to a system’s success. Ultimately, the secret of quality is love. You have to love your patient, you have to love your profession, you have to love your God. If you have love, you can then work backward to monitor and improve the system. Commercialism should not be a principal force in the system. That people should make money by investing in health care without actually being providers of health care seems somewhat perverse, like a kind of racketeering."

- Avedis Donabedian
* * *

Don Draper in the finale of Mad Men
Many of us recall the final scene of Mad Men where Machiavellian dealmaker, philanderer, and ad mogul Don Draper sits in lotus position finding either true inner peace or the next cynical direction from which to profit. This scene came to mind as I read another apparent conversion experience by Robert M. Wachter, MD in his recent opinion piece in the New York Times on how the metric measurement business fails physicians and teachers. Remarkably, Dr. Wachter, once the Chairman of the  American Board of Internal Medicine (ABIM) that is responsible for "continuously" measuring, re-testing, and re-certifying US physicians, seemed to pivot from his former self by quoting a few of Avedis Donabedian's words on quality assessment suggesting "the secret of quality is love." Unfortunately, Dr. Wachter conspicuously failed to acknowledge the full context of Donabedian's words.

Robert Wachter, MD, as "Elton John"
SHM Meeting 2014
Mandalay Bay Casino, Las Vegas and
Modern Healthcare's Most Influential
Physician Executive and Leader 2015
(Full video of the performance here)

I suppose if he can transition from a physician executive to a "down to earth" Bob Wachter, MD hitting "high notes" as Elton John at the Mandalay Casino while simultaneously profiting from a company that now under federal investigation for overbilling Medicare, why not?  Such is our current reality of politics, medicine, and corporate cronyism.

It was nearly four short years ago that Dr. Wachter wrote that we needed the ABIM's Maintenance of Certification program "more than ever." Perhaps the lucrative Digital Party in medicine was just too big for the ABIM leadership and the members of its Foundation to ignore. At the time, those in Wachter's World held the view that assuring physician quality meant physicians not only had to be re-certified every ten years but soon had to participate in some form of the ABIM's measurement program every two years for the sake of  "external stakeholders and a troubled public."  As a result, physicians were required to perform unproven practice improvement exercises, perform un-monitored research on themselves, and become glorified data entry personnel to continuously "maintain" their "board certification" or risk losing their right to practice. All of these exercises were subsequently revealed to be primarily for the medical industrial complex's extraordinary monetary gain and undisclosed political activities.  Such "love," indeed.

The expanded ABIM board certification requirements after 1990 have served as the goose that laid the Golden Egg for condo purchases, chauffeur-driven Mercedes rides, spousal travel fees, undisclosed corporate consulting arrangements, corporate mergers, political influence and the program's continuing transition to Assessment2020 - much of these occurring while Dr. Wachter served as a Director or Chairman of the ABIM. For the ABIM and its parent organization, the American Board of Medical Specialties (ABMS), success in the digital medical world still appears to mean the doctor-patient relationship has to be owned, bartered, and commoditized to serve their bottom line without really understanding all that this entails to the doctor, their patients, and the credibility of our profession.

If Bob Wachter, MD is a true physician advocate and is now having a genuine conversion experience, he would be speaking out about these abuses of physicians' trust. In fact, as the "Most Influential Physician Executive and Leader 2015," he would be leading this charge. Or perhaps I am missing something.

Meanwhile, despite all of the fast-paced changes in health care under way, the same rubber soles continue to speed down linoleum hallways, call lights blink, keyboards pound, family meetings are held with tears shed, young physicians wonder how they'll pay their educational debt, productivity quotas expand, administrative meetings multiply, patients grow furious about their rising premiums, co-pays and deductibles, physician autonomy and morale withers, and patient access to their doctor shrinks.

Fortunately, rather than standing idly by, practicing doctors are mobilizing. They are realizing that the bloated and costly bureaucratic arm of our profession has lost its way and are working to restore its integrity. Practicing physicians are finding they have a voice and are not powerless against these corporate entities that unjustifiably risk compromising their ability do their job. With these efforts, members of Wachter's World are beginning to realize they're at risk of losing their golden goose:
Last week, Andy Slavitt, Medicare’s acting administrator, announced the end of a program that tied Medicare payments to a long list of measures related to the use of electronic health records. “We have to get the hearts and minds of physicians back,” said Mr. Slavitt. “I think we’ve lost them.”
Despite these concerns of a few of our bureaucratic medical policy elite, practicing physicians remain little more than an account to be landed, a work to be optimized. To them, practicing physicians represent an opportunity to invest in new corporate ventures like Health2047, no doubt for the "love" that's involved. The respectful partnership that practicing physicians would like to have would not include the many corrupt financial practices and undisclosed conflicts of interest of the AMA and the ABMS specialty board credentialing system, their collaborating subspecialty societies, and numerous for-profit physician reporting businesses. They invoke ethics, morals, and "love" at their own risk.

In my career, I'm unaware of a broader breach of the trust of working physicians and of medical ethics by fellow colleagues than by those who secretly created the ABIM Foundation in 1989 and then funneled over $55 million of testing fees collected from working physicians while hiding its existence from physicians and the public until 1999. Yet many in our academic and bureaucratic physician community continue to support this testing agency that appears to have been expanded solely for political, corporate, and personal gain, and are indifferent to them using strongman tactics with physicians. What a perverted form of "love."

This system must change.

As health care moves forward in these uncertain times, a few of Donabedian's (other) words on quality assessment, uttered a month before his death, are prescient:
"It is the ethical dimension of individuals that is essential to a system’s success. ... Commercialism should not be a principal force in the system. That people should make money by investing in health care without actually being providers of health care seems somewhat perverse, like a kind of racketeering."
Perverse indeed.

Right now there are residents who have no idea how they'll ever pay off their educational debt and millions of patients who can't afford insurance or their drugs. If the House of Medicine can't look inward at its own bloated, self-serving, bureaucratic ranks of the ACGME that are sucking the life from direct patient care, what does this say about the prognosis for US health care?

As Tina Turner once sang, "What's love got to do with it?"


Reference: Donabedian A. A founder of quality assessment encounters a troubled system firsthand. Interview by Fitzhugh Mullan. Health Aff (Millwood). 2001 Jan-Feb;20(1):137-41.


Unknown said...

The Jan 2016 NY Times Opinion piece by Dr. Wachter is a fine example of the rotting stench of self-serving hypocrisy that has governed the behavior of the physician-administrator such as this ex-ABIM pseudo-"leader". The stunned thundering silence of the physicians who read this about-face, 180 degree turn around by Wachter was massive. Before any of us could whip out our laptops and protest these crocodile tears, the NY Times shut down the comment section after less than 100 comments. Gee I wonder why that was so?

More hypocrisy from the very architect of the current environment of Physician Metric-Mania? Does this scoundrel even have a shred of decency or compunction or is he going to rewrite his own history despite it all electronically documented on the Web and YouTube?

Dr. Wachter, you, Rich Baron, Christine Cassel et al have turned your backs on the clinicians who choose to take care of sick patients. Who will take care of you and the rest of the administrators if we are too busy willing out ABIM metric reports, clicking insane EMR MU reports or worst of all, retiring early?

Maybe you folks are hoping you will never get sick or need our services as active clinicians.

Perhaps the physician-administrators will reap, exactly what they sow.

Anonymous said...

That video of Wachter singing is truly disturbing

Dirty Dozen said...

Hospital patient safety and physician assessment from a top-ranking US medical politician?

Bob Wachter represents conflicts of interest and racketeering at its finest!

Anonymous said...

And then they will come out with...............

" We polled the MDs and while a few docs/ "stakeholders" didn't like our policies, the vast majority love and support us"

They will lie and do anything to protect that gravy train.


Dr. BARON, we know you read this daily.
Its time to come clean and tell us what you have planned for us and ACTUALLY ANSWER QUESTIONS !!!!!

In fact, I defy you to post on this site. Lets see some guts.

Anonymous said...

When did quality assessment equate with being good at insider trading?

Robert M. Wachter has certainly been "hitting the high notes" on Wall Street.
What perfect timing with shares of IPCM, "the Hospitalist Company" and the buyout by Team Health. Shares of IPCM went through the ceiling profiting Wachter handsomely.

Was Bob Wachter ever going to tell us about the DOJ investigating his company, "the Hospitalist" for cheating? The DOJ "False Claims Act" caught Charles Denham - chairman at the NQF - and CareFusion in the act of fraud also. After a lengthy controlled investigation there was a 40 million dollar settlement.


Anonymous said...

What "IS" Full Disclosure for Quality Assessment Industry Executives?

What does disclosure depend on? Ethics? Laws? Love?

ABIM's "ethics professor" Christine Cassel already proved she has none of the above - only "cartel-like instincts" and a vision of people such as herself at the top of a "world government". ("World government" is part of Cassel's strange philosophy and phraseology not mine.)

Now the highly political quality assessment leader Bob Wachter is showing us he is no different than Cassel with his versions of egregious conflicts of interest. But what is worse from my point of view is the hypocrisy of not telling the public about the patient safety issues he was possibly "advising on" or possibly covering up in his ambiguous relationship as director and Chairman of the "Quality Committee" at the Hospitalist Company.

I'm pulling my hair out at how the hospitals who employed "Wachter's IPC hospitalists" could have trusted any of these physicians when they were suspected/accused of being coached/encouraged on how to "up-code" their patient encounters. IPC was margined to the hilt getting loans and venture capital to gobble up more and more hospitalist companies which contracted out services to various hospitals and other medical institutions nationally.

The executives of IPC showered themselves with millions of dollars in stock and cash, while profits/revenues somehow miraculously kept growing. Fraud according to the DOJ was the common denominator.

So where is the SEC investigation? Is there one, Wes? If there is a cover-up here also we must insist that the DOJ share their data with the SEC's securities investigators and lawyers.

The DOJ False Claims Act investigation and lawsuit would imply false books with inflated earnings growth. The IPC merger with Team Health seemed to sail through quickly and unimpeded. The SEC would not have allowed this if they had knowledge of this. How could they? Did the Department of Justice not communicate with the Securities and Exchange Commission. This raises alarm bells?

And Wachter is considered to be the "father of the hospitalist movement"! That is a huge conflict of interest. That's like putting Wachter's hospitalist trademark to fraud. I want an explanation from Wachter. As a publicly employed person, also working for the government Wachter owes the public that much.

It is important to note that Wachter, before being officially elected as a director of IPC he was under contract with IPC as a company advisor and trainer for the hospitalist leadership teams. This warrants further investigation in my opinion as to the nature, extent and duration of this relationship. Is the DOJ appraised of these facts?

Anonymous said...

Well, I guess I probably love you, Wes. Yet I'm left wondering if you're a "real" doctor then would you have to stomp on my head with jack-boots if we ever met on person, or would you just treat me like a worthless useless stupid piece of meat? I hope neither. So many in your profession taught me, that optimally both would be done as part of the "code" which always supersedes the "oath". I like to think you are just the cat's meow & I'm scared to meet you ever and risk being disappointed.

Ed Rico said...

Anon 02:27 -

You seem to have derived an unusually harsh impression of Dr. Wes. I'm sure he would wait until at least your second or third meeting before he proceeded with any jack-booted stomping of your anatomy. /sarcasm off

Unlike the thoroughly disappointing elite professional medical politician Dr. Wachter, I don't think it's remotely possible you could be disappointed if you had the opportunity to meet Dr. Wes in person.

Blue Angel said...

How do we understand or define public fraud? If we recognize it, what do we do about it?

Knowing is not enough; we must apply that knowledge.
Being willing is not enough; we must do.
- Goethe

It's clear to me that Dr. Wes Fisher is a highly prized fighter in the medical profession battling to preserve the integrity and functionality of the medical system - and that includes physician/patient relationship and our rights on many levels.

Robert Wachter is not a practicing doctor except in early training like Chris Cassel. Both Cassel and Wachter opted for the high road as money conduits and elite politicians. I believe they have sold out the profession for dollars, fame and power.

Wes Fisher has caught these "phony Cassels and Barons in the upper seating of the medical theatre" red-handed selling the prime tickets with access to corporate America, politically aligned NGO's, and corrupt government representatives. Dr. Fisher has called the "bottom feeders" like Wachter out by diagnosing their unhealthy political ambitions and corporate activities calling them for what they are. It is undeniable that these elites like Wachter line their pockets with cash and stock at the expense of patients and physicians who were duped into believing Cassel and Baron, et al were "safety" and "quality" experts.

The truth is, and these are my words, Wachter, Cassel, Baron and the like are frauds harming the healthcare system. They are not only unnecessary intruders, but they are responsible for allowing "corporate boots" to walk all over American medicine and the sacred relationship that a physician has with patients and society.

It really does not matter whether Fisher is the real deal or not. We all must be the real deal from here on out and call graft and corruption for what it is when we uncover it. We must demand that corruption and the perps in charge of quality assessment stop ruining medicine, our lives and our country.

Instruments of greed like Wachter, Cassel, Nora and Baron stomped on our civil liberties and rights - especially our privacy. Foreign corporations like Pearson/Pearson Vue with part ownership by families such as Rothschild and Wall Street advisors like McKinsey are not concerned with patients or physicians. They are concerned with corporate growth, profits, stock price and market share. The testing lobby and legislators hold physicians in abeyance seemingly helpless. The testing monopolies even hire thugs to spy on physicians in the name of "quality assessment". But it is money, politics of money and unhealthy power they seek.

We tip our wing to the author of this blog. But more important than a blog or blogger is the personal efforts we make to end the corruption. Wes is inconsequential unless we all stand up and stop being spineless victims - subservient to the "rich baron bureaucrats" who spout propaganda in order to pump up corporate profits and get us to unconsciously obey Wall Street.

I have in mind Wall Street bankers like Andy Slavitt who infiltrate our vital government medical services only to serve the special interests who pushed for the Slavitts of the world to succeed and their well timed placement in government.

Does Wachter use the government as his personal/financial/political mouthpiece by being editor and interviewer at the Agency for Healthcare Research and Quality - part of the U.S. Department of Health & Human Services? http://www.ahrq.gov/

A Political Reader of Conflicted Safety and Quality?https://psnet.ahrq.gov/information/editor


La vieja said...

Wachter's "about-face" is merely a wet finger in the wind, to gauge which way the wind blows. And in the hospital halls, ER's and clinics, the wind is blowing at hurricane force levels. All is see and hear is anger, denial, despondence. Doctors and all staff that must use an EMR are tearing their hair out, clicking boxes ad nauseam and "providing care" but really it's no care. I bore witness in the ER, accompanying my octogenarian father when he fell off a step stool and hurt his shoulder. After the de rigeur paper bracelet and everybody verifying 5 times who he was, the MA actually sat him down by a computer and barked out a bunch of nonsense questions having zero to do with the acute visit.
Do you wear a seatbelt?
Did you get your flu shot?
Do you wear sunscreen?
There was no advice or thought regarding the answer, simply a box had to be checked/clicked for the ER to NOT get penalized on PQRS.
Thank you Dr. Wachter for helping to destroy the heart and soul of medicine, for creating a culture where safety paralyzes action, for helping to ambush doctors and patients, and for creating a vast pseudo-industry dedicated to collecting data and carrot sticking everybody into a state of catatonia. POS I hope he gets his, I can hope there's karma, right?

Anonymous said...

The video of Wachter at the Hospitalist convention in Las Vegas impersonating Elton John was very troubling; I felt squeamish and disgusted for him knowing about the DOJ fraud case against his company and how it has apparently been politically covered up; it just seems to mock honesty and integrity somehow.

I can't let Wachter represent hardworking hospitalists or the hospitalist movement. I think hospitalists need to move on from Wachter's political and financial influence. Wachter's influence, from everything I know of the False Claims Act case against IPC would be a bad idea - a bad representative just from the conflicts of interest point of view.

His stock, cash and financial/quality/ethical responsibility as a chairman and board member could become a distraction if the media pushes hard on it. Or it will just put an end to Wachter's political career. So far the Hospitalist Company, now a Team Health subsidiary, and Wachter have kept the dark secrets under wraps.

Berliner said...

Wes, I personally have problems with the doctored revenues/financials of Wachter and Singer's Hospitalist Company - IPC (stock symbol IPCM).

It fits the overall pattern we have seen with the ABIM and ABIMF finances and the cover-up of real facts. I would like to see Kurt Eichenwald take a look at the conflicts of interest, finances, and the alleged fraud at the Hospitalist Company.

It's time to stop this MOC ABIM-style "medicine show" where quality assessment frauds like Wachter and Cassel cover up "egregious quality issues" at countless medical institutions - while at the same time they lecture providers on "hand washing" and "health care reform" making hundreds of thousands $$$$$$ more in speaking fees.

"One hand washes another", Bob!

I guess maybe someday they'll say you helped popularize that phrase too. The smug hypocrisy of Wachter's corruption astonishes me.

Anonymous said...

Bob's Song
"I hope you don't mind.
I hope you don't mind
If I assess your ethics and mind,
While I doctor the codes,
And fix the bottom line."

For those of us who want to liberate Elton John from Bob Wachter's sick lyrics:
Here's the real Elton John singing, "Your song."


Anonymous said...

This is one of your best exposés on medical bureaucracy in the United States.
It is strange how the movement for "universal health coverage" took a detour quickly into being synonymous with corporate and personal wealth.

Wachter, who had his thumb out early, seems to have hijacked the gold truck and put the money designated for the patient into the hands & investment accounts of corporate American.

Bob's seems to be scurrying faster than a Golden Gate squirrel vying to take his share of the fat and political notoriety while the pork barrel money lasts.

He's just a pawn in the corporate/Wall Street game too it seems.

Anonymous said...

And the House Fell Down - by Elton John - sung by a very special surprise artist

And the House Fell Down

The sun is up and the shades are all pulled down
I'm more paranoid with every little sound
Like the leaf blower blowing the leaves around
And a siren wailing on the other side of town

Oh the TVs on and the colors really hurt my head
If I could think straight I'd wish I was dead
Or curled up naked in my lover's bed
Instead I'm hanging over Hell suspended by a single thread

And I don't recall who said it at this time
That your enemies grow strong on what you leave behind
I built it up and the wolf he came around
He huffed and puffed and the house fell down

With a rolled up note I'm hovering on that line
Three days on a diet of cocaine and wine
And a little weed just to level me sometime
I put the clock in the drawer 'cause I've cancelled out the time

And I don't recall who said it at this time
That your enemies grow strong on what you leave behind
I built it up and the wolf he came around
He huffed and puffed and the house fell down

So don't knock on my door, don't try to call
I'm holed up in this room talking to the wall
When you're high as this you think you know it all
When you're this deep in there's no place else to fall

And still that saying gets inside my mind
That your enemies grow strong on what you leave behind
I built it up and the wolf he came around
He huffed and puffed and the house fell down

Ed Rico said...

I'm sure Dr. Wachter is scurrying, all right, scurrying to keep under the legal radar as a blizzard of litigation unfolds associated with a wide scope of involvement in various relationships with IPC The Hospitalist Co. as well as ABIM.

I predict Dr. Wachter will be brushing up on his Latin in the days to come. He seems to have forgotten the meaning of "Primum Non Nocere", but I suspect he'll become familiar with a new phrase, "Nolo Contendere".

Anonymous said...

Kudos ,again, to brave Dr.Wes. Not a doc, but ,work with 'old' ones and newly minted. As suggested, these analysis' and comments and assessments and citations need broad dispersion ! Link to your Facebook contacts,, create more YouTube video " interviews", create a blog petition --- to be sent to House & Senate committees ,,,, create a Wachter 'tracking' cite ( where is the POS Now ),,do a 'newsletter ' called ----- ? ,, and---- get you patients involved ( generally ,, they love you )......
Point : much broader awareness and organization ! "They" are hoping this will go away -- in time ! You few will get tired, worn out , die!

Anonymous said...

Dr. Wes:

Once again, thank you for your tireless efforts to expose these frauds.

This is an off topic question but what about the ratings companies that physicians are now being forced to endure--Press Ganey. I can understand when a customer rates a vendor but the physician patient relationship is much different that a standard commodity based transaction. For example, we are lectured from our administrators about getting good scores even if that means prescribing narcs. Remember, the customer is always right. Medicine has gone off the rails.
Should physicians see which patients are rating them poorly to know that the relationship is not optimal. CMS has opened a can of worms and I fear that this is just another vendor seeking to feed at the trough of medicine.


Anonymous said...

Hey Ed Rico: you misunderstood, I don't have an unusually harsh impression of Dr. Wes. I have an unusually harsh impression of the Medical Aristocracy. You may have seen the recent Uber driver attack reported on television: I am one of many who was NOT surprised the assailant was a Doctor. I'm past the point of calling this a profession anymore--but I want to & think Wes is all about the professionalism and all the ideals about medicine that I love and grieve because I don't have that where I am. Probably, I wouldn't get to meet him in person, unless that was where I could receive appropriate medical care...would I go to the place that's considered America's little Soviet Union? But where I am is so beyond description, and so much worse...I sometimes wonder if I can get into Russia and maybe be safer and better off and receive better healthcare. What a sweetheart Wes is, I hope. But I fear not, the next person that messes with me is getting a can of whoop-A. Maybe not, need to get more strength in me. If I can't escape a vortex of hell, then how am I going to handle a street fight. My dream is that Wes doesn't engage in street fighting, at least with patients. God, I am lucky at least my heart is healthy! Keep fighting this beast, Wes, people need doctors.

PS I'm seeing this other disturbing comment about giving good scores even if it means prescribing narcs--PLEASE stop doing that Doctors. I have UNFILLED Rx's for narcs that I neither want nor need. Honestly, I think it's contraindicated with an untreated usually deadly lung infection. If I drop dead from this crap, it was not for lack of trying to get help--and being written a STFU script for narcs. If I was an unscrupulous person, then I could fill and resell the narcs at an excellent profit. But I am just an honest decent really f-ing sick patient trying to get treatment.

Yeah, I'll go with anonymous ID again. Wes, thanks for trying to save this profession. If it's possible then one good man can move mountains. Often I pray you are that good man.

Anonymous said...


Reading Robert M. Wachter's opinion piece on "How Measurement Fails Doctors and Teachers" in the New York Times, I was disappointed that there was no disclosure about any of his conflicts of interest.

He disclosed "nada" about the hundreds of thousands in cash, stock, and stock options he was getting from the Hospitalist Company, in addition to the $3,000 monthly consulting/advisory fees. Nothing about the ABIM relationship.

But most importantly, not a peep about the serious DOJ False Claims Act and whistleblower lawsuit with dramatic allegations leveled against Wachter's publicly traded business, IPC, the Hospitalist Company where he was handsomely rewarded as and elected board director and chairman of the Quality Committee.

Providers and patients need to know these facts. It is a crime to the public who unwittingly soak it all in from the New York Times.

Wachter's measure of what is fair to report is perverse indeed.

Of note, Wachter failed to tell us that his wife is a medical reporter for the NY Times. Yet Bob did not fail to plug his new book on EHR, etc. published by McGraw Hill. Maybe that is how the NY Times comment section was closed so soon on his recent opinion piece. It was a fairly unanimous negative bias.


I think the public should read the DOJ billing fraud charges in the original federal complaint from June 2014 below. The facts are apparent. The up-coding was systematic and intentional because it was encouraged by management. As the father of the hospitalist movement, Wachter had a long term relationship with the company and management.


Anonymous said...

I'm very troubled by this federal lawsuit and Wachter's long-term involvement with IPC, the "Hospitalist Company."

Wachter's cash/stock compensation revelations for the filing year are on page 35 of the proxy statement. Significant shareholder's are listed on page 12.

Many other insights are found about this business.

Although a latecomer to the board and IPC's stock/cash party, Wachter got more cash annually than the others which included a monthly consulting fee.

How long did he receive that consulting fee? What was it for. 108K in cash plus shares totaling over 200K for 2014. (Some shared with UCSF.)

SEC filings.

Executive compensation according to their SEC documents was substantial, but a large part was hidden in huge stock and bonus incentives. (Did the bonus compensation come at the expense of Medicare and Medicaid recipients pushing the coding envelopes to maximum as indicated by the lawsuits.

The profitability of the company revolved around that pushing of the envelope with up-coding and other excessive billing practices as alleged by the DOJ.

Mandy said...

Bob's Biases

Fascinating! On "his" blog page - "Wachter's World" - Bob transforms his egregious "conflicts of interests" into "little puffs of nothing" by watering them down into being mere "biases".

Then we discover that all this strange political/financial world of outlandish self-interest and advertising is of late primarily apologies/excuses about his ABIM/ABMS/NQF cronies.

All this cover-up of corruption sponsored by the Society of Hospital Medicine and paid for by the publishing house Wiley.

Bottom line Dr. Wachter gets paid by online publisher Wiley and encouraged by the Society of Hospital Medicine to mislead/reform us through advertising for himself and them.


Barry said...

It's not about quality at all! Wachter proves it is a lie.

Wes, what you wrote and more is true. Disgusting!

We've been researching many of these new "Quality Improvement" organizations taking government and private funds out of medicine. There are so many now it seems they are multiplying exponentially!

The "Quality Bureaucracy" is a cancer siphoning the money and energy needed for vital health of the patient and the healthcare delivery system. Patients can't get in to see doctors or get what they need. Physicians' hands are tied to give patients even the right medication/treatment that they need. It is not covered!
"I can't afford that." Or you send someone to see a specialist and they come back telling you they saw the NP in the specialty clinic. No biopsy was done. No lab work done that you needed. It was not indicated. Internal bleeding and the PA says that no testing is necessary.

This internal bleeding of the healthcare system by Bob Wachter, Chris Cassel and the other advisors in Washington is destroying lives and livelihoods. The US is becoming the land of attrition; the land of the walking dead. This austere new face of medicine is becoming the new norm. All while Wachter rakes in the money or directs it to his new skeletal cause putting all your money into his quality Frankenstein. Morality died when "nice guys" and "sensible medical politicians" took power in order cheat Americans and rob us of our right to healthcare - all legislated behind our backs. "Oh, you don't ever want to read the actual bill."

Now we see clearly what the lay of the land is; what the reality is. Thanks for informing us, Mr. Wachter. You are a cheater!

Wachter is singing a corporate mantra all about corporate profits (his profits) and slashing costs. But it's not about quality at all. Bob Wachter proves it by cheating the hospitals with his company's obvious overbilling (IPC up-coding). He can't squirm out of this one!

But Wachter's "I' hope you don't mind, while I cheat and lie like hell, just to control and rob you blind" is the corporate mantra. And Wachter and these other corporate fraudsters control Washington DC. They control the ABMS, NQF, ABIM, and the AMA. We see they took over the voice of HHS. And now we see how Wall Street is in direct charge of the CMS. "We'll just innovate and show you all the new technology that we can add to your MU."

The big Wall Street-backed company's will devour all these innovative startups and show you what the "real horror" is that will be introduced as the all new MU!

Taxpayers, patients and physicians are funding these Quality Improvement scams. It is racketeering and these racketeers take purchasing power out of the patients hands to the point that they can't get treatment. Chronic diseases like diabetes, for example, are being targeted by "quality forums" - so many organizations now that we can't even imagine or understand where the mandates are coming from.

None of this is not about Quality Improvement ("QI").

Wachter shows us the lie; it is not about QI, he's the proof. It is all about corporate deception ("CD"). Patients and physicians are being cut out of the equation in the name of "Quality". Patients can't see a physician or get the treatments they need. It is most apparent with Medicare and Medicaid patients.

Anonymous said...

Top-ranked politician and government/corporate insiders like Robert Wachter show us how ruthless our politicians can be. They will sermonize about improving quality and cutting costs "in theory" while they rob us blind. Is there no decency left!

Civil Servant said...

ABIM/ABMS MOC is a prime example of true predatory practices.

No more listening to reasonable words from predators! Just look at what they have done and are still doing behind closed doors. Wachter still influences them politically and financially.

Baron is just a shill for corporate America and the CMS. Report the political and corporate conflicts of interest to the IRS and DOJ.

Rich Baron, shut that sweat shop down! And don't forget to turn out the lights.
You and your unhealthy gang of profiteers are the waste we need to cut in medicine!

L. said...

Wes, I know this is about love, ethics and quality assessment, but you should know there are many hospitalists who literally hate Bob Wachter for imposing MOC on us.
BTW, I'd like to hear Bob's personal alibi for the DOJ/IPC billing fraud. That would be interesting. Are they going to try and gag all of us? Nobody has that much money or power. We should push on the DOJ to look at all facets of the case not just billing. It's odd because usually they talk about quality/safety violations and patient harm. They dig deep and even go after the employees to get evidence.
Check out the software IPC-Link used since 2003. Management, etc., has remote and local access to near real-time data on each hospitalist around the country, statistical reads, volume, billing, and patient data. They knew what they were doing and they knew what was going on with the upcoding. They had a very tight structure with leadership teams encouraging higher codes and numbers. Incentives were aggressively marketed for hospitalists to make huge bonuses. Management needed the numbers for their bonuses too. Tell me they did not have the team leaders place demands. It was in the structure. They eased the new honest ones in. You perform at high levels or you are marked as an under performer. Wachter has had a strong interest in their tech, watched it all closely and the raw data. That's what kind of person he is. I'd like to hear him say he did not know anything about upcoding and perjure himself. IPC is the top hospitalist company in the country. Now part of Team H. TH had a stronger balance sheet. IPC needed to sell to unload the fraud and liability. DOJ should hit the principals of IPC hard for monetary damages and not just go after Team. We will see what the damages are. Many of us feel there should be criminal charges as well. Patients at Medicare, Tricare, Medicaid, and others were monetized, shorted on their healthcare. Would not look good for IPC, health reform or the the quality 'rocket man'. It is criminal if you look into it deeply - not just a superficial false claims case. Medically physicans don't like to see it, but this is part greed and part political movement. If you look at DOJ and HHS past prosecutions individual doctors don't usually get off that easy with a civil case, so why should a company who harmed others walk without indictments or doing time. If I were the DOJ I would include other agencies, get the real data and encourage patients to come forward and their families to tell their stories. Otherwise the Chicago attorney's office may keep it tight centered around the money issue only - not expand with the obvious implications of patient harm. It's a controlled burn otherwise to contain the fire from spreading.
New York Times love stuff did not make friends as Wachter hoped. Only more enemies for ruining healthcare. Opinion piece just showed his talent for manipulation and hypocrisy. Good bye, Bob!

Anonymous said...

What a cesspool.

And I thought we couldn't get any lower than Langdon.

Anonymous said...

Wednesday will ONE year since those famous words heard around the world...

"ABIM clearly got it wrong"

Anonymous said...

IPC, the Hospitalists' smoking gun emails hiding their practice of upcoding.

IPC, the Hospitalist Company, was registered in Delaware in 1998 with executive offices in North Hollywood, California. In the DOJ False Claims court document against Wachter's Hospitalist Company they quote regional managers as far back as 2004 emailing each other saying:

"they should not publicly discuss the fact that their billing patterns for E&M CPT far exceeded national norms and agreed they should not publicly discuss the rate at which IPC billed for claims for V3 (99223) and other codes because this 'easily could lead to trouble' and 'publicizing our numbers has a large risk to it as well in terms of shouting out that we want to be audited.'" 109. page 28



We have had enough.


Slaker said...

Dr. Wachter apparently lives in his head - a rat maze of medical policy and politics with greenbacks glazing over his sad reality.

Somebody wake Wachter up, and shake him so he can see the facts on the ground! IPC's fraudulent billing practices compromised patient safety.

According to the DOJ documents and the whistle blower, IPC management "pressurized" the hospitalists employed with Bob's company to have a superhuman ability to see lots of patients in a day and after a few months on the job most of their patients would be billed at higher levels of reimbursement. IPC physicians in the DOJ complaint saw up to 56 patients in a day. (How long does it take to "admit" "see", or "dishcharge" even one patient?)

Wachter, as Quality Committee Chairman, must have had a hand in "doctoring" IPC's insidious outcomes. And the company kept it all hidden from us.

What are the data on wrongful deaths during 2003-present at Wachters' Hospitalist Company? How could Bob's company bill for 70 minutes at the highest code and only put in 5 minutes of actual time. How long does it take for a review of systems?

This is total madness - a formula for increased patient morbidity and death while the hospitalist met his bonus requirements. The bonus payment was a 70/30 split of any revenues generated above an individual's base salary!

IPC printed truckloads of stock for the executives and board of directors when the financial numbers were met or exceeded. Needless to say the hospitalists who were the workhorses for the executives and board to profit by suffered severe burnout - regardless of IPC management or Wachter downplaying it.

Thank you, Dr Fisher, for showing us the real "father of quality assessment" and what he said about racketeering. I can relate to what he revealed in the interview. Avedis Donabedian was an inspired and good man always searching for truth, never political.

Slaker said...

Interesting read below for Wachter's timing and content. Read the comments to Wachter's blog also. One commenter refers to the DOJ announcement to intervene in the whistle-blower case against his company.

Link: April 2014 Wachter's blog to hospitalists. Speaks of hospital closures and mergers. Salem Hospital merging/affiliating with OHSU(Portland, Oregon). Wachter claims he is on the Salem Hospital board advising on the need for the Salem Hospital to affiliate in spite of a healthy balance sheet. (In 2013 Wachter is listed as a trustee on the Salem Hosp. 990's 2hrs per week. 2014 unavailable.)

Link: December 2013 DOJ announcement of 120 day notice that it will be intervening in the whistle-blower lawsuit against IPC. The suit was filed in June of 2014 just after Wachter's blog posting in April 2014. Why did not Wachter respond to the allegations in behalf of IPC, or respond to the comment with a link referring to the DOJ December notification?

Speaking about hospitalist issues, hospital closures and mergers Wachter on his blog in April 2014 writes:

"Out of the ferment will come new opportunities for hospitalists. I’m on the board of IPC, the largest hospitalist company in the U.S. Several years ago, the company recognized that many patients who used to be in the hospital were now in sub-acute settings. Today, nearly one-third of IPC’s clinicians work in SNFs and long-term care facilities. I suspect that some of the hospitalists displaced by hospital closures will find work in these kinds of settings – and these will not be your father’s SNFs. The level of patient acuity may be similar to that of hospitals a decade ago."

I suspect the above article was a tactical preemptive move on Wachter's part. Is he clouding the water or clarifying something about IPC's allegations of fraudulent billing? Wachter is as "wiley" as his website sponsored by Wiley and Sons.

[Wiley's]Current initiatives

With the integration of digital technology and the traditional print medium, Wiley has stated that in the near future its customers will be able to search across all its content regardless of original medium and assemble a custom product in the format of choice.[12] Web resources are also enabling new types of publisher-customer interactions within the company's various businesses.

Higher education

Higher Education's "WileyPLUS" is an online product that combines electronic versions of texts with media resources and tools for instructors and students. It is intended to provide a single source from which instructors can manage their courses, create presentations, and assign and grade homework and tests; students can receive hints and explanations as they work on homework, and link back to relevant sections of the text.

"Wiley Custom Select" launched in February 2009 as a custom textbook system allowing instructors to combine content from different Wiley textbooks and lab manuals and add in their own material. The company has begun to make content from its STMS business available to instructors through the system, with content from its Professional/Trade business to follow.[13]


In January 2008, Wiley launched a new version of its evidence-based medicine (EBM) product, InfoPOEMs with InfoRetriever, under the name Essential Evidence Plus, providing primary-care clinicians with point-of-care access to the most extensive source of EBM information[14] via their PDAs/handheld devices and desktop computers. Essential Evidence Plus includes the InfoPOEMs daily EBM content alerting service and two new content resources—EBM Guidelines, a collection of practice guidelines, evidence summaries, and images, and e-Essential Evidence, a reference for general practitioners, nurses, and physician assistants providing first-contact care.[clarification needed]

Slaker said...

Read Wachter's blog on IPC and Adam Singer 2011. There are interesting comments from readers about IPC's substantial UCSF annual "grants" for Wachter's leadership training program (starting around 2010). Is this grant being extended with Team Health ownership? Anyone know?

Wachter met IPC's CEO Adam Singer in 1996. Then after years apart what attracted Wachter suddenly to him? Was it "love" for IPC or Adam Singer? How about the IPO? Let the stock printing party begin! How about being in love with the growth model and the acquisition spree that propelled the stock and earnings? Good old fashioned greed and the payouts to Wachter and UCSF. Welcome aboard Bob Wachter and UCSF.

Anonymous said...

Bob Wachter's Blog 2008 A Shout Out to Adam Singer IPC CEO Entrepreneur of the Year

Assessment Now said...

The situation we find ourselves in, where the "quality assessment industry" and its leadership are the "disease," is ironic to the degree that it defies the imagination. The conscious mind cannot readily admit such a nightmare; nor can our rational faculties fathom it.

Where is the ABIM's press release with a warning about Adam Singer's IPC the Hospitalist Company, and its patient safety issues. How about the Attorney General's offices; or the Surgeon General's shout about potential harms? Are they asleep, indifferent, or just blind to the serious government charges against IPC, regarding false and fraudulent claims. The patient safety issues are quite obvious.

Adam Singer the CEO of IPC said that his company would fight the federal charges vigorously. Well, not quite. Instead of a costly legal battle, Adam Singer, his executives, and the board, which included Bob Wachter unloaded the company and the liability at the end of 2015, but not without enormous growth and profit in personal bank accounts from overbilling senior citizens and retired government employees.

Would this be acceptable to the public if they really were informed? Is our government doing its job to protect the public? Are any of the "quality assurance industry" corporations doing a real job to protect patient safety. Or is it just another example of what one might call a "sick Gruberesque reality." Political capture placing the medical system (especially physicians)in the clutches of corporate power.

The American Board of Internal Medicine’s CEO, Richard Baron, a close associate of Robert Wachter, may be slumping in his chair, perhaps like a "Joe Paterno" not knowing what to do with the scandals generated from within the ABIM and its affiliates except to keep quiet. Silence is the norm at the ABIM, obviously, because Dr. Baron is also a part of this sickness we have allowed to grow around us in the US healthcare system. Baron is the NQF. He is the CMS. He is the corporate board pushing for more and more.

All this mess is the sickness of greed, lies, hypocrisy, and lust for political power.

We must recognize the problems are more far-reaching and pernicious than just the cover-up of huge money transfers to ABIM’s bastard foundation and the excesses of buying a luxury condo with a chauffeur and whatever ABIM's executives and "guests" do there. But the overwhelming reality is that sick political lusts and the modern brand of corporate greed gets sucked into the murky mix.

The "quality assurance menace" then dominates medicine via the heavy weight of the entire bureaucratic system which pushes hard against clinical physicians who are just trying to do their jobs. It even crushes many to make examples of those who do not obey.

This sick menacing reality, which dominates us must stop. It dominates the lives of even those profiting by it to their detriment. We must see the situation clearly and fashion a better reality.

Anonymous said...

The ABIM needs to come clean about who the supposed "stakeholders" are. Do they mean ABMS, Nora, Cassel, Baron, Wachter etc. or exactly who? The supposed public demands appear to come from academics after poor quality studies published by a few academics, or were they fabricated? We are now nitpicked to death by overpaid clipboard nurses and administrators, at increased cost to healthcare, without evidence of improvement in "quality". There are vast resources going to these "quality measures" with minimal evidence of "value". Many times there are no references for statements of "quality" in these publications. Others have noticed that "Today's 'evidence-based medicine' may be tomorrows malpractice" http://members.csahq.org/blog/2014/02/18/today%E2%80%99s-%E2%80%9Cevidence-based-medicine%E2%80%9D-may-be-tomorrow%E2%80%99s-malpractice

Wachter's wife, Hafner, wrote last week in NY Times about the lack of geriatricians. Older physicians sometimes used to limit their practices, and take care of their older patients.... Hafner seems to think the solution is getting more young people to go into geriatrics (more MOC$?), ignoring qualified older physicians who can take care of elderly patients. If ABIM drives out older physicians with flimsy studies, we will have only NPs taking care of us. Most MDs would choose any of a number of IM or FP physicians in their 60s and 70s who have limited their practice, over any of the nurse practitioners they have worked with. It's interesting that Kaiser, at least in some places in Northern California, stopped hiring NPs as primary care providers due to the problems with lack of competence. NP leadership supports NP independent practice, while physicians have no advocacy group, and physician leaders make our lives more difficult and drive physicians out of practice for their own profits...

I looked back through some Cassel's publications while head of NQF and ABIM. As far as I can tell, she claims no conflicts of interests, but did not disclose the hundreds of thousands she received from Kaiser or Premier. Wachter also does not disclose his conflicts of interest. Perhaps I missed where these leaders have disclosed their conflicts of interest in their academic publications... Or perhaps they believe in "confluence of interest" to support their profiteering. http://hcrenewal.blogspot.com/ Sunday January 24, 2016. JAMA jumps the shark.

Incidentally, there were highly ethical physicians, veterans of WWII, who fought for the US in Asia, Europe and North Aftica, who thought Cassel and McCally were immoral and unethical traitors with their PSR politics in the 70s and 80s. They felt that Japan would never have surrendered, and many more lives would have been lost in concentration camps, and in fighting Hitler if they had not bombed Japan. Perhaps some who have been in the military can understand this point of view. Others were bothered by Cassel and McCally's public displays of affection while McCally was married to another woman.Times have changed, but what real training does Cassel have in ethics?

lol said...

United Kingdom's NHS Taps Bob Wachter to be the New Digital Health Systems Review Czar.

Bob "the-MOC-man" Wachter and his "digital hype or harm" go to London floating on a royal barge - straight into the House of Lords.

National Health Service NHS leader Jeremy Hunt says Robert M. Wachter is the “world expert on the promise and pitfalls of new IT systems”...

Bully for Bob! I'm sure he'll do a bang up job.

Bob Wachter says about himself he is an interloper in the field of digital health, though far from a Luddite. Show us the love, Bob.

- Source - New York Thames

Ed Rico said...

Congratulations to Dr. Wachter on this latest achievement in a career filled with recognition and accolades. I couldn't agree more with the NHS regarding Dr. Wachter's expertise; he is quite skilled at making promises, it's delivering substantive results where he falls a bit short.

I'd be very interested in reviewing Dr. Wachter's contract with the NHS. Not for the compensation, which I'm sure is quite generous. A sharp professional medical politician like Dr. Wachter must have negotiated an immunity deal covering potential UK litigation arising from any future potential fallout of his recommendations or other interactions with the NHS based on his experience with the DOJ investigation of IPC The Hospitalist Co.

Anonymous said...


Ed Rico: Dr. Wachter's trip to the UK as a consultant to the NHS tells us several things. It is part of a PR smokescreen for the disastrous results already obtained in the attempts at the digitization of the health care record in the US and the UK.
NY Times and Wachter's political and familial allies there was an attempt to soften the harsh reality that Bob is a fraud and profiteer. It is all about swaying the numbers in politics. You want to create an broad consensus. Then you attack.

There is great resistance by physicians in the UK and many scandals have resulted including financial investigations, not just utter incompetence and failure. The US has had its share. Just look at the scandal in Oregon over the ACA web portal - 250 million wasted by the fallen crony of Chris Cassel there - governor Kizhaber. Let's look at the emails there. The DOJ is saying nothing about the ongoing investigation of Cassel's ally in Oregon. Why? Wachter has been actively involved there as well.

In the UK and the US, the bureaucratic controls/constrictions of EHR are onerous. The plotting between government and the medical industrial complex is concerning. Wachter uses the media to control public opinion or shape it for the future. When Wachter spoke in the past people would listen and use it as a guide for the future. Not now! Unfortunately Wachter has let us down completely engaging with a fraudulently company and not disclosing all the facets of the billing fraud of IPC and his role in covering up the mess. Profits for the company, Wachter's take, and the UCSF - just too tempting.

About the NY Times "finger to the wind" opinion piece "on love and quality", it did not fool anyone apparently in the medical profession. And teachers responded rather unfavorably toward "the Wachter." I wonder if the teachers who went to prison in Atlanta over "quality assessment" irregularities would forgive Bob Wachter if they knew that he was even involved with the unvetted investigators who masqueraded as Atlanta's "testing assessment experts" while he was a key officer at the ABIM. Or the physicians who suffered under Bob's lack of real moral fiber to stop the McCarthy era tactics he employed with other ABIM officers to destroy yet still more lives. Unvetted and questionable "security assets" were utilized to investigate and harm many teachers and physicians.

Yet these testing/security scandals and the true facts underlying their implementation has been kept under a tight lid by Wachter, Cassel, Holmboe, Nora's handlers, and Baron. Anyone who wants to follow the real thread, not the disinformation campaigns, will come to the same conclusion that the ABIM and Wachter represent fraud and deceit. It is Wachter's brand and approach. Unintended consequences or collateral damage are an acceptable price to pay. I do not agree.

Wachter must speak publicly and address these present and past issues unless he is already exercising his fifth amendment rights.

Wachter. Nice guy on the outside, but inside a real hypocrite and still a bold lying "two-faced" mouthpiece for the digital corporations. He has conflicted interests with many. And almost all the major players in the testing/quality assessment empire.

It is interesting that the Pearson board chairman is also on its competitors board as well - Wachter's publisher McGraw Hill. The Pearson chair serves on the financial division of McGraw Hill, which is influential globally. Companies and countries can be helped or hurt by the ratings or recommendations of Standard and Poor's stock or bond assessments.

Do we understand how much power Wachter's publisher McGraw Hill has in influencing the world. Pearson's connection with McKinsey, which has it tentacles everywhere, is equally disturbing. We don't look beneath the surface of things, do we?

Anonymous said...

Bob is the "Darth Vader" behind a number of "special interests" in the corporate world. He is and has been actively involved in the US government. Now the UK government is contracting him. Has this process been vetted for financial and political conflicts. Probably not, just like at the ABIM.

Bob's "still boyish face" and clever mind had everyone fooled in the past. But it is just another rented face, another costume and propagandistic song. Bob, Rich, Casell, and other played the ABIM, patients and physicians like a political fiddle. That was harmful and wrong. It is even more dangerous and morally despicable today when we see so many of the scandals that the ABIM and Wachter has been involved in.

Wachter knew in advance of the resistance/failure in the UK about EHR, yet the government wants to push forward on it. A propagandist is called in from the US with a team of experts, which includes, yes, Dr. Rico, venture capitalists from a global medical investment company based out of San Francisco.
falls short not just in prediction, but in his role as safety expert. Now he is masquerading as an expert on digital health records because he interviewed a few "so-called experts" (cronies of his) and wrote a book on the subject - which was marketed so heavily that it was bound to be a success.

Robert Wachter exemplifies onerous quality assessment demands with MOC and his shallowness to get at the real problems with medicine. Wachter's fabulous mind betrays him to see the forest for the tress at best and he is thoroughly corrupt at worst. As we can see with the apparent DOJ fraud case and our patient safety concerns, why would the UK pick Bob. Are they blind or just ill-informed or too entwined in their own kind of deceit that it does not matter if they tap one of the best deceivers.

So what about Bob, expert in EHR - Wachter the "digital doctor?"

Here's a little more of what the UK's Jeremy Hunt said in his role as NHS secretary about past digital disasters and scandals. There are links and references to UK financial investigations over EHR attempts.


Rick Bosshardt said...

I have followed this blog to the best of my ability, given my limited time and other obligations. I feel that I am a dinosaur; a private practice physician in a world that is turning physicians into employees, providers, and, even, vendors. I read with frustration, revulsion, and anger much that is happening in medicine and feel impotent as to how I, as a single individual who loves my profession, can make a difference. Please post some ideas and suggestions as to what we can do to help change the direction of medicine in the U.S.

the other Bob said...

Robert Wachter, with his digital hype and vast testing monopoly, has done grave harm to privacy and civil liberties in the United.

Maintenance of Certification through ABMS International is being pushed in many countries through government and local ngo's. So far nobody is buying into MOC, but the ABIM infrastructure is being laid through ABMS International and the ACGME.

The MOC groundwork, which includes ABMS/ABIM and the US modeled ACGME, has been set up in Singapore, and is infiltrated Japan, the Middle East, and Europe.

United Kingdom buyers of Bob's cronies' ABMS products and services beware!

Wachter retired from the ABIM board. He is guiding Assessment 2020 and the Task Force. Now he is a key lobbyist for the ABIM/ABMS and the medical industrial complex. He and his cronies are rewarded financially and with political favors.

We need to look at all the financial/political relationships and connect the dots.
The corruption is rampant. Wachter is now like a fish in international waters.

Joy said...

Render unto ABMS racketeers that which they deserve.

As Wachter, Nora, and Baron, et al steer the ABMS/ABIM with their partisan brand of "stakeholder politics", the paying clients (physicians and taxpayers) receive nothing except mendacious propaganda and untenable science.

When physicians, patients and reporters demand transparent answers about the executives' conflicts of interest or the financial escapades involving transfers of money to Cassel's "Piggy Bank" they get the cold shoulder and ABIM/ABMS silence.

Repeatedly questioned about the purchase of Wachter's "executive playhouse", the real "stakeholders" (physicians and patients) still get opaque testy responses and sadistic guarantees of continuous splitting headaches - with assurance of chronic migraine (MOC) - as a return on their hard-earned capital.

Vaughn said...

Patient's rights. Where have all the patient's rights gone?
1999 - a year of ABIM cronyism and political deceit in retrospect.

Where are the "consumer's rights" that Christine K. Cassel advocated while she was a healthcare advisor to the Clinton administration in the late 1990's? What happened to Cassel and company's "Patient Bill of Rights" introduced in 1999, the same year that she inked the ABIM Foundation's registration in Pennsylvania - even though there was the discrepant Iowa domicile issue. The truth is apparent for those who have eyes to see, yet much is intentionally withheld from the public. Or dis-information replaces fact as in Bob Wachter’s blog response entitled, "The ABIM Controversy: Where the Critics are Right, Where They’re Wrong, and Why I Feel the Need to Speak Out."

The facts point otherwise to what Dr. Wachter wrote. Facts point to the unpleasant reality that a small group of politically active medical elites deceived the public. They deceived the patient instead serving special interests that would profit or invent ways to slash healthcare costs. Many of the methods that would be utilized by social theorists like Dr. Cassel and Robert Wachter would cause grave potential harm to the patient and confuse and mislead government officials.
Robert M. Wachter was president of the Society of Hospital Medicine SHM in 1999, the rapidly growing new hospital and SNF medical specialty. Fast forward a moment, and we discover how Dr. Wachter lined his pockets at the expense of Medicare, Medicaid, and government retirees while he was a principal involved in training Hospitalist leadership teams and as board director/chair of the "quality committee" with IPC, the Hospitalist Company. IPC, as we know, stands accused of billing fraud.

The irony is that Dr Wachter a lecturing safety expert travels around the world collection huge fees on what appears to be no less than facetious presentations - possibly we could call it hypocrisy and fraud. Wachter has been defrauding the government (CMS and retired government employees) while getting money from the government directly from the HHS so perhaps the latter is more true.

Andrew 57 said...

This is a great review of what is ailing medicine today, Dr Fisher! It is big government, corporate power, and the red-tape worms.

The ABIM and ABMS execs are apparently self-centered wackos who believe they are entitled to rob care providers and rule the world! These American clowns see nothing wrong with stealing physician's money in racketeering schemes, stuffing a big wad in their own pockets, and then putting the rest of the booty to work ruining the quality of the health care system in the US. They have done this by lobbying full time in Washington DC, Philadelphia, Chicago, Princeton, Missouri, wherever...just in order to favor their rich friends and corporate partners.

These hegemonic worldniks at the ABIM, from what I understand, have never been assessed themselves. They have all been a parade of negligent political nuts and medical quacks from Brem to Benson; from Kimball to Baron. And now they are lobbying in Great Britain through the Secretary of Health. Outrageous.

Now Hunt is slashing costs everywhere he can. The NHS, through the corrupt Secretary, is on the attack with the Yanks adopting their "choosing wisely" medical plan in the UK. Hunt was scandalized as Secretary of Culture over conflicts of interest aiding Rupert Murdoch in lucrative business transactions. Cameron did not follow code on this and did not investigate. What odd cat in the Mr. Hunt's bag will pop it's head out or be beaten back during this US digital-go-round for the Secretary of Health?

It's no wonder that Jeremy Hunt, recently becoming the richest "bloke" in Cameron's cabinet, is not only out of touch, but untouchable. Let's see if Hunt catches whiff of Dr. Wachter's real character and receives a well-deserved political flogging for "not knowing about Dr. Wachter's fraud and conflicts of interest." Just like it played out before while he was Secretary of Culture over the Murdoch affair. Maybe this time...

Cameron hushed it up for Hunt last time when he was at Culture. Let's see how this US digital review opens up and presents for Secretary Hunt. Dr. Wachter and the rest of the delegation were obviously lobbyists for American and British medical corporations and the US and UK governments. And the AMA representative was lying through her charming teeth. Not to forget the Wall Street big bank boys.

NHS, care providers and the subservient, but not so happy, public will without doubt suffer another round of blows chasing the yanks' latest weapons of mass distraction.

Anonymous said...

Making sense of MOC and life after MOC/excuse me while I tell the truth

Bird Nesting/Hiding it all from the maid/the dog was confused but it saved a ton of money/why I had egregious conflicts of interest but never told the housekeeper or the ABIM

Bob's new job

Do not read these from the same blog series

The Divorce Investor

Divorce and Longevity

My letter to the ABIM:
Can we just not live together anymore and have a clean break?
Physicians need a lawyer specializing in divorce to get away from this abusive relationship. We want our share of the foundation and sale of the company. The hypocrisy and deceit they can keep.

Lisa said...

This frames it in a different context:


Summary: The end game is AI

Constant measuring and feedback from physicians will enable AI to simulate doctors and nurses and not have to hire people to do these jobs. You can be useless eaters out of work. The profits will be fabulous for those who profit.

Do you ever feel as though you are being replaced? The New World Order United Nations is not even pretending they aren't doing that--it has become a boast:


Isn't that lovely? The native white population that for years was told only to have babies when (or if) they could afford them, even as they supported a welfare state that was a non-white baby farm, is now told that we were simply bad at making babies and for this reason of infertility replacements are being sent, many of whom will also suck down taxpayer dollars in a welfare state and produce a bountiful crop of welfare & medicaid recipients--oh, um, I mean "future doctors, engineers, and other of the brightest and best professionals"

Keep throwing money into that money pit to fund your replacements!


Big Bob said...

Big data

Big Government and the Privatization of Healthcare
Bob Wachter at the NHS (another dubious scandal involving Wachter, private equity, Christine Sinsky [ABIM], big tech vendors, data miners and the AMA)

Big Pharma: Grand Rounds Tweets (more political propaganda?)

Big Insurance

Big Data

While serving on the board of directors at the ABIM, Wachter was on the advisory group on health for Google. (2007) The relationships and conflicts remain murky.

The Eye of the Corona said...

"The professor of medicine has emerged as a prominent national source for Covid-19 facts and analysis, tweeting science daily and hosting UCSF’s “Grand Rounds” videos on YouTube, where UCSF experts discuss the latest in epidemiology, virology and diagnostic testing.

He spoke with J. over the phone on May 1."

How did Robert Wachter get to be such a prominent national source for Covid-19 facts?

"fiftycents" said...

"What's love got to do with it?"
"Love" was used as a PR stunt ahead of the United Kingdom/NHS US venture capital tour. A MSM publication arranged by Wachter, the NY Times and their handlers, along with various UK ministries, hit the Sunday press to soften the harsh reality that the "quality assessment cartel" (with mandates like MOC) are primarily about corporate profits/rationing, special interests, surveillance and control.