Monday, September 05, 2016

How the ABMS MOC Program Threatens Major Medical Journal Integrity

They are two of the most prestigious academic journal's in the United States: the New England Journal of Medicine (NEJM) and the Journal of the American Medical Association (JAMA). Both have published extensively on the American Board of Medical Specialties' (ABMS) Maintenance of Certification (MOC) program. Both have clear rules requiring full disclosure of conflicts of interest: the NEJM has its Integrity Safeguards and JAMA, like the NEJM, follow the conflict of interest disclosure recommendations (pdf) of the International Committee of Medical Journal Editors.

But what happens when authors who are widely published in these journals fail to disclose financial relationships that are more than de minimus? Are articles retracted? Are authors sanctioned? Or are conflicts that also benefit the bottom line of one of these medical journals just ignored?

Take, for instance, this article that was recently published in the NEJM: "Maintenance of Certification 2.0 — Strong Start, Continued Evolution" written by Mira B. Irons, MD and Lois M. Nora, MD. The disclosures of the authors reveal that "Dr. Irons reports being employed by the American Board of Medical Specialties" and "Dr. Nora reports being an employee of the American Board of Medical Specialties, and being a coauthor on work describing the American Board of Medical Specialties Maintenance of Certification program." In another correspondence, Drs Norris and Nora, both of the ABMS, disclosed "Dr. Norris reports being on the board and Dr. Nora reports being the president and chief executive officer of the ABMS. No other potential conflict of interest relevant to this letter was reported." In JAMA in August 2015 entitled "American Board of Internal Medicine and Maintenance of Certification Standards," a similar disclosure only lists Dr. Nora's affiliation with the American Board of Medical Specialties.

What was never publicly disclosed by either of these major medical journals was the authors' significant financial relationship with the Georgia-registered Foreign Limited Liability Corporation, ABMS Solutions, LLC (Control number 11096304), whose office address exactly matches that of the American Board of Medical Specialties in Chicago, IL. Furthermore, Dr. Nora, as President and CEO of the ABMS, never mentions the congressional lobbying the ABMS conducted with members of the Congressional Energy and Commerce Committee to solidify their MOC program as a "quality" standard for "800,000 licensed US physicians," to assure virtually unlimited funding of their organization through the sale of primary source verification of physician certification status to third parties via ABMS Solutions, LLC.

It is no secret that the New England Journal of Medicine also earns money for the sale of educational products for the ABMS Maintenance of Certification program through their 'NEJM Knowledge+' educational product. This relationship makes the NEJM's response more economically difficult for them. But if the NEJM and JAMA fail to actively address the failure of ABMS authors to publicly disclose their multiple significant financial conflicts with the ABMS MOC program at the time they submitted their manuscripts,  they risk compromising their own integrity with the entire international medical community.


P.S.: I contacted the New England Journal of Medicine letter editor to make them aware of these conflicts. They are currently evaluating the situation.

11:05 CST 9/6/2016 - Link to the Georgia corporate registration fixed.

Addendum: For follow-up of the letters I sent to JAMA and New England of Journal Medicine regarding the perceived ABMS conflicts, click here.


Big Pharma and Ghost Writing said...

Unreported conflicts of interest presents a serious health safety problem in many studies. GlaxoSmithKline's ghostwriting using academics names for their own financial benefit is one example. GSK encouraged the use of Paxil in pediatric populations. Studies however proved their was potential harm.

POGO said...

"What does the Institute of Medicine say about ghostwriting?

In 2009, the Institute of Medicine (IOM) released a report on conflict of interest in medicine titled “Conflict of Interest in Medical Research, Education, and Practice.” The report called on academic centers to ban ghostwriting:

Such arrangements (which are essentially gifts) send the wrong message about the values of intellectual independence, professional ethics, accountability, and evidence-based medicine. In the context of research, they raise questions about the objectivity of research reports that other researchers as well as practitioners and developers of practice guidelines rely on.

What does the National Institutes of Health say about ghostwriting?

Dr. Francis Collins, the director of the National Institutes of Health (NIH), was asked about ghostwriting during an interview on C-SPAN. Dr. Collins said:

I was shocked by that revelation—that people would allow their names to be used on articles they did not write, that were written for them, particularly by companies that have something to gain by the way the data is presented….If we want to have the integrity of science preserved, that’s not the way to do it.

What do universities say about ghostwriting?

For his report on ghostwriting, Senator Grassley asked the top ten medical schools in the United States about their policies on ghostwriting. All reported that they do not allow or condone ghostwriting, calling it “unacceptable,” a “violation of university policy,” “inconsistent with principles of sound research and scholarship,” and “contrary to the values and principles of academic medicine.”

The University of Pennsylvania said they consider ghostwriting to be “plagiarism."

Conflicts at NEJM and JAMA said...

Program On Government Oversight - Financial conflicts are only one aspect of the corruption found here. What about the political conflicts of interest? The blurring of lines between private, corporate and government interests. A hundred thousand dollars in lobbying can be turned into billions in secure revenues for the ABMS as pointed out (or Medical Industrial Complex.)

"A [POGO] study reported in The New York Times found a ghostwriting rate of 7.9 percent in The Journal of the American Medical Association (JAMA), 7.6 percent in The Lancet, 7.6 percent in PLoS Medicine, 4.9 percent in The Annals of Internal Medicine, and 2 percent in Nature Medicine. The highest rate, at 10.9 percent, was in the New England Journal of Medicine."

The ABMS financial connections to JAMA/AMA are obvious. The NEJM, another ABMS financial partner, is one of the worst offenders in ghostwriting for interested parties at 10.9%. (as of the publication of this Program On Government Oversight POGO printing around 2010 - 2011.

Four of the institution's listed in the POGO article are Christine Cassel's own Mt Sinai, Robert Wood Johnson Foundation, NIH, and University of Pennsylvania. One of the Mt. Sinai authors mentioned involved in POGO's ghostwriting list is Dennis Charney, previously with the NIH (NIMH) and now, a dean with Icahn School of Medicine at Mt Sinai. This institution has been a broker for healthcare reform as well as active participation in domestic and global politics.

Mt Sinai, Dean Charney and CEO Davis, et al, at Aspen Ideas Festival 2014

Hillary Clinton at Aspen Ideas Festival 2014

Evidence-based decisions and foreign policy (near end at 47:00 min. in video, Mt. Sinai CEO Ken Davis asks about ACA HRC responds, Syria - empowering moderates and marginalizing radicals, abortion, contraception, blood transfusions, Supreme Court, Russian/American relations, etc.,)

Anonymous said...

More scandal for Clinton/Cassel cronies (questions arise)

Recently, Dennis Charney was "butt-shot" outside Hillary and Bill Clinton's favorite deli by a former Mt. Sinai researcher working for Charney's institution who was "fired for cause". The lawsuit involving alleged discrimination, wrongful termination, and defamation was a high profile case. The researcher's initial claim creating the conflict was the allegation that the researcher uncovered data manipulation. Civil case 2010-2012. Dismissed and dismissal upheld upon appeal.

Charney butt-shot outside Clinton's favorite local deli

An innocent male bystander was apparently also shot, but we only know his age, 56. Only one reporter asserts that the other man receiving minor injuries was "delivering cold cuts" at 7:00 am, but all other accounts are vague or leave room for interpretation. The researcher put his shotgun back in the trunk of his car and awaited the arrival of police in a Walgreen's parking lot across the street.

What has happened to medical and scientific research in America where we have more questions than answers about hidden conflicts of interest, and an increase in apparent acceptance of conflicts of interest. And what has happened that the resolution of personal/political/financial conflicts in America has found many individuals resorting to guns as a means of expressing those deep conflicts?

Has the rampant corruption turned many who feel voiceless or wronged by the endemic corruption falling under the weight of the political/financial power structures perhaps created an unprecedented mental health crisis in our country with violence as the inevitable outcome?

We need real scientific research that will find answers and solutions to real problems that plague us. Can we trust the AMA, ACP, and ABMS to be apolitical/non-pecuniary franchises exercising objectivity and doing what is in the common interest of citizens and physicians?

I think we all can see the apparent conflicts and overwhelming corruption that has left us in such a mess.

Anonymous said...

Where are the sanctions against these violators?

Anonymous said...

The conflicts reporting page should generate the important data. It is automatically generated and should have been looked at by the authors and corrected to include all financial conflicts and ranking relationship with the ABMS - not just employ. It is their responsibility to do so and it is also the NEJM's obligation to verify accuracy and inclusion with such a well known author as the CEO of the ABMS - Nora.

I consider this to be an act of fraud and others should also report it to the NEJM staff, ABMS ethics committee, American Board of Psychiatry and Neurology ethics committee, the American Board of Pediatrics and the American Board of Medical Genetics and Genomics ethics committees.

IGHPE Luxury Vacations. Sweet perks for executives of powerful organizations said...

Getting around the luxury condo issues for the ABIM/ABMS? Sweet vacation perks for Irons and Nora of the ABMS!

Revolving door financially enriched and politically connected crony network of players. (Hello Eric Holmboe of the ABIM/ACGME! Hello Humayun “Hank” Chaudhry of the FSMB!

You would have thought being on the editorial board for "Innovations in Global Health Professions Education" would have better prepared Dr. Nora (and Irons) to put the conflicts of interest data down in full. But maybe it is just for the perks.

Mira Irons and Lois Nora have many nice financial perks coming from their ABMS affiliations. The IGHPE is just one. Maybe they should make this more publicly known as it seems luxury vacations are coming more and more under scrutiny. Whence came the money for the international vacations and how much?

What another scam to enrich their personal lives and gain more political power.
How much do they get paid for being in such a privileged political and financial position? I see Eric Holmboe formerly with the ABIM is taking advantage of international luxury tours and perks also. One wonders if these are not just bribes for "in-line performance"?

Nora is on the editorial board for Innovations in Global Health Professions Education.

Mira had a nice vacation in Venice in 2016? Any idea who paid for the trip to Italy and for Dr. Irons to have her "room with a view?"

The Price of ABMS Globalism and Universal MOC said...

"Research & Innovations for Healthcare Professions 2016" - a corporate scam

From interstate FSMB racketeering to the globalization of MOC and crony digital data and healthcare delivery systems - lucrative networking opportunities all conducted out of the site of anti-MOC, anti-corruption activists in the US.

Come share the work with us on a nice private "island" across from San Marco's square.

- I wonder how many attendees shared rooms to keep those costs down. 317 euros (no view) to 7900 euros per room. Nice bar and pool on top of the building.

From the yummy brochure -
"Welcome to the second annual conference hosted by Innovations in Global
Health Professions Education (IGHPE). The conference focuses on research
and innovations that advance performance of the health professions, and
is part of our ongoing aim to build an active health profession community
inspired to lead transformative initiatives.
This event is designed to stimulate discussion with three themes:
• The Vision for Our Healthcare Professions
• Healthcare Without Borders
• Preparing for Digital Healthcare
Attendees of this conference are leaders and stakeholders in health professions education, including educators, administrators, deans, program directors, and others from Europe and around the world who are prepared to share their vision and expertise in transforming the health professions learning experience.
All are invited to discuss new paradigms, practices and digital solutions that are innovating and pushing traditional pedagogical approaches. Our aims for this forum are to frame a vision and stimulate creative thinking and collaborations that address the demand for effective, integrated, 21st century health professions education.
We hope this conference at the historic Hilton Molino Stucky, nestled on the banks of picturesque Giudecca Island in Venice, Italy, will be an opportunity to explore new ideas, make new friends and colleagues, and improve the care of patients.

We are grateful for the support of our strategic stakeholder, the Association of Medical
Schools in Europe (AMSE), which shares our common interest in stimulating discussions
and collaborations that advance the fields of education and research in the healthcare
professional community. We would like to thank Professor Peter Dieter,
President of AMSE and the AMSE membership for taking part in this program."

Lisa said...

To Anonymous Big Pharma and Ghost Writing who wrote "GSK encouraged the use of Paxil in pediatric populations. Studies however proved their was potential harm"


How many times has that one particular drug reinvented itself? I cannot recall any other drug that has shown up in medical literature more often with a wonderful new use that doesn't really seem to have any basis, except a creative PR person coming up with that. One day, we should should just go back and make a list--if someone hasn't already. The last time I saw it again NEJM discussed its merits for women's hot flashes. I would like to meet this woman who was relieved of hot flashes from this off-label use of Paxil--not saying it didn't happen. But if it ever goes OTC it will have to be labeled as magic snake oil tablets that cure anything that has ever happened to anyone ever (then of course the Arial 3 Pt Font disclaimer)

I'm not trying to malign this pharmaceutical but it makes me suspicious that it always shows up again as a cure for some new thing, but I have never met even one person who said, that's the drug that really turned my life around. Not once.

I find it amusing every time there's a blog about "medicine" and "integrity" because, you know. @cardiobrief did a great piece on eminence-based medicine, and actually wrote about the elephant that has always been on the coffee table in the middle of the room. Maybe he's considered the crazy uncle his family hides in the basement, but name me one person that wouldn't want to have a beer with him. See, you can't.

Anyway, I wondered if there would be a blog posting about @doctorwes' & @ejsmd's adventures/ trouble. It must have been too wild to put in writing or ever speak of. Good for you, if men get together for some fun and it's tame enough where you could tell what happened, it wasn't wild enough good clean fun & male bonding. If you could tell the ladies what you did without us at least cringing then you did it wrong.

Anonymous said...

Your blog is gaining more national attention.

Bizarre this post was classified as "spam" by Google. Glitch with Feedburner? Trying again …

Lisa said...

Congratulations on "spam" status, Wes!

Normally it has to be from the Trump campaign, trying to put American interests first & take care of our own before foreigners, to get marked "spam"

Be proud of yourself

Anonymous said...

More arrogant hiprocrisy from the ABIM/ABMS - those who think they should and must define what Proffesionalism is for the rest of us. They are pathetic, ridiculous, and have lost ALL credibility. Soon, if not already, the rest of their cronies AMA, ACP, JAMA, NEJM will be irretrievably covered with the same creeping stink.

Anonymous said...

I read the outdated claptrap that Nora and Irons presented to the NEJM. It is all plagiarism; even the title with the phrase "MOC 2.0" was plagiarized from anti MOC bloggers on your website, Wes.

The second point is these two prominent ABMS executives should have known better. They should have requested to put their plagiaristic propaganda on the NEJM opinion pages. It is not science and never was.

As for ABMS 2.0, ABIM 2.0, and all the other racketeering money machines of the ABMS it is all a corruption of the original contract with physicians. That contract has been violated. These organizations and the executives leading them are all c*****ate p*******tes!

Anonymous said...

Wes you got us going!! Your articles are a true reflection of today's realities that are not in the best interest of physicians. Just read the blog of Dr Salas Rushford...a must read and a must donate..
Enough is enough!

Where is the Deposition of ABIM Dir. of Investigations, Ariel Benjamin Mannes? said...

The deposition has been completely transcribed; when do the public and parties injured by ABIM and Mannes get to see it? There should be nothing privileged about this deposition.

Katharine S. Hayden, presiding
Cathy L. Waldor, referral
Date filed: 10/17/2014
Date of last filing: 09/06/2016


101 Filed & Entered: 06/06/2016
Docket Text Order
102 Filed & Entered: 06/16/2016
Docket Text Transcript
103 Filed: 06/16/2016
Entered: 06/17/2016
Docket Text Order on Motion to Dismiss
104 Filed & Entered: 06/21/2016
Docket Text Motion for Leave to Appear
Filed & Entered: 06/22/2016
Docket Text Set/Reset Motion and R&R Deadlines/Hearings
105 Filed & Entered: 06/30/2016
Docket Text Letter
106 Filed & Entered: 07/05/2016
Docket Text Order
107 Filed & Entered: 08/01/2016
Docket Text Brief in Opposition to Motion
108 Filed & Entered: 08/02/2016
Docket Text Response in Opposition to Motion
109 Filed & Entered: 08/02/2016
Docket Text Motion for Leave to File
Filed & Entered: 08/04/2016
Docket Text Set/Reset Motion and R&R Deadlines/Hearings
110 Filed & Entered: 08/08/2016
Docket Text Reply Brief to Opposition to Motion
111 Filed & Entered: 08/18/2016
Docket Text Statement
Filed & Entered: 08/19/2016
Docket Text QC - Document filed contrary to the Local Rules
112 Filed & Entered: 08/25/2016
Docket Text Memorandum in Opposition of Motion
113 Filed & Entered: 09/01/2016
Docket Text Motion for Entry of Default
114 Filed & Entered: 09/01/2016
Docket Text Reply Brief to Opposition to Motion
Filed & Entered: 09/02/2016
Docket Text Set/Reset Motion and R&R Deadlines/Hearings
115 Filed & Entered: 09/06/2016
Docket Text Letter
116 Filed & Entered: 09/06/2016
Docket Text Letter

Censured for Bullying Problems said...

The Ballard Spahr attorney Rivera-Soto may have problems with fits of insanity. He may have gone mad altogether. It may be connected to a serious medical condition, I have no way of judging, but the transcripts you posted, Wes, are telling. It is a good thing that he was censured/sanctioned (rare) as a NJ Supreme Court Judge for the bullying and intimidation of a teenager -- violating the young man's civil liberties and right to be happy. Judge Rivera Soto would not leave well enough alone a treated a teenage boy so badly that it affected his life for years. What a mess this former Supreme Court judge made of his life. They let him stay on the court, (censured) but he got in trouble again later -- once over releasing personal records (naming an individual that was off limits) and later for being politically obstinate stubborn and uppity with the other Supreme Court judges to the point of non-participation. It was so bad the legislature/judges pushed him out. If he did not resign, he was going to have been impeached, which is even rarer. What is the game here? He is a Republican and Jacobs/ABIM Democrats -- all of them. Can anyone clue me in on this strange fitful bully and is he not sick?

ABIM Insults Jaime Salas AGAIN said...

After reading the debacle unfolding with Jaime Salas being harassed by ABIM counsel, I vote it is time we try to raise more funds for him. Can you please Twitter this out on your account?

Defund the ABIM.
Fund Jaime Salas. Let's punch the ABIM in the nose again.

Anonymous said...

IGMHE and IGHPE. What are they and who funds them.
What is ABMS International doing? Seeking donations and higher roi from global operations and corporate sponsorship?

ABMS, ACGME and the dissemination of Hillary Care/Obama Care
Transplanting US Healthcare Accreditation Standards and Affordable Universal Healthcare to Qatar.
ACGME and ABMS Medical Boards to Qatar

Democratization of global medicine through IT expenditure and training("innovations")

Funded by the Qatar Foundation

Anonymous said...

I just sent some money to Dr. Salas Rushford. I encourage others to do so as well.
The ABIM needs to be exposed. A corpus of legal facts is being produced that will help others fight the ABIM. Defund the ABIM and sue them for damages. Many physicians have been damaged. They are an abusive felonious organization.
Donate to "Jimmy R"

The Poisoned Chalice said...

ABMS: The Concentrated Power of Evil Minds with Money (Politics of Greed and Financial Means of Maintaining Political Control)

How much influence do the US Medical Industrial Complex and US professional medical politicians have in global healthcare? How about the ABMS? Who are they really? What is their end game? Who do they actually serve?

In Singapore we see that the British health education system was recently ousted and replaced with the US ACGME/ABMS model moving in. Eric Holmboe ABIM/ACGME and others representing the ABMS, including Drs. Irons and Nora, have been travelling abroad to many areas of the world soliciting the expertise and services of the ABMS to many countries. But it all comes at a price. And the local buyer does not necessarily have the best interests of physicians or patients in mind, especially when we see political position and money being offered in exchange -- personal enrichment taking precedent over what serves the common good of one's country and all humanity.

Now we hear of Qatar funding their country to adopt ACGME/ABMS. Who has arranged this with the government? We find that a big part of this transitioning to ACGME/ABMS involved innovation in IT to "transform the healthcare system". Are we talking about better healthcare on behalf of the ABMS or just corporate sponsorship - a privatization of healthcare to corporate bodies and large vendors like EPIC and Cerner. Everyone knows the certifications are looking along with the MOC more and more like financial/political scams to politically control the vast numbers of physicians in the US -- and it is done at physicians' own expense, ironically.
Physicians pay for the rope with which they are tethered and must accept the tethering, because of insurers and health institutions demand that they are tethered to the scam.

Let's look at what is happening in the US's top business/political partner and military ally regarding their healthcare system -- the UK's National Health Service. One big important question has emerged in the transformative BREXIT vote -- that is the decision to leave the EU. Has anyone in the media in the US discussed it and its importance to physicians in the UK and US? Not that I have seen. What's really happening there?

We have had a brand new Prime minister in the UK. David Cameron (dishonorable mention in the Panama papers) is out and Theresa May is in with the usual complete makeover of the cabinet. Theresa May threw everyone out.

But wait a minute, did she? No, not at the Secretary of Health post, apparently. She retained the "disliked by physicians" and highly controversial man with ties to Rupert Murdoch and corporate conflicts of interest 'up the whazoo'. Cameron did not investigate as he should have over asset sales and cozy Murdoch connection - with 799 text messages to provide the fodder to get started.

May retained, to the UK voter's chagrin, Mr. Jeremy Hunt, as the Secretary of Health in charge of the NHS. That is a devastating blow to the integrity of the May cabinet and everyone knows it in the UK.

part 2 Retaining Hunt means retaining Bob Wachter as NHS digital expert said...

Robert Wachter and the NHS as digital expert appointee (per the corrupt Jeremy Hunt)

Remember Robert Wachter was appointed by Hunt/NHS to guide the National Health Service in the UK explore how to approach digital technology in healthcare. This is a huge cost to the UK taxpayers and the NHS has squandered a great deal of money on aborted attempts at utilizing EHR such as occurred at several major hospital systems where they installed EPIC but it went badly and had fiascoes with budgets.

So now in comes Bob Wachter (appointed NHS fall-winter 2015-2016) who wrote one silly book on 'digital doctoring'. It is a series of interviews. He is not the expert, just regurgitating and speculating in the usual Wachterian manner with 'on the one hand' and 'on the other hand' over until you have to close the book in disgust. We know he is just selling like usual and not really "critically thinking". It is just his technique. A sick technique that we all see through, especially as seen in his defense/salesmanship of the ABIM, and in his admission of being in league with NQF's Chuck Denham (but not really).

And we have Wachter introducing the President CEO of IPC, the Hospitalist Company as the man he always despised but now loves because he was giving millions of dollars to Wachter's institution and lining Wachter's pockets with hundreds of thousands in compensation steer attention away from the Medicare fraud and whistleblower lawsuit. Bob is a classic silver tongue for the ABMS mob and his political platform. That is why IPC paid him. They paid for his silver tongue and HHS/DOJ connections. The US/EU/UK should have investigated Bob Wachter and Jeremy Hunt imo. They are a bad news duo. (And who they represent)

The typical Bob Wachter style of salesmanship is that of first saying critical things to get you to see how objective he is. But the real purpose and outcome is clear. Digital technology and the companies that Wachter and Hunt are representing are going to prosper under their "advisory". Wachter is clearly nothing more than a broker for corporations and thus it shows us a lot about the ABMS in general, which Wachter represented for a decade on boards and as trustee. The ABMS execs are literally corporate proxies and scam artists making a killing off physician's fees.

I think an investigation should be conducted to see actually how Wachter (a fake expert) was chosen out of collection of real experts. What kind of political cronyism/corporate power brokering was in play here?

Bob Wachter, went to UK last year with "great success" he tell us along with the media. He led a delegations of AMA/ABMS/Venture Capital groups from his hometown SanFran/Technology Representatives, etc. But Bob Wachter appears to be acting more like a seasoned smooth-talking entrepreneur and venture capitalist rather than a real technology expert. And that is the point. That is why it needs investigating, along with Wachter's obvious conflicts of interest, cover-up and participation in ABIM's wrongdoing, but especially the ICP DOJ lawsuit against Wachter's company for Medicare fraud.

more said...

Welcome to the UK politics under the thumb, not of the EU, but of US special interests!

Mr. conflicts of interests, Jeremy Hunt, who many say should have been investigated for shady practices in his last government post as Culture Secretary stays on as Health Secretary after a great deal of controversy.

And Dr. Bob Wachter the "digital conflicts of interest guy" and "IPC, the Hospitalist cover up man" comes to the UK on behalf of corporate/special interests once more at Innovations 2016 NHS. And no one is investigating the egregious conflicts and wrongdoing of both men - Hunt and Wachter.

So much for the physicians and patient populations "Brexiting" from special interests and the US Wall Street/corporate agenda. No one is covering the real healthcare facts and chaos on the ground. Not a chance of it.

The media is not doing its job to investigate and tell us who is really holding the "poisoned chalice" of healthcare in their hands and what it means for everyone's care. Who is reporting on how Wall Street @CMS, Digital Bob, Jeremy Hunt as Secretary of Health, "ABMS global innovations", "IGHPE Healthcare without borders" the AMA, ACP, ACGME, Robert Wood Johnson Foundation, countless Open Society Foundations and subsidiaries of George Soros influences politics and finance, and on and on and how it all impacts the ability for physicians to treat their patients.

Who has time to "keep up" with MOC, treating physicians, and to keep up with all the politics and money tossed around out there. No physicians can do it. But it is clear as a crystal glass that the ABMS is up to no good with its evil global crusades.

There seems to be a big blur in physicians' minds whether they are a quality assurance organization, a branch of the state department, global bank account with ties to corporate special interests, or just a powerful lobbyist organizations with offices, institutions and connections infringing on all parts of the planet.

Plus no one is investigating the repeated aggravated attacks on healthcare in the US on all levels of society -- even in the government chambers and secret backchannels infiltrated by these NGO's like the ABMS with their ambitious plans to take over practicing clinical and academic physicians all over the world. This is not a joke or a damn conspiracy theory. It is a fact.

Interventionism in Healthcare as Warfare said...

Choosing Wisely: the moral obligation to end it

Physicians in America are not doing the UK, Singapore, Qatar, Japan, and the EU any favors by continuing to support the ABMS monopoly and heavily subsidized plans to innovate their way into a hegemonic global empire.

Choosing Wisely is also going along for the ride with all of its unintended consequences. That is a horror that no one can totally and wholly fathom with the mind and heart.

The ABMS and so many in its web of power have way too much political power and money. We must DrExit from these evil organizations and defund them, or they will devour us. Power begets power. They are getting stronger not weaker with the power of the purse and those who contribute. The real money flow and the numbers remain hidden: the brokering of donor and recipient is often a clandestine opaque affair.

If you control medicine in a country you have a foothold toward strong political and financial control. You have an oligarchical model of government often as a result of by default.

Sweeping anti-MOC legislation that protects US physicians and patients from these corrupt institutions is strongly advised. We cannot wait. We need it now. MOC is like an illicit drug through which these cartels fund themselves and their expansionist agendas.

Yet we can't stop there. Further action is necessary at the level of the DOJ. We are looking at "medical politicians" who have transformed "non-profit" "charitable" organizations into cleptocratic "political greenhouses" and presently they have little to do with quality assurance.

How do we know what to legislate in order to curb these organizations, and how to protect ourselves when we don't know the full scope and range of their power, finances, and from where all their the money flows -- or what other political and felonious pieces they may hold.

It is not a person, an organization or even just the ABMS that wields the control. It is a huge network and a giant web of many various cartels stringing their rackets together controlled by a powerful corporate elite. And that elite is buying up or merging with the standing few pieces on the board.

Dante said...

Degeneration: the result of corrupt policy and evil mandate

The ABMS, ACGME, AMA, and ACP have degenerated into little more than a collection of powerful political fanatics who are dangerous to the healthcare delivery system in the US. They are financially motivated organizations with morally questionable people working for them at all levels. They hide many of their people from us by not including them on their 990 tax forms, such as ABIM's goon squad director and convicted double felon, A. Benjamin Mannes.

We discovered many of these "wannabees of the medical elite" by surprise in online searches. No person can judge another, but we do have moral perceptions and candid impressions that are undeniable to us and we have right to express that moral perception. It is not judgment, because it is a perception that is not without compassion for the world. We should not cease ever in our search for what is true and moral according to the reason and conscience we are born with and hopefully enlighten and awaken through development.

But the pureness of perception is interrupted sometimes when there is a sense of traitorous rub. Many of these executives/employees of these organizations under scrutiny we find are morally bankrupt people. And yet they (or others) present themselves as moral giants. It is a psychological thread of mystery that we may never unravel as to what buffers to reality are in play. These executives (they are all executives)are often seen by the common man and woman as pseudo-physician actors speaking to private cameras making propaganda videos.

It is what it is. But it does often hit a nerve. Are these former medical colleagues really worth all that big money that they might be putting in offshore hedge fund accounts or investment properties?

Any astute onlooker can easily 'see through' these professional medical bureaucrats and recognize that they have sold-out for the personal enrichment packages offered to them. And many of them have succumbed to the feigned fleeting images of their own political importance and few passing moments that some out their online might be recognizing their ideologically induced mental prowess.

Didn't someone on this blog or somewhere in the dusty arena of pain and quantitative experience profess to us, that beyond all the lies and illusions presented in life, only love bares the true measure of anything.