Saturday, March 12, 2016

When the ABIM Comes Knocking

Imagine early one morning your doorbell rings. You wake from sleep and come to the door and open it. There before you is "a lawyer and a few other people from the American Board of Internal Medicine (ABIM)."  They hand you a document, signed by a judge, that they can search your premises and seize things. You're confused and feel powerless to act. They enter, move to your study (home office) that contains the records of your ACGME-accredited board review course that you've given for years, collecting documents. They open your computer, taking portions of it so it no longer works. They rummage through your wife's jewelry box. They spend the entire day boxing and inventorying things that they collect, then leave.

Then, some time later, a settlement deal is cut with you. One that apparently the ABIM does not want others to see. You're advised by your counsel not to bring that subpoenaed settlement agreement with you for your deposition. And remarkably, the very same lawyer that raided your home is there at your deposition representing the ABIM.

Sound unreal?

Yesterday, Dr. Jaime A. Salas Rushford posted on his blog the 142-page deposition of Rajender K. Arora, MD from January 21, 2016, obtained as part of his defense of the ABIM suit filed against him. Dr. Arora ran the board review course that resulted in 5 suits and 134 physician sanctions by the ABIM as reported in the Wall Street Journal. It also prompted physician sanction letters to be sent by Ms. Lynn Langdon, Chief Operating Officer of the ABIM at the time, to thousands more.  Dr. Arora's account of the raid on his home in December 2009 begins on page 62 of the posted transcript.  The lawyer that came to his door is identified on page 63 (Ms. Hara Jacobs). The accounting of the search of Dr. Arora's wife's jewelry box is found on page 93.

So if you've got a few minutes, grab a cup of coffee and read the deposition, especially the part about the raid on Dr. Arora's home. I have a feeling this story is about to get very interesting for practicing US physicians and very uncomfortable for the ABIM as more details about this apparent physician sting operation emerge.

-Wes

Related: "Strongman, Bosses, and the American Board of Internal Medicine

31 comments:

Anonymous said...

Gee, why hasn't ABIM mentioned this ?
So much for openness and transparency.

Well, on the bright side, at least the Gestapo is still alive and well.

BlueAngel said...

A Restraint of Trade and Sabotage of American Civil Liberties

Bottom line here is the restraint of trade to enhance ABMS' lucrative businesses. Some of the practices employed include the use of secret police - literally - who investigated and brought forth compromised evidence. Also employed by the ABIM was an arsenal of dirty-tricks attorneys with powerful corporate, financial, and political connections.

What we witnessed was not just a restraint of trade but a full-blown restraint of political freedoms and constitutional guarantees through a deliberate sabotage of legal and democratic processes. Part of this process included the branding of physicians in the media and denying them of due process. This effectively took many physicians out of the political and judicial process by silencing them through the use of fear-mongering tactics. Dr Fisher has written of this.

End result is the destruction of the constitution by an elite group of PROFESSIONAL MEDICAL BUREAUCRATS, a testing empire, and the special interests and agendas they represent.

When these ABMS-sponsored thugs led by the ABIM/Ballard Spahr were given an "ex-parte" writ to seize property of an ACCME-approved board review company, every American's civil liberties was destroyed along with amendments to our constitution.

This is a condemnable act of injustice and violence enacted by the ABIM and their cronies against vulnerable physicians and the entire population of physician health providers via the media, propaganda and fear tactics. Hidden political agendas were substantially served making this not just a heinous usurpation of civil rights and abuse of the legal system, but a sabotage of the democratic political processes many Americans have died for defending. This includes many members of my family.

It is unprecedented in the history of healthcare in the US. This unjustified attack on physicians was both political and corporate in nature.

If the full truth were brought out into the open with actual facts replacing the ABIM's fictional accounts we would be ashamed as a nation. We would be ashamed of our bureaucrat-physician partners who sold out to special interests and opaque political motivations.

It is not a proud moment for us to read this deposition given what we already know of the 'bad ABIM/ABMS actors' who implemented this sting operation and unjust legal proceeding and sanctions against physicians.

I condemn the corporate sponsors and the compromised federal, state and local officials who assisted in this heinous attack--especially those who benefitted personally, whether that boon was financial or political.

Steve Parker, M.D. said...

It seems odd to me that a lawyer for ABIM was there for the seizure. But I'm no attorney and have no experience with this sort of thing. It would be nice to have a comment from a lawyer.

My favorite part of the deposition is when Dr. Arora's lawyer told him not to answer a question because "...it's a bullshit question."

Anonymous said...

I read this recent court document and others from 2009 until the present. Wes is right there is more to come that is less than flattering for the ABIM and their counsel.

Would Dr. Arora have exercised his 1st amendment rights and answered the questions as he would have wished if the attorney in his family's nightmares was not there staring at him from across the table? Was Arora "gagged" psychologically with trauma preventing him from really responding or remembering. The ABIM is costing everyone big money with all these endless legal attacks and police actions.

Dr. Salas Rushford's lawyer, Mr. Gonzalez, did not ask a bullshit question at all about copyright infringement. Dr. Arora wanted to continue, but his lawyer, Ms. Miller, would not let him answer. I believe based on what he said in the deposition, the answer is and will always be "no he did not infringe on ABIM's flimsy testing copyrights! How could he, he does not have superhuman abilities and he stated that he made up his own questions based on content."

The ABIM never had any beef with him over his courses. Why suddenly was he the object of attack? This is a mystery and must be answered by the ABIM. They did not cross examine him because they were afraid of the answers they might get on the record.

This old man and his wife were surprised in the early morning, intimidated throughout the day as the ABIM and Hara Jacobs of Ballard Spahr ransacked Arora's house - even putting their hands into his wife's private things, her jewelry box. This old couple after twenty years of serving the ABIM and internal medicine programs were suddenly turned into criminals wrongfully and threatened with horrendous loss if they did not surrender themselves to ABIM's demands.

Based on what Dr. Arora's lawyer said about why she did not produce any documents pertaining to the previous lawsuit settlement with ABIM tells us what is in it and what is not.

So, it is obvious if you can read between the lines physicians were the key target and they had to be sanctioned and sued according to a plan and timeline.
Before the ABMS could proceed they had to get Dr. Arora to submit at any cost using any threat so he did not put up a fight or a lengthy battle. This deposition shows us without doubt that the ABIM has a great deal to hide from us. We will see if they comply at all with discovery and the documents that will get at the facts.

As it is now, Dr. Arora has no recollection of Dr. Salas Rushford or any of the sued or sanctioned physicians who attended his courses. A key potential witness for the ABIM and they did not want to cross-examine Dr. Arora. What are they crazy, afraid of something coming out, or just telling us they are as guilty as hell at the ABIM. What kind of counsel is that! And why was Richard Baron not there for the reunion with Dr. Arora and to tell him "sorry we got it wrong" in person.

This means there is no supporting testimony and no recognition by Dr. Arora of the defendant Dr. Salas Rushford. Dr. Arora did not recognize any of the ABIM's evidence, but he did corroborate information that substantiate Dr. Salas Rushford's lawsuit against the ABIM and key defendants there.

My main question is will ABIM's lead attorney in NJ, the honorable Mr. Soto want to put his name to this lawsuit when he begins to see he is essentially becoming a criminal lawyer defending the ABIM and Hara Jacobs who in my opinion violated the civil liberties of physicians and may have tampered with the investigative and legal process. As a former high court judge in New Jersey Soto should get the picture quickly. I believe Soto's principles may be in conflict with who and what he really has to defend here. I believe he does not like it one bit already.

Anonymous said...

Page 62 and after of the deposition Dr. Wes has referenced is a must read for those who think they are benefiting from ABIM activities or even better for those who want to take on ABIM and its strong arm tactics. As a group physicians need to say "Go to hell" to ABIM. It will make your blood boil in anger!

Shame on the ABIM said...

it would appear that the ABIM tragedy continues to emit a worsening, rotting stench. How is it that a non-clinical testing organization can assume power over the Civil Liberties of individuals and get away with it? Mostly because there is no sense of outrage from the community of hard working physicians at large.

As Medicine is being transformed, it is clear that no one really quite knows what will hold for the future. There is a mad rush for power, money and influence usually under the guise of "quality" or "process improvement" and other buzzwords. Once possession of money or power begins, its intoxicating effects begin to corrupt and rot the hopeful power brokers such as the ABIM. This deposition is the top layer of a heaping pile of toxic ABIM behavior that they hoped would be hidden by a WSJ article proclaiming a moral and ethic victory. Over whom? Your Diplomates and constituency? Seizure of personal property and an early morning visit from a Sheriff serving a search warrant?

How in the world is this representative of Medicine and physicians?

This indeed is the handiwork of a Gestapo like organization hell bent on steam rolling over the lives of ordinary clinicians.
The KGB and the McCarthy Commission had more class.

Shame on the ABIM. Shame on the ABIM Foundation.
Shame on all of us for letting this happen and pretending it does not matter.

Anonymous said...

It would appear that Attorney Miller is clearly hiding something as part of a confidentiality clause in the original settlement. My guess is if that data were to be revealed it would be material to the current case. To get Arora off the hook, it looks like they cut a deal but the ABIM neglected to consider that others would be pissed off enough to invoke full transparency.

Keep on pushing Dr. Jimmy. The more you dig around the more likely we will find dead bodies, grime and lots of proof that the ABIM is a heavy handed thug like operation that maneuvers like organized crime.

ABIM- We got it wrong. said...

Dr. Jimmy stated that he estimated ~2700 ABIM physicians were sanctioned unjustly by this slimy cartel. What if one-fourth of this cohort filed papers to countersue the ABIM?

The ABIM money gas tank will be drawing on fumes and the structure of this debacle will collapse onto itself.

Anonymous said...

Is there a fund to go after this dysfunction scam group ? A fund set up to sue , sue , sue -- often ! The organization, the board members , the officers, the lawyers who are part of this ? And, exposing judges who are , for some reason, aligned when this folly ! I'm ready to donate
( not a doc ,,,but, very much respect the work physicians/nurses/techs do. ). You tube videos -- go viral.. Petitions ! Jeez -- let's start playing hardball ! Enough of the postings ---- more focused, strong action is clearly needed. Sorry for the rant !

The whole truth and nothing but the truth said...

The blind-folded dogs guarding the bridge to justice. When will we see truth?

The ABIM has put themselves in the alley behind Walnut Street and now operates with a gutter-mentality. They have done so with their obvious low blows to phycians over the years. In so doing they have compromised the trust and integrity of the entire quality assessment bureaucracy in the United States.

This ABMS-endorsed highly coordinated police action by the ABIM represents the seizure of our civil rights and not just the "writ to seize property" spoken of in the Arora deposition. The deposition is only the tip of the iceberg in this lawsuit. It reveals clearly the ABIM and it dark mechanisms. It operates in revolving door world of partnerships with a fiendish reality--protected by a macabre cloak of silence and a compromised legal system and political structure.

The ABMS is a Frankenstein of umbrella organizations run amok flapping arms in the wind, grunting with objections, always blocking the truth, our sunshine laws, and even foiling the Freedom of Information Act.

We see how even in court, where the whole truth and nothing but the truth is demanded, how little the ABMS/ABIM gives of that whole truth. In fact we are directed away from the truth with disinformation.

Fiendish puzzle? Yes. Here are some pieces to the story.

A unrecognized dark face appears in the deposition. Who is he? We don't know yet. Even Arora wants to know. He cannot recall the details. But he may wake up remembering and cry foul when he recovers from his catatonia. If we could watch the video version we could learn more of who these "respectable" ABIM attorneys are and how the ABIM and connected circles operate outside ethical practice blocking discovery of the truth and even with further investigation see how the ABIM/ABMS may have acted outside the law to get what they wanted.

The body parts (lies, secret police and financial deception) are still in the dumpster out back. Parts of the ABIM's ongoing scandals have been rotting for years covered over with more fresh lies. When will it stop. The lies are getting heaped to the sky.

And the public and physicians have not given a damn to take care of this organized affront to human dignity called the ABMS and ABIM--partly because of the veils of secrecy ABIM cleverly weaves for us. They wave veils of silence in front of our hypnotized faces about everything--especially concerning their obfuscated finances, Wall-street shenanigans and penchants for propaganda and Hollywood-style makeovers to recover their fallen status with the public.

With ever-new ABIM-speak under the heading of "professionalism" they are always ripe with self-prepared publications with which they have repeatedly attempted to whitewash their negligence and fiduciary irresponsibility.
But they defend themselves with bags full of air and fingers to the wind.

Yes, Rich Baron and Lois Nora have certainly been taking care of business alright--their own business--not that business they were once upon a time been entrusted with. Nothing but harm to the client-physicians and "unintended consequences" in place of real protection for the public.

The ABMS has made sure of taking care of their own personal finances and partisan politics by ignoring their pact and obligations to the public--except filling that void with empty words and endless propaganda.

What do we really see when encounter any of the ABMS trademarks?
Deep monetary distress and onerous time constraints for physicians.
Financial deceit, lies, and political corruption are the hallmarks of the ABIM and the ABMS' shadowy practices.

Thomas Nielsen said...

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

This is a call to all doctors. I implore you. I know you – I am one of you – and I know your nature. You 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. Allow me to extemporize, so that I may show you why this is critical to our future.

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? With every revelation about the tactics of the ABIM/ABMS we get a glimpse of their true intentions. They do not have your best interests at heart but are only after your money. But this is not a money fight (we will discuss this later), it 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. What they are implying is that you need them to help prove to your patients 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.

Thomas Nielsen said...

Why is it 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 true obscenity today is the ABMS/ABIM system.
And this goes beyond just the MOC fight. Now we have medical students being taken advantage of through the National Board of Medical Examiners' Step 2 CS requirementhttp://drwes.blogspot.com/2016/03/when-medical-students-push-back.html. This is another unproven regulatory hoop that does nothing but enrich the people who are putting this in doctors’ ways.
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.

Thomas Nielsen said...

sacredcowonaspit.com

Thomas Nielsen said...

This is an equation that all doctors should learn.

ABMS + MACRA = Regulatory Capture

The Power of Intimidation said...

Wes, I read that Dr. Arora's attorneys--Camille Miller and Melanie Miller--state on their website that they defended Dr. Arora and "other physicians" in the aftermath of ABIM v. ABR.

Do you or does anyone else on this blog know who the "other physicians" were and what the outcome of their defense was if the Cozen/O'Connell attorneys C.& M. Miller were retained as their counsel?

I can only think of one who was perhaps co-defended with Dr. Arora. That would be Dr. Kachadourian. Or was she able to afford an attorney of her own? According to Dr. Arora in the deposition, Dr. Anise Kachadourian was not a paid employee. But she was somehow painted as "an assistant" by the ABIM in their lawsuit.
Not according to Dr. Arora. He said he got tired of reading his questions at a course and she offered to read for the old man.

Also, I am unaware of any other countersuits connected to the ABR other than the two below.
ABIM v. Salas Rushford v ABIM (2014)
ABIM v Sarah Von Muller v ABIM in 2010?

Were there any other ABR related countersuits? Is not the current case ABIM v SR v ABIM et al, especially during the discovery process just creating hatred toward the ABIM and revealing damning facts about their strong-arm tactics. Might this open the door for fresh lawsuits?

Was Christine Cassel, Lynn Langdon and Rich Baron nuts when they decided to go after a lawyer's son? I thought when they culled through the files, which they still retain, they only picked the soft targets--IMG's, women with children and old men!

The ABIM's legal team led by Hara Jacobs really screwed up by pursuing physicians and helping to persecute them. Obviously. This ended up costing physicians and taxpayers millions and millions of dollars in losses defending nothing but their own well entrenched markets--which only opened up a Pandora's box of loathing and liability for the officers and executives of the ABIM.

Maybe Baron and all the other members of the "six-figure club" at the ABIM should take a cut in pay to make up for these endless legal fiascos. And I hope to high heaven that Lynn Langdon, "who no longer works for the ABIM" is not getting a big bonus, severance package, or 600K job guarding the documents room. She violated laws as far a I am concerned and should be the one to pay for it.

But Jacobs and Ballard Spahr always gets paid whether ABIM wins of loses.

Dr. Arora's attorneys: There was no trial and no defense for Arora, just a settlement. I wonder if his two attorneys would consider a class action lawsuit against the ABIM at this time. Or sue the ABIM on behalf of Dr. Arora and Kachadourian on a contingency for withholding key evidence and all the financial and personal damages. They have a large firm with the power and finances to do so.

Camille Miller, Cozen/O'Conner
"Served as lead trial counsel for Arora Board Review and various doctors in defense of claims of copyright infringement and breach of contract filed by the American Board of Internal Medicine."

https://www.cozen.com/people/bios/miller-camille

Camille Miller, Cozen/O'Conner
"Served as counsel for Arora Board Review and various doctors in defense of claims of copyright infringement and breach of contract filed by the American Board of Internal Medicine."

https://www.cozen.com/people/bios/miller-melanie

2020 Views said...

The ABIM came knocking at two doors. Dr Arora's family home and the home of Dr. Anise Kachadourian. Did ABIM seize Dr. Arora's family personal health files histories, financial documents, bank statements, tax records and family photos, etc. along with their several computers, phones, other electronic devices. They seized untold data on physicians in box after box of course related files. Not even J Edgar Hoover had that many personal files on people in his watch list. Yes over twenty years of physicians' files, program information and a great deal of unknown information was looted by Ballard Spahr, ABIM security, and federal marshals.

Did the ABIM misuse or violate their court-granted authority/opportunity to seize records and family documents from the homes of Drs. Arora and Kachadourian? What a perfect way to win in a trial when you have the power of the feds to scare the daylights out of you with the first stealthy below the belt punch. You never forget a raid like that when they hit your private parts.

Dr. Arora stated that the ABIM destroyed at least one computer, which had to be disposed of. Original copies were not returned for months, if at all. Did the ABIM tamper with his and your personal and professional data. It was phycians' data too. That was the big prize they wanted. Why? What did they do with it. They got sole custodial rights to take it to the ABIM and copy it all. There was no court monitoring for the ABIM! What are they doing with that data now? Think about it for more than a few moments. We should be frightened of these do as they please monsters. If they don't vet their executives who have had egregious conflicts of interest, do you think the ABIM or ABMS vets their security people?

This rape of personal information is being done to all of us. It was not just a few thousand physicians that have been violated. All of us have been tampered with, intimidated and our lives compromised. Have you ever been raped or violated financially, any way. That is how those whose lives were invaded/personal property stolen feel. Has anyone ever offered to help Dr. Kachadourian, Dr. Arora, or Dr. Von Muller recover from this assault. Or any of the thousands of physician who feel violated by the ABIM, who has offered support to them?

Has anyone offered any real help at all? Have the attorneys really done their job defending and prosecuting the ABIM and ABMS? They are the criminals cheating everyone creating a society of victims. When the ABIM broke into Dr. Arora's home they broke into my home as well. They stole everyone's personal property and life. We cannot allow the same miserable wheel to keep turning. The wheel of fear, obfuscation of facts, and intimidation must stop. We need to get our voices back.



Anonymous said...



The plot thickens !!!
Hara JACOBS... a new victim shows up !! Who is Bradley D. Mittman, M.D ??

Intellectual Property Litigation

American Board of Internal Medicine v. Sarah Von Muller, M.D. (E.D. Pa. 2010). Won 12-day federal jury trial as lead trial counsel in exam security case; obtained monetary judgment on copyright and contract claims and a defense verdict on counterclaims for tortious interference, defamation, commercial disparagement, and invasion of privacy; obtained attorneys' fees award on copyright claim


American Board of Internal Medicine v. Arora Board Review (E.D. Pa. 2009). Obtained a temporary restraining order, seizure order, and permanent injunction against a test preparation company that collected and disseminated copyrighted examination questions


American Board of Internal Medicine v. Bradley D. Mittman, M.D. et al. (C.D. Cal. 2008). Obtained statutory damages and permanent injunction against a test preparation company that collected and disseminated copyrighted examination questions; court awarded monetary damages and permanent injunction against defendants as the ultimate sanction for failing to participate in discovery

Art Fougner MD said...

Some rob you with a six gun.
Others do it with a fountain pen.

Woody Guthrie

Anonymous said...

“Steal a little and they throw you in jail.
Steal a lot and they make you King.”

Bob Dylan

Ed Rico said...

If you Google "FRONTRUNNERS", you can read all about Dr. Bradley Mittman and his experiences with ABIM.

BTW Who would brag about litigation experience against physicians? I hope Ms. Jacobs is receiving her medical care from Dr. Baron.

Anonymous said...

This lady has made a career out of attacking docs.

I hope she walks into some internists office and he knows who this lovely woman is.

"Hey..you're the woman who screwed Sara Von Muller, Arora and Frontrunners, right?....Now get hell out of my office !!!"

ABIM The Correctional Medical Home: Journal of Ethical Practice in Quality Assessment Industry said...

The medical assessment bureaucracy with its allure, entrapment, and regulatory capture has acted in ways beneath their dignity and failed miserably the test of professionalism which they themselves preach, but certainly do not maintain.

Anonymous said...

"This lady has made a career out of attacking docs."

Who else made careers and a market out of this testing/copyright/security industry? Read the deposition carefully. Read ABIM v. ABR for who else was involved in the legal attack. Put two and two together. Investigate them online. It won't take long to find the hidden faces in the new and established markets in the testing/security/surveillance business. And the lobbyists and legal muscle behind them.

For the lure of money people stretch ethics and bend the rules.
The ABMS is a prime example. Dr. Arora is a saint when you compare him with the criminals that demonized and pursued him and how they achieved their aims. Anybody who studies Dr. Arora's real life know he served medicine well and with great compassion.

Interestingly, the Arora deposition mentions an ABIM v. ABR settlement from June 2010, but neither Miller or Rivera-Soto and Hara Jacobs produced the documents requested. Why not?

Does it have anything to do with improper investigations conducted. Plus the demonization and pursuit of phycians which ensued—the defamation of docs and egregious civil liberties violations? Was there improper influence? Collusion? We’d like to know, but in the absence of clean transparent responses we get stonewalling and diversion from the ABIM and ABMS. (The ABMS is involved too.) So our highly active brains which some say are hard wired to look for conspiracies start looking for details, patterns, and people involved.

I usually try to debunk conspiracy theories, but if any story has a conspiracy behind it, this one does--political, legal and financial. That's part of the reason for the lid kept so tightly on this ABIM/ABMS story, the organizations, their political and corporate friends and influential partners.

Pennsylvania is an interesting hotbed of strange bedfellows and peddlers working for the commonwealth. And so is New Jersey. Potential conflicts of interest in power, law and finance are everywhere. It is impossible to keep track of even a thimble-full of it.

MNM said...

The Hindu approach to ABIM's False Claims

Arora v ABIM: If the ABIM had a common sense approach and not a thoughtless greedy one...

One forever stamp and ten minutes time composing a nice letter to Dr. Arora in 2009 would have saved thousands of lives and many millions of dollars.

The ABIM could have lowered their fees and taken a raise in pay at the same time.
Well...they upped their pay anyway to adjust for 0% inflation.

Langdon "mowed the grass", and got a huge bonus.
Cassel did her part, moving up the corporate ladder. She left the house of medicine derelict and in a complete mess. But she took an egregious amount of money hauling it out by the truckload anyway.
Baron got a big boon/reward from Bob Wachter for his part in the deed.

Now the ABIM is a broken organization gasping its last breaths.

Bob Wachter tried to defend it and his cronies as he feigned to clean out his ABIM drawer; but instead he threw us a hanging curve ball and a piñata to swing at wildly and festively in the air. Bob continues to prepare his own demise by pretending. He pretends in venues too big to imagine that he is not an utter public fraud involved in patient safety violations and upcoding. He is even a master of putting all his conflicts of interest on the stage with him for transparency.

Good luck to you all. You are so busted.

Anonymous said...

You know what? After all this withholding of evidence by the ABIM, I'm beginning to believe that they cheated in their investigation. Also they had Arora's files and personal information for nearly a year, they should have returned it within a few days. The "evidence" should have been in custodial care somewhere where it could not be tampered with. It appears they had free range with it to do whatever they pleased. How contemptible is that! They could have done anything to it. Lost part of it or added to it from other sources. How did they trace Dr. Salas Rushford after four years? Did they get help from law enforcement or illicit access. Was a judge involved? I am highly skeptical of the ABIM and their methods. I'd throw the case out. What bullshit we are discovering from a bullshit organization pretending to certify physicians. It is the biggest scam of the past decade.

Look at the way the ABIM is stalling to cough up documents in their case against Dr Jimmy. With Arora it must have been mostly Sabre rattling with little or nothing that was admissible in court. They just fooled everybody. Arora folded for lack of money and his old age and that alone gave a false legitimacy to the ABIM's subsequent attacks on physicians.

Now with this Goliath versus David case it appears they are withholding exculpatory evidence that may apply to all cases previously filed against physicians.

I think the deposition of Dr Arora was marvelous and further depositions to come may have the ABIM scared of what will be revealed -- something perhaps even more scandalous than we can imagine right now.

Anonymous said...

I find this all very troubling. My understanding is that the US Marshalls only get involved if there is criminal activity, and why they supported this ruthless testing company is unclear...

Two of ABIMs repeated allegations are that their tests a copyrighted and trade secrets. I can no longer ethically sign up for MOC, as I cannot sign the ABIM Business Associate Agreement for HIPAA (This is fraud as they are NOT my business associate), nor can I say that ABIM should be able to copyright medical knowledge, and that medical knowledge is ABIM trade secrets. ABIM was found to not be in the public interest for reasons of taxation. I do not believe they serve the interests of physicians... They appear to be simply a multi-million dollar testing industry.

Von Muller's "jury found that, under the merger doctrine, at least some of the exam content allegedly copied by Dr. Von Muller was not copyrightable. That doctrine precludes copyright protection for an idea when the idea and the expression of it are inseparable...Von Muller's attorney... said...'You can't copyright a teaching point. They can't protect medical fact or scientific knowledge or some concept. ... They can only copyright original expression'."

Trade Secrets Blog, in the article, Medical Board Sues Test Preparation Company for Theft of Trade Secrets - The Physician Certification Test Questions! says, "...We have some doubts whether test questions, obtained from test takers, constitute trade secrets under any commonly accepted definition of that term. But the allegation is an interesting one and we'll keep an eye on this one for you.http://wombletradesecrets.blogspot.com/2010/01/medical-board-sues-test-preparation.html

I agree that the "cheating ring" appears to actually be individuals in the ABIM and ACP. I attended a board review course sponsored by UCSF and ACP a few years before 2008. Junior faculty said things like "you can expect this on the test" and there were substantially similar questions on the test, but needless to say ABIM is not going after ACP board review. Many of us must take these expensive courses just to pass the testing industry ABIM multiple choice exam, which has little to do with the actual practice of medicine. The course typically gives you the "questions du jour" that the elite industry is promoting that year. The test is difficult for those of us who went to schools where multiple choice testing was not emphasized... and I suspect for many who speak English as a second language... Arora appears to be a competent physician who had difficulty passing the multiple choice test. He figured out how to get himself and then others through this onerous multiple choice test. According to Wes, Salas-Rushford was a first responder in the Haitian earthquake crisis. His residency program recommended the AMA-certified Arora course.

ABIM's statement has no evidence to back it: "Certification by the American Board of Internal Medicine (ABIM) has stood for the highest standard in internal medicine and its 20 subspecialties and has meant that internists have demonstrated – to their peers and to the public – that they have the clinical judgment, skills and attitudes essential for the delivery of excellent patient care." ABIM' is a greedy multi-million dollar testing company in collusion with ACP. Board certification only demonstrates that someone took the board review course and passed a multiple choice test. The practice assessments are ridiculous waste of time.

I'm much more concerned about the lack of transparency of the ABIM and ABIM foundation, the use of testing moneys for lobbying for Cassel's political issues, etc, and other breaches of ethics by ABIM than I am with these trumped up charges against these two physicians.

DH said...

I want some damn facts on this Wes! Can you, an attorney or Dr. Salas Rushford provide us with some real data. This is sickening, not just troubling.
My question to Hara Jacobs? Who else was with you from Ballard Spahr on the day of seizure? Who was on the ABIM security team? Did Dr. Arora have a list of people entering his house? He should have been given a list of names. He has rights. Who were they, their background, integrity. Were they vetted? Did any have police background. Abuse of power histories. Felony records. I see a name in the deposition that had such a felony record who may be director of testing security at ABIM. I want that list of names myself to examine. I don't want that thug anywhere near my ABIM files! Let's have some transparency from the ABIM and Ballard Spahr. Maybe Hara Jacobs should be put under oath here. I the ABIM using felons to seize property or investigate us. What are his conflicts of interest. Is that what the ABIM is afraid of? Others have suggested they did something improper. I feel that this is so. They are not cooperating with discovery. This whole thing of using marshals is outrageous. Dr. Arora did not have any legal representation present as this was a sealed court order. Who gave that authority? Was Arora given the opportunity to contact an attorney to challenge/observe this heinous entry? No. Arora had no opportunity to challenge the legality of the claims. Outrageous. That should have been his right. No way would I issue that ex-parte writ to seize if I were the federal judge. I would say "go through the discovery process." We have protections in this country. Did these protections apply to Dr. Arora? Apparently not. Why was he not given any lists of items taken? He seems to not know what was going on. No warning. Shock and awe. Where was his property taken?
If we don't know who was involved we have several problems arising out of this. include unidentified individuals. Federal Marshals must give names and identify themselves. Dr. Arora was violated just like any mafia would strong-arm a competitor. We have more questions than answers. I would challenge the ABIM and ABMS on this as testing security officers are shared. Has anyone called the ABIM to talk to Richard Baron about this and challenge him. He was there and involved too.
According to sources close to the Frontrunners case Ballard Spahr reported to Dr. Baron. I assume others like Langdon were involved very closely with all this too.
I want answers and I want the ABIM to be held accountable for this sick abuse of power.

Anonymous said...

This is public fraud!

Anonymous said...

If the ABIM secret police ever come knocking on my door, I am going to quickly introduce them to my two in-house attorneys, Mr. Smith and Mr. Wesson. Assisted by the law firms of Sturm Ruger and Heckler & Koch.

Dietrich said...

There is absolutely nothing the ABIM has that anyone would want to steal.

How can anyone support a system that on one hand will have you pay and waste your time to ultimately get their certificate of approval, while on the other, participate in legal actions against the very same clients.

If you log in to ABIM lately you will be invited to rejoin their MOC program, but only if you agree to their terms, including an obligation to pay them big bucks per certificate. The EULA, so to speak, as if I am willingly purchasing a product I desire. Their terms or YOU won't get paid by the insurance companies. That is extortion.

They got it all wrong. In the 2 years since that message, they have shown us what all wrong is. They weren't making enough for themselves.

I suppose I will be leaving medicine when my current certificate runs out. What about the physicians that don't plan on certifying again. If ABIM succeeds in linking state licensure with active participation in the MOC program, you'll be out of a license in 1-2 years.

I devoted my life to medicine and I now feel manipulated. I have very little free time, and that time is eaten up by to a great deal by these MOCs and have come to the conclusion that because I can't fight this alone, I will be retired when my certificate expires.

I ask every physician, can you live with the threat that, after investing over a decade in education, you could be suddenly out a gainfully employed career in 1-2 years, or at worst have the noose of 10 years looming over you?

If every physician would vow not to recertify we all win.

Anonymous said...

Dr. Anise Kachdourian cheated and failed to pass test. You speak of the end of a doctor's privacy. I was a patient with Kachdourian. How do I feel? She was my Hematologist/Oncologist. She failed to diagnosis and stop my platelets from dropping. The stress she caused, and I was so uneducated. She failed to diagnosis aplastic anemia and PNH. I was alone and afraid. That was in 2008. She also was only renting office space and part of the practice; she never disclosed. I was duped by Dr. Fishkin and Kachdourian.