Friday, April 14, 2017

Dear Legislator

Physicians, consider providing the following letter (or a modified version) to every state legislator considering anti-MOC legislation.

Dear Legislator -

Across the country, bills are appearing in state House and Senate chambers regarding a trademarked  educational product owned by the American Board of Medical Specialties (ABMS) called Maintenance of Certification (MOC). No doubt a team of gray-suits representing the insurance companies and hospital systems in your area (aka, lobbyists) will be knocking on your door explaining why this program is so important to assuring the public that their physicians are of the highest quality and competency. They will insist that this proprietary physician continuing educational program is the only integrated system of physician education that assures quality educational content for doctors while also providing a multitude of practice improvement modules to assure the highest quality of care for patients.

Please don't be fooled. As your life-time certified ABMS Board certified doctor, I have seen the implementation of "continuous" MOC in 1990 and watched it grow into a cottage industry costing physicians nearly $1 billion and 32.7 million hours away from patients annually (over $23,000 per doctor every 10 years) without proven benefit to patient care. ABMS MOC product replicates Continuous Medical Education we already are required to do to maintain our license in each state and does not permit physicians the freedom to chose the education they need for their practice, but rather forces them to comply with an unnecessary, expensive, and repetitive mandated computer-testing exercise. Imagine having to retake your high school trigonometry final examination to continue to practice your trade today. This is the equivalent to what physicians must now endure every 10 years.

The ABMS MOC program grew from a financial need of the ABMS and their 24 member boards, especially the American Board of Internal Medicine (ABIM) which "certifies" one quarter of all US physicians. The  ABIM is currently $50.6 million dollars in debt (according to its most recently-available 2015 public tax returns) while their executives earn three- or four-times the salaries of the average working physician, enjoy complementary spousal air travel, and purchase luxury condominiums complete with chauffeur-driven town cars for themselves - all at working physicians' expense. They then sell our testing information for profit to ABMS Solutions, a for-profit corporation based in Georgia.

The ABMS and their lobbyists say that a computerized test or a continuous question-and-answer barrage fed to our cell phones or laptop computers is superior to direct patient care experience for maintaining our competency to practice. I would hope you can see through their propaganda.

Finally, the ABIM and the ABMS have been involved with highly irregular financial dealings, including falsifying tax forms and transferring many our our testing fees to the ABIM Foundation in the Cayman Islands. They also perform "research" on physicians and their practices without informed consent or Institutional Review Board oversight - potentially in violation of federal law.

For these reasons I would ask that you strongly reject the importance and value of the ABMS MOC program to practicing US physicians. We have carefully researched the financial and political dealings of this conglomerate of independent non-profit agencies that are pushing for MOC and would ask to have them investigated by the appropriate authorities, including the Federal Trade Commission and Internal Revenue Service before siding with their lobbyists' demands.

Such an action would be in the best interest of our patients and US healthcare, not the endless ABMS MOC testing of physicians who struggle to serve as patient advocates in our increasingly regulatory healthcare environment.

Your caring physician -


cuenca said...

beautiful! big issue up for voting and big lobbying with fights in FL--will forward--thank you!!!

Bethany said...

Mandated MOC is a nefarious 'pay-to-play' all the way.

Anonymous said...

ABMS MOC is the rich baron's 'pot of gold' that keeps on going -- just to enrich profligate executives who serve powerful special interests.

Ironically, the ABMS "MOC pot of gold" keeps on going because physicians are forced by the ABMS cartel to keep putting their hard-earned cash into it.

Patel said...

ABMS MOC is a cunning Ponzi scheme with nothing but misery for physicians and patients in the ABMS pyramid scheme.

Anonymous said...

There's nothing voluntary about MOC at all. It is violatory harming patients and physicians.

ABMS MOC is based on coercion. "Pay up or you won't work. Pay up or you won't get paid."

Physicians and patients need legislative relief. They need to be free of mandatory MOC.

E E Hunt said...

Can anyone explain to me why Pearson Vue has no record of Dr. Richard James Baron's 2008 geriatric medicine re-certification test? There are five testing centers in Philadelphia or within a short distance. Did Dr. Baron really take this required test to remain certified? The cutoff date for geriatric medicine is 1988 and after. It is mandatory for him to remain certified initial certification 1988. We all know the onerous testing experience and police state drill. Was Baron cheating?
Baron was occupied at the time 2007-2008 working with Ballard Spahr chasing down competitive board prep companies, engaged in political projects, NCQA (gearing up for NQF), Commonwealth Fund, ABIM board as chair/treasurer, clinical work and administrative clinical work, promoting ACO models, seamless care, and other political work related with his employment with CMS.

It is not restricted information to verify if a physician took a test at a Pearson Vue testing center. It is part of the process of verifying certification integrity and MOC participation. I spoke with an agent in New Delhi, India. Pearson Vue had my testing center information from many years ago (more than one specialty) and emailed the testing center information record to me. ABIM ID, phone number, email.

There is no Pearson Vue record of Christine Karen Cassel taking her 2008 re-certification test in geriatric medicine either. Initial certification 1998.

Anonymous said...

Fake MOC Fraudulent Executives - this says it all!

Anonymous said...

Testing irregularities and improbabilities at the ABIM? Do ABIM execs and officers really take the test? And here is a strange case: how and why would a grandfathered physician re-certify in three ABIM specialties in the same month? Is it even possible to schedule for three lengthy specialty exams in one month? Twice already in his carreer: the first time 11/1997 and then again on 5/2007? 2017 is here and will the physician take the 10-year test. Is the Philadelphia physcian registered already and where?

Does this strange anomaly in testing have anything to do with the fact that the physician's spouse Dr. Lorna Lynn is a long time executive working for the ABIM? The timeline is interesting. Lynn started out as Medical Secretary of Testing in 1995. Lorna took her exam in internal medicine in 1999. Harold I Palevsky, her husband took his three specialty certification tests during 11/1997.
Both physicians were apparently grandfathered. So, I am inquiring as towhat kind of test cheating goes on at the ABIM? And if they do take a test where and what resources have been made available to them. How can a secretary of testing who has access to questions even take the test legitimately. What about her husband?

Harold I. Palevsky, MD
Professor of Medicine at the Hospital of the University of Pennsylvania
Attending Physician, Pulmonary and Critical Care Division, Department of Medicine, Hospital of the University of Pennsylvania
Attending Physician, Pulmonary and Critical Care Medicine, Department of Medicine , Penn Presbyterian Medical Center
Chief, Pulmonary, Allergy, and Critical Care Division, Department of Medicine , Penn Presbyterian Medical Center
Director, Pulmonary Vascular Disease Program, Penn Presbyterian Medical Center
Bach Fund Grant Review Committee, Penn Presbyterian Medical Center
Associate Fellow, The Center for Public Health Initiatives, University of Pennsylvania
Department: Medicine
Contact information
Penn Medicine University City
3737 Market Street, 10th Floor
Philadelphia, PA 19104
Office: (215) 662-8585
Fax: (215) 243-4643
Search PubMed for articles
Penn Lung Center Faculty
Columbia College of Columbia University, New York, NY, 1973.
M.D. (Medicine)
Medical College of Virginia, 1978.
Post-Graduate Training
Intern in Medicine , Hospital of the University of Pennsylvania, 1978-1979.
Resident in Medicine , Hospital of the University of Pennsylvania, 1979-1981.
Fellow, Cardiovascular-Pulmonary Division , Hospital of the University of Pennsylvania, 1981-1984.

Diplomate, National Board of Medical Examiners , 1979.
Diplomate, American Board of Internal Medicine(Recertified, 11/97 and 5/2007), 1981.
Diplomate, Subspecialty Board of Pulmonary Medicine,(Recertified, 11/97 and 5/2007), 1984.
Diplomate, Subspecialty Board in Critical Care Medicine,(recertified, 11/97 and 5/2007), 1987.
UNOS Certification, Transplant Pulmonologist, 1993.
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Anonymous said...

Five testing centers in Philadelphia. Where do ABIM execs and officers take their test? The never-never program in the land of make believe? Or in a place for cheaters and elites at the ABMS testing center with full 24/7 access to the questions and answers on cloud nine? How many of those old board members could pass a test? Or really take the time to study? And then spend all that time and money going to a Pearson Vue Center. I'll bet you Delhi says nobody did!