Tuesday, July 18, 2017

Certification Matters: Drugs, a Young Companion, Drug-Fueled Parties

The incredible story broke yesterday in the Los Angeles Times on the secret life of Carmen A. Puliafito, MD, Dean of the Keck School of Medicine at USC.

As of this morning at 06:34AM CST, he was listed as participating in Maintenance of Certification on the ABMS Certification Matters website.

Clearly, "Certification Matters" and gives a clear picture of what the divide between bureaucratic leadership in medicine and practicing physicians on the front line of health care today looks like.



  1. He was a grandfathered ophthalmologist participating in MOC. Where did he find the time to do that MOC?


    Carmen Puliafito was on the 2021 cycle for MOC. "Students considered him a 'god'", he claimed. Did Carmen do the MOC busywork himself? Or was it done by a enamored or paid fellow? When you open one can of worms several others come unhinged.


    What was the Dean's relationship with the young 17 brother of Ms. Warren or the two other intimate drug partners that were with him and mentioned in the investigative article.

    Will ABOP be obliged to "investigate" and put him before a panel for ethical breaches and sanction Dr Puliafito or is this kind of treatment only for select and economically vulnerable individuals? If this turns out to be so then the ABMS, ABOP, and the ABIM are clearly guilty of discrimination.

  2. This story reminds me of the undisclosed activity at ABIM's luxury condo. Dr. Baron and others refuse to talk about who those "guests" were. They still won't release a log of its use from 2007 until it was quietly sold at a substantial loss recently.

    Philly's hot second baseman bought his real estate investment property at the Ayer around the same time as the ABIM in 2008.

    Now Chase rents it out. "The entire living space was architect-designed and is dramatic yet comfortable, able to accommodate the most private of individuals or those who enjoy entertaining." Advertised as close to a famous local stripper's club.

    ABIM's own favorite entertainment spot, the Philadelphia Penthouse Gentleman's Club. (Must be of mature age to open link.)

    Why did ABIM never itemize the cost of the remodeling for their 2.3 million dollar luxury condo in order to make it just right for their "guests", executives', officers', staff and "directors'" uniquely creative utilization?

  3. If Pulafito's last name was Arora, that would have made a case for grandstanding or wasting time! The hedonistic activities at ABIM is a mere strip tease compared to the eye opening bacchanal from the revered ophthalmologist's department at Keck.

  4. USC's double dilemma: love for big tobacco and love for unhealthy illicit drugs

    USC's Keck Medical School has the Thomas H. Brem Chair in Medicine. You'd think they would be more politically sensitive regarding all the stumping Brem did for big tobacco in Congress, which most certainly led to higher morbidity and mortality rates in the US and around the world as protective legislation from DC was delayed.

    Perhaps they should consider renaming that Chair after a more honorable physician than the former ABIM Chairman and ABMS President, Dr. Thomas H. Brem.

    Now, Carmen Puliafito stains USC's reputation further with his Bacchanalian rituals and party buddies allowed to sit in Thomas H. Brem chair in medicine staining Brem's already sullied seat further. Puliafito has been fundraising for liver research helping USC bring in 6 million dollars in NIH grant money to the party who now sits in Brem's Chair.


  5. Tawdry and repellent activity from a low life sleaze who racketeers for the universities that hire him. Honestly I'm not surprised, this one actually got caught. I've head through the years of similar out of control behavior from other academic chairmen. Most people with extreme monetary influence inhabit this foul underbelly.

  6. "USC president addresses drug allegations against former medical school dean
    Updated 9:07 pm, Wednesday, July 19, 2017"

    In a letter Tuesday, USC President C.L. Max Nikias said:

    "'Our university categorically condemns the unlawful possession, use, or distribution of drugs," the president said. "We are concerned about Dr. Puliafito and his family and hope that, if the article's assertions are true, he receives the help and treatment he may need for a full recovery.'"

    "He [Puliafito] remained on the Keck faculty and continued to represent the university at public events as recently as Saturday. [July 15, 2017]

    The current dean of the medical school told a gathering of medical scholars and graduate students on Wednesday that USC had launched multiple investigations into Puliafito's conduct."
    'These allegations, if they are true, they are horrible and despicable,' Dr. Rohit Varma told a town hall-type meeting, according to the Times, which obtained a recording of the meeting.
    'He's a man who had a brilliant career, all gone down the drain,' Varma said.
    Varma said Puliafito had sought treatment in the past for alcoholism but the drug allegations 'came as a complete shock to us.'
    'He called me yesterday and he apologized for what had happened and for putting me and the school and SC through what has happened, and he informed me that he's going to go and get help,' Varma said.

  7. "USC dean drug use allegations not likely to slow fundraising, expert says

    Observers of higher education philanthropy say the allegations are unlikely to significantly dampen the university's fundraising efforts."

    When the story broke a few days ago about Carmen Puliafito, the faculty, students and the nation were stunned and did not know what USC officials would say or how they'd react.

    One faculty member remarked about the silence saying, “'[USC President Max Nikias] needs to clarify, what are the values that we stand for, and given those values what then do we do with an individual who has broken our trust,' Tierney said. He and other faculty said they'd not received any communication from USC administration about the Puliafito allegations."

    USC's only offical statement prior to yesterday's President's letter and words from the new Dean today were, “'The university is not at liberty to discuss personnel matters, which by law are confidential,' said USC Director of Communications Eddie North-Hager."

    That led one populist writer on philanthropic giving to remark when asked about the future of donations and funding for the University going forward.

    “'They’ve been on a fundraising tear in recent years,' said David Callahan, who has researched and written about philanthropic giving.'I don’t think this is going to derail anything, except if there’s revelations about… if they protected him, if they knew what was going on and they looked the other way,' he said.

    If that happens, donors may have second thoughts about giving to a university that’s out to raise large sums no matter what the costs.

    The largest donor to USC’s medical school, the Keck Foundation, would not answer questions about whether the revelations about Puliafito would affect any future giving and referred the questions to USC."

    We'll see what the USC inhouse investigation uncovers about what the administration knew and when they knew it. They must have all been very busy talking back and forth among themselves and with Dr. Puliafito getting the stories straight relying on their teams of lawyers. I wonder if any of the recordings of the conversations are going to leak out at some point when we least expect it?

    Right now the official version, one of shock and horror.

    "I knew Doctor had a drinking problem, but, oh Lordy, nothing like this would have ever occurred to us."

    I suspect we'll learn the truth only if, and when, the secretly recorded strategy sessions with their legal teams are handed over to Wikileaks. For now, they've closed the lid tight on this one at USC Keck Medical School.

  8. "Letter to USC faculty from Provost Michael Quick about Carmen Puliafito
    JULY 19, 2017

    This is a let­ter from USC Prov­ost Mi­chael Quick to the school’s fac­ulty. He writes that 'we made what we felt were the best de­cisions we could make, as swiftly as could be done in a prudent and thought­ful man­ner, and giv­en the in­form­a­tion that we had at the time.'”


  9. We present an unscientific review of MOC, a comparative analysis of physicians "participating in MOC" versus those who are "not participating in MOC" highlighting behavioral and ethical issues worthy of disciplinary action

    Diplomates studied

    Stephen Gruber, MD director of USC Norris Comprehensive Cancer Center is board certified in medical oncology, de-certified in internal medicine
    No behavioral or ethical issues: NOT PARTICIPATING IN MOC

    Carmin Puliafito, MD former Dean of Keck School of Medicine (profile not found) is board certified in Ophthalmology
    Has behavioral and ethical issues: Puliafito is PARTICIPATING IN MOC

    So far, our study indicates that participating in MOC has severe psychological and debilitating ethical ramifications. Lets's add two more random diplomates to our study.

    Christine Cassel, MD former ABIM CEO, Founding Dean Kaiser School of Medicine is a board- certified grandfather in internal medicine. De-certified in geriatric medicine
    Cassel allegedly has no behavioral or ethical issues: NOT PARTICIPATING IN MOC

    Kevin B. Weiss, MD, former ABMS CEO, currently VP accreditation ACGME is board certified grandfathered in internal medicine
    Weiss allegedly has no behavioral or ethical issues: NOT PARTICIPATING IN MOC

    Abstract: According to this study, relying on best-available and the most reliable prime-sources-of-verification, we easily conclude that "not participating in MOC" is good for your career. You move up the ladder of success like a greased pig. You make more money than anyone else in healthcare, and you have the time, money, and power in order to weasel your way out of trouble.

    Conclusion: those who "participate in MOC" are infinitely more likely to have known behavioral and ethical issues leading to disciplinary action.*

    *Study was made only on elite non-working-class physicians who sit at desks at home in slippers and attend occasional phone conferences and frequent five-star retreats for a living. Occasional ghost-written manuscripts submitted on your behalf (conflict free) to major medical journals touting the benefits of participating in MOC for rank-and-file docs.

    Note: Working class physicians were to busy seeing patients and doing MOC busywork to find time to participate in our study. This is unlikely to change unless anti-MOC statutory relief is passed in each state and territory.

    In summary
    Of those participating in MOC (among the elite class) you are infinitely more likely to mess up big-time** and get caught in scandals where the whole world will end up knowing about it.

    **According to LA Times year-long investigation and published article on Dean C. Puliafito
    So far, the CA State Medical Board and USC have declined to comment on disciplinary actions and are studying the matter. ABOP and ABMS have declined to comment about their declination to not make any statement about any investigation they are pursuing or initiating or wheeling out the sanctioning panels. Such panels appear from past ABMS history to be "ready made" and "waiting" only for their political pawns who meet certain criteria for enhancing financial returns and gaining media attention to instill fear. The current scenario with Dean Puliafito does not fit their program agenda, as it would undermine faith in physician administrators, due to the fact that many professional medical bureaucrats at the ABMS quality cartel blatantly collude, racketeer and commit public fraud from position to position.


  10. While the LA Times investigates one Dean of a medical school, they are missing a much bigger story of systemic corruption involving collusion, fraud and racketeering within the ABMS and ACGME

    Let's look at Asia. Singapore apparently was an entertainment destination for Dean Carmen Puliafito. USC sent a large delegation there in 2014. What for, really?

    Singapore is and has been a prime entertainment capital of the world for ACGME and ABMS "business" people as well. And a potentially lucrative market for them and their corporate sponsors.

    And apparently USC Keck Medical School, like the ABMS and ACGME, are spending money hand-over-fist on travel abroad to "enhance their business prospects" in Asia, including Malaysia and Indonesia. Sinaporeans make up one of the largest number of international student populations at USC. The school ranks number-one in providing education to international students in the US.

    ACGME/ABMS/ABIM and Singapore (Here's where a greater story of wrongdoing is! Puliafito is just the tip of the iceberg. A sales agent.)

    The Graduate Medical Education Program in Singapore changed from using the British system and was fully accredited by ACGME-International. IN ONLY TWO SHORT YEARS!

    How is that possible when in the United States there are numerous GME programs on probation? Can't the ACGME help their own programs here in America to get fully accredited and stay that way? ACGME and ACGME-I comprise the very same people, so they are spreading themselves thinly when they create whole new systems abroad. Ones that are too big to fail.

    Is the ACGME diluting their brand and lowering the quality of their service by going abroad to Singapore and the Middle East? Have they have maligned programs here in the US, where they have passed programs internationally seeking arranged marriages with other medical and political systems? Have they shown extreme favor in Singapore overlooking many deficiencies searching for elusive profits abroad?

    If so, why do we allow this additional scam to flourish? They are doing under under the radar. Few people even know of ABMS-I and ACGME-I or JC-I.

  11. MOC around the bloc and around the clock with racketeers like Puliafito

    What Puliafito was doing in his personal life was despicable, and that may just be only one piece of a larger jigsaw puzzle involving the double life of a corrupt Dean. But Carmen is just the front man for a larger kind of organized crime and unhealthy excesses in lifestyle here in the US.

    Dean Carmen Puliafito's double standard is one only screw in a larger corporate crony machine that is undermining healthcare in the US. MOC is a major cog in that machinery that keeps it going. A much bigger problem to fix than one man seeking personal help for his addictive behavior and incompetence and negligence in governing his private life. Carmen P. is an insignificant story, if we do not dig further and uncover the real systemic issues. Puliafito's story means nothing unless it draws our justice system in to look more broadly and deeply. The story is meaningless otherwise, except for the sensationalism it produces.

    That is why it is important to stop and repair the whole machine, removing the problematic parts and cleansing out the filth.

    Who will investigate the corruption so rampant in the quality assurance organizations? MOC is one long continuous binge party for conflicted executives with self-dealing and excesses beyond belief. They do not serve the public, but only themselves.

    Are consumers being ripped off here and abroad with a double, triple and even quadruple standards? What does that mean for the quality assurance that the ABMS, ACGME and JC profess to provide. Punishment in the form of probationary sentences and strong-arming sanctions and lawsuits are utilized here in the US and an entirely different metric and soft power is used abroad.

    In Singapore, many things are tolerated medically and ethically that would not be accepted here. Will we institute physician-assisted caning, which rips off skin and flesh, here after the Singaporean-approved ACGME-I and ABMS-I and ABMS-Singapore models. That is partly why the ABMS and ABMS-I had to create a totally new entity for Singapore called ABMS-Singapore.

    Open your eyes, LA Times! You have opened the door; now enter and take a look around at the systems of quality assurance controlling physicians and healthcare markets. Move on to the bigger stories taking place behind the scenes, and the people who racketeer like Puliafito They are part of the same system of control and dirty money.

    MOC money is paying for a distracting empire-building and international expansion, which only serves to enrich ABMS and ACGME executives and dilutes quality of care here in the US.

    MOC is perhaps the biggest educational Ponzi scheme in the history of the US and now the perps are trying to increase their cash and self-dealing powers around the globe.





  12. MOC Office of Standards and MeasurementThu Jul 20, 07:43:00 PM CDT

    Remit the standard MOC fee along with your points by the due date, or else pay the penalty!"

  13. How can you work with a standard where there is none? And how can you strive for quality when they stand between you and your work?

  14. "Hollywood's Top Doctors: Best Oncologists in Los Angeles 9/2014
    Elite physicians who qualified for 'The Hollywood Reporter’s' inaugural list of the top docs in L.A."

    We start the list of top docs in Hollywood with Morgan Freeman's favorite internist who is board certified, grandfathered and not participating in MOC.

    All the following physicians are the top ten oncologists, and none of them on the ABIM list,
    with the exception of two, were participating in MOC. The two (not listed) were not grandfathered physicians due to a stroke of bad luck. They were born past the 1990 line of demarcation/cutoff and had little choice but to participate. (Drs. Chap and Chow.)

    Yet, there were several on the top ten 'who's-who' list born after 1990 chosing not to participate in MOC. USC's Dr. Argus, one of the foremost oncologists in the country from USC is no longer certified at all!
    Dr. Gruber of USC is not grandfathered but chose not to participate in MOC. Dr. Fakih is a NO to MOC, and he is not grandfathered.

    Out of 10 certified top ABIM docs only two are listed as participating in MOC. The top ABIM doc, who was not grandfathered, decided that certification was perhaps just a rite of passage and chose not to re-certify at all.

    That means 80% of the top oncologists to the stars do not participate in MOC at all. Morgan Freeman's internist was not included in the calculation.

    Soram Singh Khalsa (Morgan Freeman's choice, internist)

    Today's Date: Jul 21, 2017

    Internal Medicine: Certified
    Participating in Maintenance of Certification: No

    Internal Medicine: 1977

    David B. Agus (USC Wilshire Clinic) Oncology

    Today's Date: Jul 21, 2017

    Not Certified

    Internal Medicine: 1995
    Medical Oncology: 1997

    Marwan Ghazi Fakih

    Today's Date: Jul 21, 2017

    Medical Oncology: Certified
    Participating in Maintenance of Certification: No

    Internal Medicine: 1995
    Medical Oncology: 2001

    Robert Alan Figlin

    Today's Date: Jul 21, 2017

    Medical Oncology: Certified
    Internal Medicine: Certified
    Participating in Maintenance of Certification: No

    Internal Medicine: 1979
    Medical Oncology: 1983
    http://www.abim.org/verify-physician/Figlin-Robert-d1LSOuNv19I=.aspxPatricia Anne Ganz

    Patricia Anne Ganz

    Today's Date: Jul 21, 2017

    Medical Oncology: Certified
    Internal Medicine: Certified
    Participating in Maintenance of Certification: No

    Internal Medicine: 1976
    Medical Oncology: 1979

    John Anthony Glaspy

    Today's Date: Jul 21, 2017

    Hematology: Certified
    Medical Oncology: Certified
    Internal Medicine: Certified
    Participating in Maintenance of Certification: No

    Internal Medicine: 1982
    Medical Oncology: 1985
    Hematology: 1986

    Mouni William Audeh

    Today's Date: Jul 21, 2017

    Medical Oncology: Certified
    Internal Medicine: Certified
    Participating in Maintenance of Certification: No

    Internal Medicine: 1986
    Medical Oncology: 1989

    Stephen Bernard Gruber

    Today's Date: Jul 21, 2017

    Medical Oncology: Certified
    Participating in Maintenance of Certification: No

    Internal Medicine: 1995
    Medical Oncology: 1998

  15. LA Times reporter asks "what did the USC President know and when did he know it"?

  16. Do we have a story of cover-up and cover-up?

    From accreditation to accreditation. From certification to recertification. Did the ACGME, AAMC, USC and ABMS administrations or their staffs cover up serious problems and wrongdoing? Ethical or professional deficiencies.

    Did any of them have any personal, professional or business relationships with Puliafito?

    Did the ABMS, ACGME, USC or LCME committees, and their staff, boards and administrations, have reason to suspect that Dean Puliafito was using drugs, had a serious and repeated alcohol problem (unreported) and that he was not complying with the "professional and ethical standards" of these organizations and in the oath every physician takes?

    Why was his admitted alcohol problem not reported? Was it covered up? Were there any complaints that were "taken care of" by any one at USC by the staff, board or administration? Did any of this knowledge find its way to the ABMS, ACGME or AAMC/LCME?

    And did any of them know or suspect at any time that Carmen Puliafito was breaking the law?

    Carmen Puliafito's wife is a psychiatrist that followed him from job to job maintaining her own local professional career. Her name is Janet Pine. It would be unusual to think that she did not know what was going on with her husband for years.

    Further reading on the ACGME, AAMC and Dean Carmen Puliafito.

    ACGME 2008 Puliafito pleased after ACGME's surprise inspection of LAC-USC and glowing remarks (by ACGME) granting full accreditation.

    2010 AAMC LCME 8-year accreditation for USC Hospital + LAC

    2010 Keck Deans's report

    2011 Dean's report Keck ACGME five-year accreditation achieved

    2011 Dean's report AAMC President Kirsch and Puliafito meet
    2012 five year contract renewal of Puliafito marking his achievements.

    2013 Dean's report World-famous neuroscientists recruited to USC

    2014 Pulafito, Dean of the Keck School of Medicine went to Singapore and Indonesia. Out of 106 photos of the Singapore event on flickr, Puliafito can only be seen in one photo.

    Dec 7, 2015 keynote speaker in Chicago Ophthalmology Society with "conflicts of interest" listed. Does not list girlfriend, or illicit drug connections, obviously. Was his girlfriend with him in Chicago? The timeline is correct. Was he "enhancing himself" with drugs to give his best performance?

    2017 residency hours change. ACGME allows up to 28 hours for first-year residents

    2017 July 12 New Dean Vohit duscusses LCME accreditation process. http://hscnews.usc.edu/leaders-address-faculty-at-town-hall/

  17. ["Whether a Bruin or a Trojan be, the tradition is to fight"]

    In this Shakespearean tragedy, we can hear the administration speaking in monologue like Hamlet, and among themselves in private from the most sacrosanct chambers of USC.

    "We all knew his life was in the gutter, but he brought in the money."

    Yes, we knew, but now we need to find out who is doing this to us and why; who is trying to bring us down."

    "I concur, we need to find out who and why, and we need to fight back."

    "I agree, it's not just a reflection of the times."

    [A poetic new USC dean speaks out]

    “He’s a man who had a brilliant career, all gone down the drain,” Varma said. “I’m standing in this place where my predecessor now has this taint. ... It is sad.”

    He also said that Puliafito had sought treatment in the past for alcoholism, but that the allegations in the article that he used drugs “came as a complete shock to us.”

    ["How goes the night boy?"

    "Good, but the day heralds ill with a trumpet waxing shrill."]

    [Reports were made in the past that Puliafito appeared drunk at campus events]

    At the meeting on the Keck campus, students — some wearing hospital scrubs — said university administrators should have known more about Puliafito’s troubling behavior, including reports that he appeared drunk or otherwise intoxicated at campus events. One woman said that it “seems shocking that no one has been able to figure anything out in the last 10 years. ... People are now going to be questioning our professionalism.”

    [In comes the Yang gang to investigate the matter (law firm comprised of loyal USC alumni)]

    "Yang was an L.A. Superior Court judge and was appointed U. S. attorney for the Central District of California in May 2002 by President George W. Bush. She is a graduate of Pitzer College and Boston College Law School."