Monday, February 22, 2016

My Letter to the Chair, Cardiovascular Board, ABIM

Recently, an email was sent to all Cardiovascular Disease diplomats requesting a review of the American Board of Internal Medicine Cardiovascular Disease Examination "Blueprint" for content on the Cardiovascular Disease Examination. The email was authored by Mariel Jessup, MD, Chair of the Cardiovascular Board and George W. Dec, Jr., MD, Chair, Cardiovascular Board of Cardiovascular Disease Exam Committee (I'm not really sure how these titles differ, but I digress).

The purpose of the "survey" and "blueprint" was to "assure the MOC examination is reflective of CV disease specialists are actually doing today, and we hope you share your perspectives to help get us there." Petitioning cardiovascular disease specialists through "short surveys" so the responses of physicians can be spun by the ABIM as evidence of "buy-in" by the cardiovascular community is a classic and well-recognized political tactic. 

Here's my letter I sent to the ABIM Cardiovascular leadership in charge of this endeavor.  I encourage my cardiovascular colleagues to send them your thoughts at :
18 Feb 2016

Dear Drs. Dec and Jessup-

I received your 11 Feb 2016 email to update the content of the Cardiovascular Disease MOC examination by way of your Blueprint Review Tool. No doubt you have plenty of people who have blindly edited your “Blueprint” without considering why we must perform the ABMS MOC program in the first place. I have no idea if this letter will resonate with you or make you seriously reconsider your support of this endeavor, but I feel compelled to notify you why US physicians are no longer content with the MOC status quo that was imposed unilaterally by the ABIM and their supporting professional organizations in 1990. MOC was a financial model that bailed the ABIM out of a financial hole then and now has created a much bigger set of problems for the ABIM.

As I’m sure you are well aware, there had been no credible, independent, peer-reviewed studies that have shown the ABMS MOC program improves patient outcomes in any way. There are, however, limitless propaganda pieces written by staff at the ABIM about the purported “benefits” of MOC. Tax disclosures have shown serious financial mismanagement and erroneous tax filings by the ABIM. Most of the financial transgressions pertain to the secret creation and funneling of over $70 million of our physician testing fees to the ABIM Foundation from 1989-2007, an organization that was reportedly created to define and publish a self-generated definition of “medical professionalism” that included a “social justice” imperative as one of its prerequisites. Their $2.3 million condominium purchase in December, 2007 didn’t help either. The fact that the cost for MOC has increased $247 percent in the last 15 years (over 16%/yr – far in excess of inflation) with $55 million of physician fees paid annually to the ABIM needs serious reconsideration in this era of astronomical health care costs. The ABIM is an independent, non-profit corporation that enjoys a tax-exempt status from the federal government as a 501(c)(3) corporation with requirements to be apolitical, but lobbied Congress without disclosure – a violation of rules for non-profit status of that kind. As a 501(c)(3) corporation, the ABIM’s membership is not elected, but rather appointed (as I’m sure you both were). Conflicts of interest with the leadership remain an unaddressed issue with the ABIM and bylaws reflect they continue. One only has to see the conflicts between Christine Cassel, MD and CECity/Premier/Kaiser Health Plan and Hospitals and Robert M. Wachter, MD and IPC Hospitalist Co/TeamHealth (and their ongoing federal investigation on Medicare overbilling) to appreciate how problematic these conflicts have become for the ABIM as a credible organization to practicing physicians and patients.

Furthermore, the ABIM took the unprecedented action to sue 5 physicians and sanction 134 more who were attempting to study for their certification examinations at a board review course in 2009 and then publishing a press release with the five physicians’ names in the Wall Street Journal in 2010 before due process. While the ABIM claimed “Copyright infringement” with their sanctions, none of the five physicians EVER paid a fine for such since all were covered in their actions by merger doctrine. (It’s very hard to copyright general medical knowledge.) With this move and the contract entrapment physicians must endure when they enroll in MOC, trust in the ABIM as a credible physician quality measure has been seriously compromised.

Blueprints don’t restore trust. Credible, trustworthy actions that acknowledge prior wrongs and meaningful efforts to correct them does. Ending the lucrative MOC program and restoring the ABIM to an elected organization with bylaws that remove double-dipping with corporations that stand to benefit from physician certification reporting (see, for instance) would go a long way at correcting the current situation. Ending MOC busywork and retracting the failed MOC program and using credible CME to suffice in its stead would also be necessary.

I propose you make these last actions your “Blueprint for Success” for the ABMS Cardiovascular Disease MOC program. Anything else will fail to restore the trust of practicing cardiologists and is doomed to fail. I wish you both the best of luck.


Westby G. Fisher, MD
ABIM Diplomat #127308


Blog Administrator said...

Fantastiic! #NOMOC STAT!

DnDrite said...

Electing who you trust at the ABIM and ABMS

I don't believe physicians have necessarily ever trusted the ABMS/ABIM programs or the leadership. Before MOC is was certainly less onerous with a voluntary lifetime certification, but of late it has become plainer that the historical relationship between physicians and the medical specialty boards has been one of fear and obeying. It has also become a subverted relationship of obvious deceitful practice with ever-increasing payments and busywork requirements now even the word "voluntary" does not mean what it truly means.

The willing nature of physicians to participate in the ABMS Empire of never-ending testing and surveillance has been shattered. Dishonesty, broken promises, ruthless practices, ever-changing policies and contractual fraud have destroyed the ABMS.

Invention of ever more clever financial schemes, methods of testing, annual payment demands, pledges of honesty with threat of sanctions, civil and criminal prosecution written into the finely worded pages of nightmarish contractual language - written by ABMS executives, abusive lawyers and testing security schemers.

Certification and MOC have become hideous mandates due to payers, employers and legislators who have also been deceived or payed-off into "believing" that MOC equals better care and quality - when the only obvious result is bureaucratically-induced burnout, financial distress and untimely busywork.

ABMS newspeak

Language gets perverted at the ABMS. The honorable word "professionalism", if we look at Robert M. Wachter and Christine K. Cassel, is a synonymous blur with egregious long-running conflicts of interest, endless new ABMS-speak, medical propaganda, Medicare fraud, and crony corporate capitalism.

When will it ever end?

DD2 said...

The corruption will end when democracy comes to the ABMS.

Much needed change will come with the renewed will of physicians, board members, executives, and the public to voluntarily support the incorporation of democratic elections into the whole of the ABMS structure. This should be instituted for the ABMS in Chicago and all the 24 ABMS medical specialty boards.

I am referring to the ineluctable need for the democratic election of all board members, officers and executives to each of the medical specialty boards. Highly informed practicing clinical physicians should get to make the nominations - not the highly-conflicted self-appointed representatives who have populated the offices in Chicago and Philadelphia for far too many years.

Candidates and diplomates will make up the electorate. The inclusiveness of this democratic principle was intended when the ABIM, its subspecialists and other ABMS members with their subspecialties were established during the great financial crisis of the 1930's, the war years and beyond. FDR's socialistic movement was founded upon democratic principles, and the volunteers and workers and later fighting men and women who pulled us out of the depression and won the 2nd World War were all fighting to preserve democracy, human rights and freedoms.

The fairness and objectivity which the framers of the ABIM wrote into their articles of incorporations testimony to this belief in democracy. Even the temporality of committees and organizations to do a job and then move on. They even anticipated that the organization (ABIM) would be dissolved after fifty years or sooner after the organizational frame and a certain quality and order in sub-specialization was achieved.

It was all voluntary at the time of inception and no one was concerned about acquiring or losing lavish incomes from being a professional medical bureaucrat. It was all voluntary humanitarian, and non-profit in the beginning.

Physicians can elect to make it simple, plain and direct again. What we clearly have today is profit motivations, outrageous executive compensation, and highly-conflicted professional medical politicians leading the quality assessment organizations muddying the waters with cronyism, greed and partisan politics. The entire ABMS has drifted so far afield it has little to do with quality assessment and patient safety, except in lip service.

2020views said...

If the conflicts of interest at the ABIM - and other ABMS member boards' executives and officers - were just limited to "double dipping"!

Ah, wouldn't that be refreshing.

And if it were as simple as pointing out the apparent conflicts to the oversight or ethics committee at the ABMS in Chicago!

"Yes, thank you for bringing these concerning observations to our attention. We will be calling a special meeting of the ethics committee tonight, and I can assure you, if the suspicions turn out to be true, their certifications will be revoked.

But I'm afraid the conflicts are as many and varied as their greedy fingers and slippery toes.

The sad truth today is that almost all the greedy "little bureaucratic piggies have gone to market." (triple-dipping or more)

And there is no oversight or ethics committee to send them "wee, wee, wee, all the way home."

The ABMS instead hires white-collar crime lawyers and experts in risk management to shepherd the problems for them; until busy clients forget.

Anonymous said...

Dr Wes,

They are a multi million dollar corporation...

Please be careful.... Nothing these people would do would shock me.

And you are now their worst nightmare.

P said...

Interesting point. "Wes may be the ABMS' worst nightmare."

But I'm afraid when you step back and take a look at the bigger picture, the situation is even worse. The ABMS is just a small basket of fries in the overall testing/security/surveillance franchise.

A part of that in its turn is just a part of the medical industrial complex. And the medical industrial complex has to give homage to something else and pay for protection.

Wes' and his blog are just a dot on an orange frog's back.

Little splashes that they learn how to adjust to and manage. They might even find a way to benefit by Wes' irritating orange color. They may even arrange to give him an award for his courageous reporting or give him a "spot on column" somewhere.

Wes is safe until/unless he starts to play it safe.

e-bird said...

Withholding the money from the ABMS is a good strategy. Money is the reason they exist. Ok, it's the power, too; but it's mostly the money and what they "can and do" do with it. End MOC's tie to employment the quick way - federal legislation with physician/patient protections. Patients need a better bill of rights that includes keeping more doctors in the system. NP's and PA's just won't do as primary physicians, except as air traffic control. Most just don't know what to do and do little for the patient. Physicians end up fixing a lot of the mistakes they make or adding the tests that they did not do. Specialists are even having to pick up the slack of hypertension and diabetes that they can't manage. MOC makes a mess of healthcare. Totally unnecessary. So very harmful. The ABMS certification process is problematic with pass/fail rates. Arora was targeted partly for his success rates.
That cost them a lot of money each year, even though the program directors loved him and some even worshiped him for saving their programs form the ACGME. Just observations.

Thomas Nielsen said...

Doctors everywhere, I implore you. I know you – I am one of you – and I know your nature. We want to soothe, to placate, to moderate pain.

This current MOC fight is anathema to many of you. In many of your minds it is too hard, too dangerous, and too disruptive. What is most disturbing is that some of you think that it is unnecessary or even pointless. Please let me show you why this is not true. Indulge my elaborations, so that I may show you why this is critical to our future.

Why it is necessary to fight the Maintenance of Certification program:

Many of you may be asking why it is necessary to fight this fight. Why not just go through the MOC modules, earn your points, pay your fees, and be done with it? This is not a money fight (we will discuss this later). This is a fight for principles. You are a professional, and maintaining your status as a professional requires you to be up to date on the key elements of your area of expertise. We already face requirements placed by our medical boards for continuing medical education. I personally could not face my patients if I were not informed of current advances in medicine, particularly in my field. It is part of being a doctor and a professional.

The ABMS and ABIM would have you believe that patients are demanding that their doctors undergo some artificial trials in order to determine that they are competent, because they have no other way of deciding if their doctor is good. I have more faith in the abilities of the average patient. Patients have a sense of the competence of their doctor, and they are able to ask questions to probe your knowledge. They also have the freedom (for now) to go to a different doctor if they are not impressed.

The ABMS and ABIM are playing on your underlying insecurity that you do not know everything, but what they are implying is that therefore you need to prove that you know anything. They are using your inner fears to their advantage. I can tell you that with everything you have gone through, you are more than competent, you are very knowledgeable, and you do not need more and more certifications on your wall to prove that fact.

Continuing medical education is a good thing - that we can agree on. But beyond the requirements of the medical boards and your own personal search for knowledge we do not need any new programs.

Why it is necessary to fight MOC now:

This fight is insidious. The people who are thrusting this upon us are financially enmeshed in this system and do not have your best interests in mind. This fight needs to come to a head now, because the majority of the regulations that will hinder us in the future have yet to be written.

The passage of MACRA, which was the ‘SGR fix’ brought in new concepts for physician pay. Now we will be paid in one of two ways, the Alternative Payment Models (APMs), or Merit-Based Incentive Payment System (MIPS).

If you are part of a larger system or in some specialties, you may get paid as part of a lump sum through the APM. God knows what crumbs will be left of the lump sum after the hospital system takes its part.

For others who will be in the MIPS system, your pay will be determined by (straight from the cms web site):

• Quality
• Resource use
• Clinical practice improvement
• Meaningful use of certified EHR technology

Note that we have the MOC part 4, practice improvement, which was supposedly put to rest, rising like a zombie to stalk us again. And we are also to be judged on ‘quality’, which no one can seem to define. Supreme Court Justice Potter Stewart famously defined obscenity with the phrase ‘I know it when I see it’. This is about the best we can do for defining medical quality. The obscenity today is the ABMS/ABIM system.

Thomas Nielsen said...

What about the money?

I said before that it is not about the money, but it is. Certainly to the non-practicing bureaucrats at the ABMS/ABIM it is about the money, because they do not do anything productive on their own. They have to take your money. And it is your hard earned money. To some of you it may seem a pittance, but to others these are large sums. Please take pity on your fellow doctors who may not be in as good of a financial position. The greedy overlords of the certification scam need their seven figure salaries. I wonder how often they take call.

Anonymous said...

Oh ..They must be sitting around in meetings asking "How the heck can we Arora this guy Wes"! How does he know all the truth?
"Who does he think he is"
"Where is Guido when we need him"
"What would Cassel Do"..etc...
Then they realize there is a mole in the meeting but the darned mole is not even MOCd but grandfathered and not even practising! They can't Arora him!
The happy ending would be they shoot out each other Mob fashion and the clean up crew takes out the trash in open debris carts...but these rascals have eaten free lunch for too long and are unlikely to give up.
Great job Wes. They can't hurt you professionally as you have the brains and brawn in right proportions. Make sure they don’t try to physically harm you. Nothing is beyond them.

james gaulte said...

As the risk of being repetitive,let me say again "Bravo"!

Lisa said...

No one plays whack-a-mole with ABIM like #127308. A little concerned P describes "Wes' irritating orange color" and hoping it's not a health problem.

"'medical professionalism' that included a 'social justice' imperative as one of its prerequisites" means that my extermination is morally required because of my White skin, even though I have never acted to harm another and enjoy being nice and getting along, without any crimes or moral problems. Until Whiteness is eradicated, all means necessary to get rid of us will be executed, leaving no ethnic group on earth to sponge off of anymore. Medicine is just the next tier of attack, armed forces doing guerrilla warfare for social justice against the only people, who as a group, are the most law-abiding, peaceful and altruistic. No longer can this be tolerated.

At this point, I hesitate to call anyone doctor because it's like a slur against their character. I never thought I would see this much corruption in my lifetime without ever leaving the United States. Basically nothing is illegal unless someone took some money they were not supposed to, killing is still okay for some reason.

I have to be under my own medical care without necessary resources, and have reached the point where I pray daily that only doctors who should have been brought to justice by now are the ones who kill themselves and thereby make the world a better place. The house of medicine is a mess and disgrace and health hazard. People need to clean this up.

P said...

Lisa, we are exporting our way of life to every country who will have us. And if they don't invite us, let's just say we find ways to invite ourselves in.

You wrote, "Medicine is just the next tier of attack, armed forces doing guerrilla warfare for social justice"...and "I have to be under my own medical care without necessary resources"...

The corporations and banks are not getting "enough" elsewhere in the world, so they've begun IMF-style austerity here in the US - and even started looting us too - whether you are green, orange or "red, white and blue"...

Protestor234 said...

Thanks for posting this link to Dr. Salas Rushford's defense and counterclaim against the ABIM. There is a great deal that will hopefully come out in this case in the discovery process to help fight the injustice that the ABMS and ABIM puts us through. The onerous MOC is one of the big tortures, and we need it to end.

The ABMS is comprised of monopolistic corporations which have put physician through the gauntlet. It's time to end the useless forced march they put us through.

The past lawsuits against physicians were the result of dirty tricks and now it is time to expose the dirty actors who perpetrated the hell they make us live under. I encourage everyone to support the legal battles wherever they are waged against the ABMS and ABIM.

Employees who have faced racial discrimination or been victims of sexism in the workplace at the ABIM have won their cases. ABIM's discrimination against physicians with disabilities can be challenged and beaten back. We can win against the Langdon's, the Cassels and Baron's of the world and their strongmen if we really send a loud message in every way possible. We must pay with efforts now or we will pay later by being further victimized and abused by the ABIM and ABMS.!donate/c1ghi

Anonymous said...

Is the UK's National Health Service on a One Way Road to Privatization? What does that mean for the US healthcare reform? What is the privatization they are talking about and who will benefit?

Anonymous said...

ABIM Announces Members of New Geriatric Medicine Board

Read more:

"The specialty boards have played an integral role in transforming ABIM's work and will help guide ABIM in the development of an even better MOC program," said Richard J. Baron, MD, President and CEO of ABIM. "I am confident that under Bruce's leadership, the Geriatric Medicine Board will work in the footsteps of the previously assembled Boards and continue to make MOC and Certification relevant as they drive innovation in the options we offer ABIM Board Certified geriatricians to meet MOC requirements."

The Geriatric Medicine Board works closely with the Geriatric Medicine Exam Committee, which is charged with developing the examinations and with maintaining exam blueprints that appropriately mirror the specialty's scope of knowledge and practice for both initial Certification and MOC. Both internists and family medicine physicians can pursue additional training in geriatrics, and the Geriatric Medicine Exam Committee includes experts from both parent disciplines. The Geriatric Medicine Board will oversee programs for ABIM Board Certified geriatricians.

"This is a tremendous opportunity to foster new partnerships and build upon existing relationships within the geriatric medicine community while working to improve the Certification and MOC programs," said Dr. Leff, Chair of the Geriatric Medicine Board. "I am excited to gather input from geriatricians across the country to ensure that the MOC program better reflects what they see in practice."



Anonymous said...

What is the new geriatrics MOC board all about? What does it mean really?
If we dig for the truth, it means that the ABMS and ABIM are scheming for ways to keep MOC.

What are they doing?

They are acting quite aggressively looking for ways to politically align themselves with the very medical societies we pay into and in whom we place our trust. The ABMS/ABIM is looking to financially benefit and empower the medical specialty societies and other ABMS affiliates in order to keep power and revenues growing.

Anyone can see all the MOC being offered currently by the medical specialty societies, but the ABMS is expanding and doubling down on their efforts with organizations like the AAMC to allow them to enhance their abilities to make money off of new MOC creation and activities.

Universities are also being enlisted like the University of Michigan and the University of North Carolina, Duke, UCSF - virtually anywhere and everywhere the ABMS has friends or has found a soft spot on the revolving door for money and political empowerment.

This is a shrewd political/financial move on the part of the ABMS and ABIM. I'll provide some evidence and links below to show you what and how they are doing it all. It is an endless maze of associates, corporations, government and foundations.

It is all about creating more money flow from MOC. It is a very big money maker for the ABMS and they are using that revenue stream and MOC requirement of to their advantage. It is a leverage tool for the future that they hold in their hand now.

This means it does not look good for a patient/passive approach regarding the anti-MOC movement. Anyone who believes over time that MOC will end and corruption will be cleaned up at the ABMS without strong grassroots organization, potent political alliances and adversarial court actions will should reconsider changing their views concerning the proper remedy and become more active.

Unless strong countermeasures are applied these full-time highly paid executives with their legal teams have time and money on their side. This means strengthening grassroots efforts with alternative boards and support for MOC by physicians must end. It may be necessary to sue the ABIM/ABMS stakeholder enabling the current situation.

Federal and state legislation must be drafted and submitted to stop MOC from continuing to create work related issues. I mean any underlying circumstances and requirements which stand between a physician and their ability to practice. Specifically hospitals and payers requiring MOC or ABIM certification must cease and desist in this pr Also it is important to confront the ABMS and ABIM for the unethical and illegal practices. These amount to profiteering/racketeering, IRS irregularities, non-profit status, and executive/officer interests which conflict. The ABMS and ABIM have violated ethics, policies and laws governing public quality assessment organizations.

The problematic legislation attached to the PP ACA will kick in soon and by that time the ABMS will have "purchased" support from the medical specialty societies and others. They will do this by giving them virtually free initial entrance into the MOC party. The affiliates and many third-party vendors are being given a stake in the MOC money grab already in large numbers. One wonders why the specialty boards are not talking about ending MOC for their members. They are not inclined to lose the revenues.

That is why MOC must end now and not later. Later there will be less chance, unless some shrewd president decides that these "ABMS nasties" need to be closed down or fired. I'm not going to count on what has not happened by executive action in 100 years.

Maybe it's time to lawyer up? Maybe it's time to find support in some anti-corruption candiates who have a real heart to represent the people.

cont. said...

Rich Baron is worried about ABIM's declining revenues as physicians say no thank you to MOC. He may have to cut his salary. The ABIM/ABMS is looking to improve the bottom line. ABMS gets a members' fee from all the member boards like the ABIM. It is not cheap. Costs are rising even thought inflation rates are low and all member boards want to raise those fees to physicians somehow. This is why they hire lawyers who specialize in mergers and acquisitions.

Follow the ABMS links and activities online and you will easily see how they are seeking many other ways to receive "kickbacks" in the form of fees or undisclosed payments form affiliates via new CE opportunities, etc. The ABMS has developed pathways for new ABMS MOC via AAMC medical education portal working with universities, corporations or specialty societies who wish to profit by MOC.

FYI ABMS gets a fee for putting these MOC MAKERS in the ABMS MOC directory. But later they can and will "change policy at any time" on the new and old participants to get more. Your societies are selling you out, but even they are scammed thinking they are getting a great deal. Physicians won't care after some years go by. It's pain free to allow the societies and universities to make money at little or not cost to the ABMS during the start up years, but then ouch! watch out for the new charges to come once they have been enticed into the ABMS money machine.

Physicians and the societies are being shafted by this ruse, which is essentially a bribe to the new makers of MOC. Let's be clear, the ABMS is essentially buying MOC endorsements this way! When physicians realize what is happening will it be too late?

Those letters and personal phone calls to the specialty boards and the ABIM blueprint teams take on a new meaning now that we know more of the story.

Anonymous said...

New ABIM/ABFM geriatric MOC board?
This is going to send a message to geriatricians that there is no sign of relief in sight about MOC. This will reduce the number of geriatric fellows and increase the numbers of early retirees these specialties. Maybe even more coming at it from family medicine.
Enough is enough. MOC has to go!

Anonymous said...

Here's a debate/trial worth watching. Robert Wachter is the winner and loser.

"Patient Safety Is Not Elective
A Debate at the 16th Annual NPSF Patient Safety Congress

The question of whether certain patient safety practices should be considered inviolable, with violators subject to penalties potentially including fines, suspensions, or loss of their jobs, was the topic of a debate at the 16th Annual National Patient Safety Foundation Patient Safety Congress, held in May 2014. Gregg S. Meyer, MD, MSc, chief clinical officer, Partners HealthCare, defended the focus on systems as the best use of resources to advance patient safety. Robert M. Wachter, MD, chief of the Division of Hospital Medicine, University of California, San Francisco, argued that leaders must address individuals who choose to disregard established safety rules. Each took his respective position for the purposes of debate only."

Meyer does say that the DOJ is necessary for criminal violations. There is an undertone of nervousness on the part of Wachter in this debate.
Both Wachter and Meyer have worked for the HHS AHRQ. Meyer is now an executive at the National Patient Safety Foundation.

One month later Adam Singer, Robert Wachter et al with IPC, the Hospitalist Company were charged by the Department of Justice with a False Claims Act lawsuit alleging systematic intentional billing fraud. Wachter was director and chairman of the quality committee. He received stock and cash worth hundreds of thousands of dollars and benefitted by the sale of the company to Team Health when shares of IPCM nearly doubled in anticipation of and final announcement of the news.

Prior to that lawsuits were filed in Texas claiming that Wachter's company where he trained hospitalist leadership teams

Anonymous said...

NY Times article on the decline in gerontologists.

2020views said...

Wes, the content of your reporting is important to the public as it represents what physicians are up against just to practice medicine. Physicians face an unusual wall of untested quality reporting from unaccountable organizations belonging to the ABMS. These organizations are full of financial corruption and rife with negligent operations which all require physicians to perform redundant low value self-assessment exercises.

The ABIM and ABMS have structured MOC into their evaluatory process for the purposes of self-inurement and creating free time with which to plan and direct political activities involving liberal health care platforms. This is quite transparent even if the ABIM is not forthcoming on the financial underpinnings making it possible. It has been a hidden problem in the past, but it is clear what the organizations are doing today thanks to reporting in Newsweek, Dr. Wes and so many medical publications that have picked up parts of the story.

Part of the story that is not told

Foundations such as the ABIMF supported enhanced personal inurement and political inurement for democratic national convention platforms DNC, before and after the elections of 2008. We see this with the double payments to executives and the transfer of profits to the ABIMF from the ABIM in the years prior, which created funds for foundational campaigns to support and sustain those personal and political campaigns of Christine Cassel, Bob Wachter, Eric Holmboe, Richard Baron and others. Even Lynn Langdon's role as COO and head of investigative services played into this support of a highly political DNC healthcare platform and personal inurement of staggering proportions. According to Hillary Clinton, a close associate of Christine Cassel and the rest, Obama Care should be also called Hillary Care since she came up with it long before Obama. Cassel while working for the ABIM, ABIMF, and NQF was a top advisor to president Obama on healthcare reform.

2020views said...

Let's look at ABIM 2009. Cassel was just appointed to Obama's PCAST.

We could view the sanctions and lawsuits against thousands of physicians as fitting into a tidy timeline to suppress/violate, physicians' constitutional rights with many elements in Pennsylvania government, the White House advisory, and the Federal Courts taking active roles in an "unprecedented event" in the history of medicine involving ABIM's claims to science involving their secretive multiple choice testing practices and copyrights. I find all of the activities of Lynn Langdon, Eric Holmboe, Richard Baron, Robert Wachter and Christine Cassel to be not only highly suspicious, but they clearly crossed the legal threshold of what is allowed under the laws of the United States. Time and evidence will bear me out on this.

The ABIM and ABMS have enjoyed protections from federal and state investigation and prosecution for far too long. In my view it is high time to investigate high treason in an election year where a new president will be elected in less than a year.
I want to know the next president's views on corruption and fraud as we find it at the quality assessment organizations. Lives depend on it, especially as patient safety and quality of care recommendations have been coming from such highly conflicted individuals and their organizations such as the ABIM, ABMS, ACP, AMA and NQF. The ABIM, its highly irregular Foundation and NQF, for example, have been little more than physician test/sweat shops for self-enrichment of revolving door executives and crony officers. The organizations were designed and utilized by liberal democrats using them as platforms for political and corporate influence pedaling.

These enhanced functions of the ABIMF were created by Dr. Kimball and Cassel to provide a spill-over account for over-charges consciously imposed on physicians by the ABIM. The Foundation became a tax haven for hiding those profits, capital gains and revenue increases, which at the same time expanded the platform for political influence pedaling.
With all we know, it is fair to say there is a surfeit of evidence to support indictments and convictions of the executives and officers of the ABIM and ABMS.

Wes, can you explain why this process has been thwarted or stymied?

Does anyone disagree with this assessment? Does any of the thousands of physician who were sanctioned or sued by the ABIM for attending an ABMS competitor's board review course feel cheated out of their rights and unjustly disempowered. I feel that ALL physicians were politically sanctioned by Christine Cassel, Richard Baron, and Bob Wachter in 2009 in order to subdue physicians for their own financial gains, but moreover this served to enhance political influence and control at a critical juncture in the healthcare reform process. We, as a society were robbed of more than money. We had our democracy stolen. It does not matter what political party we ascribe to. It was done to all Americans.

Why no democracy at the ABMS?

Why are working clinical physicians, who pay the bills for these politicians at the ABMS, not nominating and electing their own leadership. Do we live in a democracy or a cleptocracy?

Facts show that the ABMS and ABIM offer no democratic rights. They offer no involvement except a few belated surveys. I do not want my life, professional and otherwise, dictated to or decided by a few egregiously conflicted and self-appointed executives, and their crony officers who continue to rob us blind.

Lisa said...

P: I'm glad I checked back and saw your response.

Yes, I totally agree that Banksters are to blame, and that there are these 'austerity' measures being imposed. I've actually been extremely pro-doctor, because I see the nonsense being imposed.

I maintain that this is "guerrilla warfare for social justice" and was even told "people like you don't deserve medicine". My pro-doctor kindness can only go so far, and has surpassed what any other human being would do. There were no banksters breathing down the neck of doctors who intentionally did as much harm to me as possible--I spoke to customer service for the BEST insurance that I paid quite a lot for--and they would tell me, "you are 100% covered for this and that" and then doctors would actively militate for my expedient death, obstructing and harming as much as possible.

There is no excuse of banksters made them do it. There is a conspiracy to inflict torture and hopefully death, there is no way to deny that. It was doctor choice, 100% doctor choice. Since I am not a black person having a nightmare, or having died by suicide by police, there is not going to be help from the DOJ. There isn't going to be help from anyone, most likely.

Am I still pro-doctor? Limited, very limited. I have a love and respect for medicine. Some of these physicians aren't doing medicine; they need 'social justice' (aka kill that fu%king cracker, beat it, torture it, tear it limb from limb)

God has an opinion: may that encourage those doctors who aren't out hunting, and for those who are, suicide is not a bad option for you at all. We might call it a public service.