Tuesday, April 19, 2016

NEJM Fails to Publish Comments Critical of ACCME Perspective Piece

Screen Shot was taken 4/19/2016 of NEJM web page showing undeclared conflict of interest
(Click to enlarge)
I find it interesting that my comment to the New England of Journal of Medicine pointing out the undisclosed conflict of interest highlighted above and mentioned two days ago on this blog has yet to be published in the comments section appended to the article. Authors must disclose their financial conflicts. Why don't the editors of the New England Journal of Medicine?

It appears the cronyism displayed by the ACGME in support of the American Board of Medical Specialties Maintenance of Certification (MOC) product also extends to our "finest" medical publications.

Caveat emptor.


Addendum 07:50AM CST: 9 Comments (including mine) now appear on the NEJM website.


Tick Tock said...

Let's cut to the chase.

This entire industry of "CME" or "MOC" or whatever abbreviation used to generate massive amounts of money off of hard working physicians is on really shaky legal ground. If the ABIM or any organization decides to make their process a de facto obstruction of a physician's ability work, they will be legally liable. Period.

Once a physician passes the initial certification, there is absolutely no universal definition of what it takes to remain as a legitimate, certified or fit or capable physician. That's why the declaration of a certified physician as now "uncertified" is a very difficult process usually left up to Medical Exec Committees and State Medical Examiners. There are many parties involved and lots of vetting by Chiefs of services, trial attorneys and State Attorney Generals.

It's a really big deal when a physician is defrocked.

There is no UNIVERSAL definition. None whatsoever. And the ABIM is deluding itself when it thinks that it is the common denominator in this profession's certification calculus.

Why do you think the ABIM was sneaking around Washington DC with hired lobbyists and political mercenaries trying to get the ACA to declare the ABIM as the sole arbiter for CMS qualified physicians? Think of the power they were trying to work into the Federal Code.

In fact each State has its own version of what it takes to be a physician in good standing. Each Federal agency has its own definition. Each hospital has its own criteria. There is no statute that declares the ABIM and especially the ABIM MOC or the ABIMF as the sole arbiters of what it takes to be a doctor in good standing enough to go take care of patients.

If the ABIM declares a physician as unable to continue as a physician via ABIM MOC, and if the ABIM is wrong, then the ABIM is liable for loss of income and restraint of trade and the destruction of a career. That's why they are playing the word game.

Look at their semantics- "Not participating in MOC". Imagine if they came right out and declared that a physician was "unprepared" or "unable" or "unfit" or "un-certified". And what if they were wrong?

Let's say, of the 200,000 Diplomates, Rich Baron declares or categorizes 10% of the population as not ABIM worthy. And let's say this declaration materially reduces these physicians' ability to hold a job and perform their duties. And let's say, the ABIM's MOC process was wrong 80% of the time. Think of the thousands of lawsuits. Think about the ABIM legal exposure. More so since, the scientific literature published how wasteful and irrelevant ABIM MOC is to declaring a hard working physician as "certified".

Does anyone actually think, the ABIM business insurance policy is strong enough to withstand thousands of lawsuits in all 50 States?

No one trusts the ABIM anymore and there are scientific data now published that the ABIM MOC process is an utter failure. Wachter, Cassel, Baron et al, have flown this plane into the ground.

It is only a matter of time before this will become a fight to the death in courtrooms across all 50 States. That fight will spell disaster for the ABIM MOC and an end to this ugly chapter in its history.

Anonymous said...


Paul said...

I'm really tired of this rampant corruption in the medical quality/testing bureaucracy. It is a sorry fact that the publishers have little to no integrity left. They have gone the way of the main stream media. Propaganda, sensationalism and commercials.

All science is lost when egregiously conflicted fools rule.

Anonymous said...

Well said by Tick Tock above! ABMS MOC has just run out of time and money.

Hickory, dickory, doc.
The louse ran up the clock.
The clock struck one,
The louse ran down,
Hickory, dickory, doc.

It's time to lawyer up against MOC and the ABMS.

James O'Brien, M.D. said...

He asked the question "what do I need to learn", I as in individual his answer was a "we" collective. Typical central planning talk smoothed over with beauty contestant platitudes.

He has no f***ing idea what I need to learn so he should shut the hell up.

However, I know what he needs to learn in life. He needs to learn humility.

See my comment if they print it.

the truth said...

We'd all be better off
if the world were free
of the American Board of Medical Scams.

Anonymous said...

Forget the article. Just read the comments.

Not meeting ACGME Standards said...

How could anyone trust the ACGME board and staff members? Or its committees and member selection process? Just look at them and their policies.

ACGME Committees and Members Selection Process

Thomas Nasca, ACGME CEO (ACGME doesn't really want to disclose his salary publicly.)

Eric Holmboe, ACGME (Castle/Langdon/Baron crony. Instrumental in persecution of physicians in 2008 and onward. Overreach in ABIM v. ABR. Did not know the meaning of staying within job description.)

Freedom From MOC ACT 2016 passed by all 50 states and territories said...

There are dramatic warning signs that the ABMS and ACGME are about to have massive heart attacks. Yet they just sit there heavy in their seats and pretend everything is alright. How can these executives and officers in charge even call themselves doctors and good bureaucrats when they cannot see themselves accurately--as they really are--and diagnose correctly.

The ABMS/ACGME arteries have been corrupted--clotted with greed, propaganda, and unhealthy lifestyles for decades.

State legislatures need to take emergency action and pass legislation similar or better than the Oklahoma "Freedom from MOC" ACT. State governments need to do this 'bypass surgery' before the coming doom or it will be too late to save medicine. The consequences will be staggering. Everything will fall like dominoes.

'Freedom from MOC' Act now!

In todays era of instant messaging and digital replication, it should not take more than a few days or weeks to mount a campaign to end the MOC MANDATE forever.
The simple wording of the legislation is waiting as a model for all the states to pass.

2016 can be the year of freedom and patients will get more of what they need--time and less burned-out physicians. Better informed and educated physicians with focused, relevant CME.
Make it so. Make it a real campaign. Get the legislators and presidential candidates to all commit.


James O'Brien, M.D. said...

Today NEJM finally published my comment. The essence was I do know what I need to learn, but central planners cannot possibly know.

Anonymous said...

Hats off to you, James OBrien! An excellent comment to that NEJM tripe.


It's all so clear now. MOC was an inside job--a conspiracy!


Good news from the 'End of MOC Street'. News about MOC, Chris Cassel, Bob Wachter Rich Baron and more...

Christine Cassel, past NQF CEO and former CEO/President of the ABIM and ABIM Foundation, is no longer supporting Maintenance of Certification (MOC). Confer ABIM's website. She is still a grandfathered certificate holder, but listed as no longer participating in MOC.

Now free of MOC, MS Cassel is moving on from the NQF to pursue other more lucrative positions while participating in the formation of the new Kaiser Permanente National School of Medicine. Christine is looking forward to an ABMS MOC-free future where the American entrepreneurial spirit and new medical schools will innovate to create newer more relevant and viable forms of CME for physicians.

Unconfirmed reports from California reveal that Chris Cassel and Bob Wachter have purchased a house together in San Francisco on Love Street--with multiple greenhouses--where they anticipate a rich future growing medical supplies (C-25, in patch, oral, injectable and inhaled forms) for the Kaiser Permanente Pharmacies of California, Oregon, and Washington.

John A. Benson, MD will be acting as President/co-founder and as Chief Medical Officer of the pharmacological properties and quality assessment division. Dr. Benson, as you may know, was first president of the ABIM, who, like Cassel, has also gone AWOL from the ABIM MOC program. Dr. Benson is listed as "not participating in MOC."

Bob Wachter, who once found MOC "useful and even fun," now prefers to be motivated not by "the panel" or "the stick" to learn and educate himself, but by his budding new product line called "Pure Love."

Also reported--from Philly--were the strong wishes of Rich Baron to join them on the west coast as soon as he can procure enough deferred compensation from the ABIM and ABIM Foundation bank accounts. The CFO is finding it harder to get away with financial manipulations, because of all the scrutiny form this site. Baron in a private conversation recently confided to his 'secret police' director that "MOC just ain't worth it anymore; it just is not worth all the grief."

"I just can't take another dreary winter here in Philly without the 'old guard' to help find new ways to dish out fun for all."

We wish all these talented business partners luck in their future endeavors.





Anonymous said...

MOC is only truly voluntary for elites like Christine Cassel who never practiced medicine and never depended on any income derived from it.

After residency, Dr. Cassel always depended on hard-working physicians' income, i.e., the MOC tax, foundation stipends, medical society dues, NIH grants, lucrative board positions, federal and state tax money, RWJF cronyism, etc.

Invariably clinical physicians participate in MOC because they do not have a choice. Or they never had inclination to sell out like Baron, Cassel, and Wachter.

Anonymous said...

ProPublica Study: How the Securities and Exchange Commission works. Link below.

ABIM Conflicts of Interest. Compare how the SEC may have overlooked "egregious offenders" like Christine K Cassel and Robert M Wachter, because of their positions in politics and government job connections.

Chris Cassel had conflicts of interest while working for the ABIM and ABIMF.
She had conflicts getting paid to 'serve' on the boards of Premiere, while the ABIM made huge purchases of a Premiere buyout candidate's products and services. Kaiser benefited from Cassels corporate and government connections.

Wachter served on IPC, the Hospitalist Company's board of directors as quality chairman and received six figure salary, stock and a monthly payment for training IPC leaders on how to "comply with quality." Wachter's university received large infusions of cash from IPC for the appearance of leadership training, which was little more than whitewash for IPC's transgressions against Medicare and vulnerable patient populations. Investors sued, patients sued. The SEC approved of the sale of IPC to Team Health in record time.

Anonymous said...

Dr. Salas Rushford's case involving the ABIM reveals how corrupt and evil this big ABMS bully on the block really is.

Anonymous said...

Thanks in part to the ABMS, ABIM and their cronies it is becoming more difficult if not impossible to have a physician for your primary care provider. Specialists are having to take care of primary care related issues as a result of the dwindling numbers of thorough/well trained physicians. In rural areas of our country NP's are even running local specialty clinics seeing patients independently without a qualified specialist physician. The breakdown of medicine is here now. Patients are being underserved and not getting the quality of care they deserve.
Why does the ABMS even push the MOC crap when there are not even certified doctors to care for patients' medical conditions. This is the twilight zone where patients are going round and round seeing NP's instead of primary doctors and qualified specialists.

Anonymous said...

Rich Baron, "MD" and the rest of his bobble-head bureaucrat crowd refuse to work for a living. There never was a bigger bunch of losers, liars and boot-lickers.

If these ABMS executives did not have powerful political friends and key corporate elites to do favors for, Rich and his corrupt cronies would have been begging on the street or in jail long ago.

What BS and propaganda the ABMS and ABIM put out online with the hope of keeping the FEDS from investigating this corrupt network of public fraudsters - indicting them for their profiteering and revolving door scams.

Anonymous said...

So what, you refused to publish my comments..