Today Ohio legislators will be introduced to the concept of "Maintenance of Certification" or "MOC" when House Bill 273 is introduced by Representative Theresa Gavarone (R) to the Ohio Health Committee. Most of the Committee members won't have a clue what MOC is or why they should care.
Lobbyists from the American Board of Medical Specialties (ABMS) and the American Hospital Association (AHA) will claim "the legislation puts patients at risk" and that "patients deserve to know their physicians are up to date" even though this statement flies in the face of the ABMS's own data and that of independent researchers. They even have the nerve to make statements like this: "Faced with a physician who was certified after residency who has not kept the certificate current, patients will be in the dark."
Like the members of these corporations ever set foot in a patient exam room...
Here's ABMS's ACTUAL history of promoting patient "safety" and knowing what patients think.
Recall that in 1969, Dr. Thomas Brem, former Chair of the ABIM and President of the "Advisory Board of Medical Specialties" (our current ABMS) testified before the House Committee on Interstate and Foreign Commerce, stumped for Big Tobacco by testifying "neither can offer unequivocal scientific proof that smoking does or does not cause cancer of the lung." Dr. Brem conveniently failed to mention he was receiving payments from "Special Account No. 4" that was maintained by tobacco company lobbyists. How many lives were affected by this testimony?
While we'd like to think this is just an isolated event, it was not. In fact, such corporate collusion has been the hallmark of the ABMS and their member boards as they shower themselves with lavish salaries and perks at the expense of vulnerable work-a-day physicians.
For her entire career as President and CEO of the American Board of Internal Medicine, Christine Cassel, MD served on the board of directors of the Greenwall Foundation, Kaiser Permanente, Premier Inc and other organizations with quality health care agendas at diplomates' expense while never disclosing these conflicts of interest. It was only after she joined the National Quality Forum (that receives the majority of its funds from government contracts), that these financial relationships were exposed. Citing the "distraction" of it all, she quickly resigned her affilitation with Kaiser and Premier, but not before bilking her unsuspecting ABIM colleagues for over $8.9 million and free travel for her spouse and helping to facilitate the $400 million purchase of CECity, Inc. by Premier (in which she held stock).
Robert Wachter, MD, the golden-boy of corporate medicine and promoter of hospitalist medicine, was also former chairman of the board of the ABIM for a time. He, too, would rather not discuss his "love agenda" for medicine once his relationship with IPC The Hospitalist Company was exposed by the Department of Justice for overbilling patients. It is no wonder he brought down his industry-sponsored blog, Wachter's World.
Nothing to see here, folks.
Other ABMS member boards and their corporate partners would also not like legislators to examine the American Board of Pediatrics, who saw no problem giving James Stockman, III, MD a $2.4 million golden parachute to help fund his car collection and retaining him to work eight hours a week for a $793,438 annual salary. Who funds such largess?
James Puffer, MD of the American Board of Family Medicine and their directors have also enjoyed high salaries while quietly funding his organizations' Foundation's purchase of corporate office buildings and running for-profit real estate management companies. I'm not sure I've ever seen a clearer quality and patient safety initiative funded by diplomates.
The truth be told, MOC is a horrible embarrassment to our profession. We are doctors, for goodness sake. We are not funding vehicles for political and corporate agendas. It is sickening to me that we continue to see medical specialty societies joining the ranks of these highly-conflicted organizations so they can dovetail their lucrative data registries with maintenance of certification as their next sure-fire business model. Is spending time, energy and money lobbying on Capital Hill to keep such registries funded on the backs of working physicians more important than supporting doctors' effort to remain at the patient's bedside rather than at the keyboard?
It seems so.
MOC is coercive, hopelessly financially conflicted, and corrupt. Working physicians need Ohio representatives (and all state representatives) to examine the facts, not cave to the hospital and insurance company lobbies. Working doctors know the score now. Many any are quitting rather than subjecting themselves to MOC again and again just to keep money flowing to the ABMS and their member boards so they can keep working. Patients, particularly those in rural areas, lose when this happens.
From it's inception, MOC was created from lifetime board certification, not for patient care quality or safety, but rather so ABMS officers and directors could pay themselves handsomely. It continuation is fueled by deception, political agendas, and cronyism. MOC also requires coercion and strongman tactics to keep the money flowing. No matter how our own bureaucratic colleagues might sugarcoat MOC on the pipedream of assuring patient care quality and safety, critical examination of the evidence clearly demonstates what an embarrassement the program has been to the integrity of US medicine.
It's time to end it.
What is mandatory MOC and what needs to be done? (To the Ohio Legislature and Industry Lobbyists)
Mandatory MOC is a willful and malicious defrauding of the public based on a contemptible financial and political sham.
The colluding indolent proponents of MOC have the filth of corruption and blood money on their greedy hands.
Some call the mandating of MOC a blatant example of a lucrative educational Ponzi scheme. There is ample evidence to support this and that MOC does not make a better DOC. It only hurts physicians and patients with a costly and wasteful time-consuming process that restricts patient access.
Above all it is painfully evident that the MOC sham was created by those with great hypocrisy and avarice and had not a whit of concern for patient safety in mind, except for use in their deceitful financial PowerPoint presentation models and disingenuous political ploys to legislators and propaganda directed at the gullible public.
No highly placed friends, profiting corporate allies, egregious compensation lavished on themselves, or the lie of politics will ever be enough to compensate/ameliorate the sickening hypocrisy ABMS executives must live with or the outrageous wrongs they do and have done. MOC, therefore, even harms the executives and employees of the ABMS and their associates by allowing the corruption to continue.
Nothing will or can remove the deep dirt-red stain on the hands of those who have sold themselves out for money and political rank, save when they end the indentured status of physician and patient. That means to end mandatory MOC.
Legislators at the state level must intervene and give statutory relief to physicians, patients and even to the MOC's perpetrators at the ABMS and their proxies. MOC madness has become a corrupt vicious money machine and manipulative hard-to-stop cycle for all. Sanity, reason and science must be restored to the practice of medicine. MOC's many abuses must stop.
The coercive and corrupt elements of certification need to end and the voluntary nature of recertification must be restored. The states should and must be the arbiter of continuing medical education not the corrupt ABMS. The ABMS has little appetite for reform, but they have a great continuous appetite for revenue expansion and power.
This should be self-evident by now: most of the corruption and hypocrisy in the quality assurance cartel (ABMS and affiliates) will cease when the professional medical politicians and their profiting/controlling industry partners are forced to remove the immoral ball and chain of mandatory MOC.
Statutory relief at the state level is the only way to faithfully achieve educational sanity and balance again in medicine by putting an end to the ills of mandatory MOC.
But it cannot be done half-way with half-measures. The legislative scalpel must cut the cancer of mandatory MOC out of the practice of medicine completely.
MOC must not be allowed to be tied to licensure, employment or reimbursement in any way.
OHIO Citizens and Citizens of Every State: Is it not time to act before it's too late to do anything?
ABMS spends royally on disinformation campaigns to legislators and the public. Their business cronies spend lavishly on keeping the legislators in their pockets lobbying to grow revenues and maintain the status quo.
The oligarchy and their kleptocracy only strengthens with our inaction and passivity! They have teams of "money-changers" like the private equity firms who have short and long-term stakes everywhere in the certification/testing markets and the healthcare industry.
On top of the over-the-top mandates of MOC and knowing how it hurts physicians right-to- work and a patients right-to-care makes the truth of MOC's harmful effects even more painful. Does one understand that the investors/shareholders/helathcare industry will not let go easily of MOC. Do we really understand what purpose MOC serves? If we understood more we would act more due to the severity of the problem and the tenacity of those who control. Yes, it is about money, but it is more than that.
I'm talking about how corruption has entered into our financial, corporate, judicial, executive, and legislative "systems" at so many levels and in so many subtle and explicit ways. All this ABMS graft grows while sovereignty and individuals rights erode.
The ABMS/ABIM has been a key participating player in the destruction of much of our rights and what has been constitutionally inviolable.
From Brem to Cassel to Baron; from Brem to Weiss to Nora the die of lies and abuse of patients' and physicians' rights has been cast.
Thomas Brem of the USC Keck School of Medicine lied for the tobacco company and it caused an increase in morbidity and death. What has Cassel, Baron, Nora and Wachter's lies and abuses of power cost us?
What about Ariel B. Mannes' obvious individual abuses and involvement in Cassel, Baron, and Weiss' blatant overreach and overstepping of a corporation's authority? (Yes, the ABMS was vigorously involved too. Look at what was at stake in healthcare at the time and what they were lobbying behind our backs for.)
What about Mannes' and Cassel's felonious lies to the court and withholding of pertinent facts involving thousands of ABIM/ABMS' political, financial and judicial victims!
The ABMS according to its bylaws is responsible for each of its "specialty members"! They did nothing to stop the overreach because they were a strong part of it. Read Wes's ABIM, Medicine's 'House of Cards'". The ABMS has thrown more than a reporter off the roof! Hiring of undisclosed felons to investigate/surveil/intrude on privacy and control/intimidate physicians should make one mad as hell.
As citizens of our individual states we must get the lies and abuses to stop. Will the legislatures listen?
Certainly if nobody speaks out the states will do nothing. We must all be active (patient and physician) or we are lost in every way. The ABMS with their selfish monetization, politicization and power-mongering has clearly violated laws of the land and we need to scream about it. I would not stop with the ending of MOC.
A higher authority must take the ABMS by its "white collar criminal neck" and investigate and indict.
When abusers remain on top unabated the abuses will continue. Who else sees this truth and feels the same outrage sufficiently to do something about it!
One thing is certain. The phony ethical facade of the ABIM, ABMS and many of the other specialty boards and their corresponding societies has been exposed.
Moreover several of their iconic masks have been completely shattered. Christine Cassel's face. Robert M. Wachter's mug. Thomas Brem's death mask. Lets's add that half-shattered mask hanging halfway over Dr. Baron's protruding jaw. Sorry, Rich, I used to respect you!
There is a saying about politicians. Clean faces; dirty hands.
How about the ABMS/ABIM's own Thomas Brem and the USC Keck School of Medicine's current disgraced Dean Carmen Puliafito! I am referring to the American Board of Ophthalmology's 'grandfathered MOC darling' who prefers drug parties, nearly under-age prostitutes and contributing to the delinquency and drug addiction of minors to showing up for work at his office or going home to see his family.
How about that. The ABO still lists Carmen Puliafito as certified and meeting the 'MOC standard'. What a very high standard it is when we are mostly talking about lining your pockets with millions of hard working physicians'/med students' dollars and investing in offshore accounts and travel to Singapore's gateway to the silk road business empires.
ABO says Puliafito is certified and maintaining MOC. That is some measure and some organization, the ABMS, when they pulled certification immediately on suspicion of cheating and threatened thousands with colluding with Dr. Arora violating their constitutional rights from 2009 to present.
LA Times did a series of investigative articles on the American Board of Opthalmology's poster physician. I wonder if he really took that test himself or was it just a business deal? Maybe someone can inquire with the ABMS or file a complaint with them for hypocrisy and continued sucking up to the elite and bold-faced discrimination.
Given the importance of the anti-MOC movement, and the concerning nature of the problems dealing with the ABMS/ABIM, I'm surprised that Wes' blog-site does not have non-stop responses and that his Twitter account is not teaming with a half-million followers flooded with constant responses.
Ohio doctors/voters need to contact their state representatives to encourage legislative action putting an end to the deleterious effects of MOC. We all need statutory relief.
If the mainstream media did not suppress the troubling realities about the nefarious activities of the ABIM and ABMS the floodgates of truth would be wide open.
ABIM/ABMS On Trial (I'm still following this blog daily, and why I do!)
Every physician and patient should make themselves familiar with ABIM/ABMS court records and horrendous totally unacceptable policies. The physician motto of "do no harm" does not apply to them or their onerous "take it or leave it" policies.
Speaking of mottoes, the ABIM's motto "of the profession for the public" is a telling one. It is a total farce. I mean it is easy to see what a lie it is. Unless, of course, you are talking about their executives/officers working as "professional" politicians, psychometricians, risk assessors, revolving door corporate/government lobbyists/corporate board specialists, and we must not forget the blessed multitude of Wall Street bankers in their midst that have inhabited the suites of the ABIM's 17th floor.
As far being "for the public" (as in "we the people" or as in being a patient), that is a huge laugh and a tragic display of larceny and 'hog slop'. I am feigning to paraphrase Dr. Robert M. Wachter's favorite expression "hogwash". Like Dr. Wachter of the infamous over-billing /short-on-safety Hospitalist Company fame, the ABIM along with the rest of ABMS have systematically and underhandedly served only their own personal financial gains and partisan political interests. Look at the ABIM Foundation and its secret lucrative history jockeying with risky stocks with their "money managers" that went belly up taking on way too much risk.
In fact, just like Wachter's IPC, the entire ABMS member boards following the ABIM executives' example and Bob Wachter, have up-coded their compensation packages accross the board from "non-profit" or "non-pecuniary", as they used to say, into one of the most lucrative professions earning more money than many of the best lobbyists on "K Street" or top investment bankers on "Wall street". Even the bonuses and golden parachutes are comparable.
Moreover, Court records abound (publicly available or legally suppressed) revealing client and employee discrimination. (Gagged or otherwise.) This is no joke. It's sadly true. Cassel and Baron and Langdon et al can attest to it considering the many times they have been sued and settled. Such copious court records and even ABIM's own inquisition rack called "the panel" testify to their many abuses. Their "private" records show how the ABIM/ABMS has callously shredded the constitution and magna carta as they tax away physicians against their will, violating the privacy, liberties and especially the due process of diplomates and candidates repeatedly for years.
Even when we thought they had learned from their mistakes and transgressions, they went after a Puerto Rican physician in 2012 and sued him in 2014 dragging him through hell for five years. There is something sinister about the way the ABIM conducts business as usual. They sanctioned and sued this physician with a vengeance and ferocity in a time-barred case that any first-year law school student would know was "off limits" due to its unmistakable age.
They went after yet another young vulnerable physician for political and financial reasons trying to do harm with pure malice (if you look at the absurd assumptions they made) and they had an intent to do more damage to him than a category five hurricane.
Just a company man or woman? Or something else? How about state actors and strong political advocates?
Dr Richard Baron, a democrat CEO/President of the ABIM/ABIMF, is a state actor (during his entire professional lifetime) working in an out of government who succeeded a state actor named Dr. Christine Cassel (democrat) also a professional medical politician working in an out of government all her adult life.
Dr. Baron hired back-to-back "chiefs of staff" from professional government positions and strong ties to the democrat party to run the ABIM as its "internal CEO's".
Robert Wachter (AHRQ) a democrat, former chairman of the ABIM and longtime board member/trustee/2020 task force is certainly a state actor, who like Christine Cassel, was spared indictment most likely because they had very close and highly placed connections in government at the time.
Lynn Langdon was at ABIM/ABMS for 44 years running the ABIM as COO and in charge of the the investigative bureau they created secretly. She is a staunch democrat.
And the CFO who first registered the American Board of Internal Medicine, Hank Strozeski, he is also a democrat.
Who or what gives/gave the ABIM/ABMS its authority. They say it is just a testing company after all.
But then why has there invariably been democrats in charge for decades at ABIM; how did that happen?
The ABMS isn't keeping up with certification responsibilities. MOC must end or all is lost.
MOC and the pursuit of money and hiring non-qualified (non-medical) outsiders to manage the organizations has diverted their attention from their core mission. MOC has harmed the ABMS and literally overwhelmed their capacity to do a competent and thorough job.
The ABIM/ABMS is not able to keep up with its certification programs and obligations.
Read or skim through the following ABIM pdf file for a clear example of the staggering/boated requirements for certification. Consider the very complex business partnership and the ABMS' intimate relationship with the ACGME, FSMB, medical societies, program directors/programs, and on and on. And now consider the added burdens of keeping up with the American Osteopathic Association/Board integration/assimilation/merger.
Logically and practically ABMS and the 24 member boards cannot keep up with its original mission and sole objective of certification. The ABIM and entire ABMS for example do not even have an accurate head count of how many certified physicians there are in American (and globally). Many listed as certified do not qualify for certification because they lack an unrestricted license, or are retired for years or even dead. What an ironic situation for the ABMS to say physicians are not keeping up when they are Aesop's proverbial mother crab hobbling through the quagmire and sand drifts of their own making and habit.
What an embarrassment MOC is indeed. Legislators need to rein it in with statutory relief.
Legislators will not know anything about the ACGME, and its place in medical education, but what a joke it is and ultimate embarrassment when the "physician" in charge of the ACGME active/unrestricted medical license and does not even practice medicine at all. I am too embarrassed to even mention the name of this former Christine Cassel/ABIM strongman who attempted to damage so many physicians while he was CMO of the American Board of Internal Medicine just before he went through the revolving-door over to the ACMGE!
FSMB verifies that the ACGME ABIM partner executive has no medical license.
ABIM even shows this non-licesensed, non-practicing bureaucrat to be participating in MOC.
How is that possible to have such an innacurate account of one of the top executives at the ABIM/ACGME/ABMS! How can you qualify to participate in MOC when you don't qualify for certification! Please, get real, ABMS!
Who are they trying to fool at the ABIM/ABMS? The ABMS is a mess and needs to be completely reformed. The current corrupt money-hungry power-crazed masqueraders should all be fired and replaced by real practicing physician/educators who qualify for certification! I am so embarrassed for these people and so outraged at the same time. Something needs to be done now. Let the reform begin by taking the money out of it and ending the MOC mania. Even the medical societies and institutions are being corrupted by the bribe of MOC money from educational offerings. IT has to be stopped.
The former dean of the USC medical school is another blatant example. The morality of the ABMS allows such illegal acts as illicit drug use and distribution to be a criteria for certification and MOC. I have lived to see it all. Carmen Puliafito's prostitute has more integrity than the ABMS certified Puliafito. The young women came forward and reported the criminality and is trying to turn her life around.
If legislators only knew the truth about the ABMS (they are not trying to turn anything around, just turn a profit) they would introduce legislation to shut it down and start over with something that has morality and true nature of a non-profit charity at its core.
I shudder with what I have learned of the ABMS and their MOC Ponzi scheme!
Are lawmakers and the institutions that are supposed to protect the public negligent turning a blind toward ABMS MOC and other acts of fraud?
When we consider all that the ABIM and other member boards have done in secret from their violations of privacy, constitutional rights and other violatory actions can we trust them?
When we add in all that has been uncovered about their acts pertaining to egregious conflicts of interest that was not disclosed can we trust their transparency? And when it comes to the financial to political shenanigans can we really trust them at all?
I have been looking at statistics of their pass-fail rates on the MOC and certification exams.
The numbers are atrocious and there are strange patterns and anomalies. How about the residency program pass-failure rates? These rates may tell us a great deal about the ABMS and relationships with the most successful programs. Who creates the question pool and its possible inequitable distribution or dissemination among programs whose reputation could not tolerate a low number of passing candidates.
Does the ABIM play with their pass-fail mathematical models/algorithms? By their own admission they do so. They even justify what they do without proper clarification and openness concerning their very complicated system of pass-fail, which we know involves a rare breed of psychometricians that nobody understands. Many of them are young and do not have sufficient understanding of what they are doing and the significance. They are just doing what they are told to do.
In my lifetime I have seen falsification after falsification of data. Almost every industry does it and educational programs have done their share, so it is not out of line to point this out that there is nobody regulating the ABMS member boards and their testing/certification program. Nobody. So many in industry and science have been caught in the past when their was an outside audit. When patient safety and trust is so important, it has become clear that the ABMS has failed us on both.
It is fair to say that the ABIM certification and MOC testing results are not questioned enough. Or is it questioned at all by physicians, legislators, the public and educational programs? Have they opened up their books or statistical data to the public for purview? Not that I know of. Doesn't safety depend on honesty and we can unequivocally exclaim the ABIM and ABMS have not been transparent and honest in so many ways.
Why is it that we don't have a continued statistic on MOC and the residency/fellowship relationship? Is it no longer relevant. It may be a subtle point but it will not escape subtle minds what may be implied by the maintenance of a statistic when they are involved in the maintenance of a certification. It is important data that might tell us something.The pass-fail rates and the closed-mouth attitude toward it is another big chink in the armor of the testing cartel and whatever it is the ABMS and ABIM feel so strongly about hiding.
We must open a dialogue about these important issues and hold the ABMS accountable.
ABMS corruption now wears a FIGmd leaf (the power of money and lobbying to create a data mania and money frenzy)
Why should legislators create legislation concerning a business? It should be obvious, because ABMS and its member boards were never meant to be businesses!
ABMS and all of the member boards are non-profit charities. But they are no longer serving a state/government role anymore. They are big out of control businesses and that is the point that everyone must understand.
ABMS MOC does not serve the public at all; MOC exists to add revenue to their bottom lines so they can pay huge outrageous salaries to themselves with golden parachutes and deferred monies tucked away for themselves that only a forensic auditor could discover. CEO bailout of the plane with millions in earnings from a non-profit charitable organization. That is wrong today and it was wrong when they first changed the bylaws to try and get away with it.
Through collusion with the healthcare industry, medical societies, the government, and an archipelago of non-profit NGOs, the ABMS and partners have become a lucrative powerhouse/juggernaut that is completely unregulated.
The ABMS is literally a monster of power and finance completely out of control. The growth model and immoral/unethical payouts go against the IRS rules which non-profits must comply with. There is no self-regulation anymore by physicians. Medical education is controlled by a mad money machine.
The ABMS executives have tainted the legitimacy of their "regulatory" capacity by abusing physicians right to work and a patient's right to care.
The states need to legislate relief to physicians and patients.
If the state legislates to limit the power of the MOC program to monitor physicians medical education, what will replace it?
The states already monitor a physicians keeping up with CME tied to their licensure, etc.
Maintenance of continuous education related to a physicians credentials is already done by the states. Besides ABIM does not monitor a physician's work, the state medical boards do.
The ABIM except for initial certification has no mandate to create MOC. Yet they collude with the insurers and hospital associations to create a mandate. Why? For money and control. The many state actors and corporate-backed "sell-outs" who have inhabited the ABMS umbrella and boards should be proof enough of this corruption and malfeasance of the most extraordinary kind.
The ABMS and in particular the ABIM does not do anything except rake in money. MOC is a redundant invention to rake in the money created by the ABMS.
The ABMS, member boards and their lucrative partners are mad with money and flaunt a financial and political hubris that is over the top and beyond belief.
ABIM/ABMS got it wrong on so many things, especially MOC!
To say it is greed and hubris is an understatement! Now Uber is apologizing doing something out of "rich baron's playbook", because it is not in good standing with the city of London.
They are not going to get their license renewed by the city officials. Not fit and proper to operate in London, they say. No license, no work. Simple as that.
That is the same kind of power that the ABMS member boards hold over the heads of physicians and indirectly over the heads of a physician's patients. No MOC no certification. No certification, good luck finding a job or getting paid by insurance.
Yet the ABMS and boards are not accountable to anyone. They can act as unfit and improperly as the please.
Are ABMS, the umbrella and the member boards fit and proper to operate in the Windy City and "land of Lincoln"? I don't think so. How about ABIM and ABS in Philly; are they fit and proper to be entitled to keep their doors open in Philly and Pennsylvania?
Who is going to pull their organizational license when they have virtually no oversight. Who is going to sanction/revoke their certification when they have not attempted to earn one. Why the double standard? Why is MOC even important to these uncertified medical boards.
Why don't the ABMS boards and umbrella hold themselves to an international standard and get certified with an organization that will hold them accountable. If they believe in certification and the maintenance thereof, they should join ANSI or a similar organization that does regular audits and holds you to a standard of ethics and business.
Can the department of states suspend or cancel their state registrations until they can reform what they do? How about forcing them to earn a certification through ANSI?
You know it is absolutely without precedent how Christine Cassel, the former CEO of the ABMS' flagship specialty board ABIM, has decided to thumb her nose at MOC and not participate.
That tells us how unimportant it is to keep up with MOC for the new founding dean of the Kaiser Permanente School of Medicine. It says explicitly to all that MOC is a waste of time. Christine Cassel knows more about MOC than anyone so she should know how useless it is.
The former head of the ABMS Kevin Weiss (now head of the ACGME) has likewise snubbed his obligatory nose at MOC and chooses not to participated in MOC. It is a total distraction and waste of time for the chief of the ACGME who imposes certification and signing up for MOC on hundreds of thousands of medical students/residents/fellows. In his case it is not hypocrisy, it is just a fact that one of the fathers of the MOC mandate knows it is just a money scam and only harms a physicians and patient. He has one of the deepest knowledge bases of how fake MOC is. And he knows how he lobbied in DC with Christine Cassel and others to get MOC made part of the ACA as law and not just policy, and so on.
It is equally devastating to the integrity of the regulatory process that physicians go through getting certified, when, until a few days ago, for example, Christine Cassel was snubbing her responsibility at renewing her medical license with the state of New Mexico, so she could remain certified and hopefully be allowed to work in the state of California as founding dean of the KP school and the various roles that should entail. (If she is not just a figurehead, who delegated many of her own responsibilities to others as we saw at OHSU and the ABIM.)
What a chaotic mess the leaders of the ABMS cartel are making of things when laziness/display of honest attitude creates endless the appearance of hypocrisy and indolence of the first rank.
It was mentioned here that the former CMO of the ABIM, now milestone project VP with the ACGME is not even licensed to practice medicine and yet he is considered to be certified in internal medicine. (I believe he is still allowed to prescribe an antibiotic, etc. for himself or his family if he feels he needs to.) Eric Holmboe lives next to a golf course in Pennsylvania and like Chris Cassel (who set such an unstellar work record) claims work for the ACGME in another state without showing up much for work.
Holmboe's work is another example of profligacy and power abuses run amok. His career displays this. Go to the court documents and lawsuits against the ABIM where Holmboe is named time after time as a defendant with Chris Cassel and Rich Baron.
God knows how long (how many decades) it has been since these ABMS/ACGME experts have ever been obligated to actually treat a patient on their own or to even see a patient. How can they feign to educate or be heads of medical education? What is the end product if not arcane esoteric theory passed off as new. The MOC tests have little to do with maintenance as the questions come from the same pool as the certification test questions. Very little money goes on the actual educational aspect of the ABMS and a great deal goes to the compensation packages. This needs to be investigated. It is not just an embarrassment, it may be fraud.
The state legislators should know that when they regulate ABMS MOC that they are regulating pretenders. Great pretenders. I am so very sorry to be one of the many who are realizing this. It brings pain and shame of medicine. But it can be fixed when we fight to change the corruption and negligence. Politics and money rule at the ABMS and not education.
This is troubling as we have seen what has been published and what new products they have been marketing at the the ABMS/NEJM "Group". I can't believe the depth of the conflicts of interest between all these non-profit organizations.
Richard E Hawkins and Big Data (the big drum roll toward enhancing AMA/ABMS profits in an era where physician member societies have nothing to do with its members and and loyalty erodes)
HSS textbook put out by the AMA/Hawkins (the allances become clearer now)
The ABMS is immoral and schizoid. They no longer understand what certification is. The executives and board appear devoid of the capacity to act ethically and do the right and decent thing, which is to end MOC now.
While millions of American live on under fifty-thousand dollars a year and have a great deal of trouble getting to see a physician, especially in rural America, it's astounding that executives at the non-profit charities associated with the ABMS take home an average families annual income in a single month.
In the case of ABIM/ABMS executives at the CEO level distribute seventy-thousand dollars to themselves on a monthly basis. They draw from the foundations they cleverly set up in order to supplement their incomes. And they defer hundreds of thousands every year for their golden parachutes. Benefits, first class travel, personal-use real estate, self-dealing political adventurism, and the gift of working from home highlight their lucky elite careers.
The sad thing about all this and the preaching they do about equity in healthcare is the executives and employees exhibit none of it in their personal lives. If they work at a free clinic it is for show and primarily to meet the requirements for certification by holding an active unrestricted license. (Or not!)
But even here they feel entitled to just hold active-retired licenses and try to slip through the cracks of ABMS requirements in order to be fully licensed, certified, and doing MOC. The employee/executive MDs of these organizations are the ones I'm addressing. And even to some of the arch-hypocrites who are paying their salaries and requiring them to be fully licensed, certified and participating in MOC. Yet many of them are not keeping up. Or they are feigning with earnest expressions for the public's' view.
The examples or this breed of political doctors at the ABMS and ACGME are full of this kind of lip service to the requirements. It is a kind of fraud or at least deep seated personal hypocrisy of the highest order, when their colleague physicians who actually see patients at these "free clinics" do not participate in MOC, because they see no value in it. (They don't work for the ABMS.)
And moreover such hard-working physicians are too busy caring for the sick and trying to help those without insurance. The ABMS insider executive physicians who do this "free clinic" phony contract charade are interlopers and even freeloaders taking hundreds of thousands of dollars from hard working physicians every year, while at the same time creating a testing scourge and impossible/onerous MOC requirements that destroy the physician base in our country.
There are no words for these ABMS/MD employees who do such a thing.
MOC and its impact on already critical physician shortages is a very important factor to consider. We are in a health crisis and any additional burdens will break the camels back.
The burgeoning array of demands from MOC to MACRA, plus all the other additional requirements and red tape on top of that, create a perfect storm for collapse of healthcare.
MOC is literally frigid spoiled molasses poured over physicians and their ability to work and see patients. Out of touch and financially burdened medical specialty boards' executives created MOC to sustain unsustainable and unacceptable payouts to themselves.
From another important angle ABMS insiders should know that MOC is a hot political potato; nobody in the profession wants it. It is burnout and meltdown for client who must pay dearly with time and money and perpetrators of MOC who want the revenue and control.
Only those who see personal profit from it are pushing for it. This is painfully clear.
Ultimately MOC is a brick tossed on/at a physician's already heavily laden backs. More than a bale of straw it will certainly by the laws of physics destroy the ABMS and its partners as they ignorantly and from greed obliterate the practice of medicine.
MOC is a betrayal of client and it is a betrayal of self.
The ABMS was created for its most highly trained, knowledgeable and skillful component - the physician specialist. And not the other way around. The ABMS was not created to self-perpetuate unreasonable inurement for conflicted medical politicians who sit in soft executive chairs at the ABMS doing less for education than they do for the bottom line. They all to often do this work for the "quality assurance/certification testing cartels while shilling and lobbying for healthcare industry giants sitting on their corporate boards.
The onus is on the state legislatures to remove the crippling burden of MOC by passing clear and decisive statutes that end the onerous assault of mandatory MOC on physicians and its unacceptable ties to insurance payments and a physicians right to work.
But even more important decisive legislation is needed to remove the patients' plight regarding their ability to be seen by their physician. MOC derides the patients' ultimate right to care.
Wes, the examples you gave are perfect examples of ABMS disinformation and fearmongering.
I believe most legislators are savvy enough to recognize Malarkey and strong arming when they read it or hear it. ABMS'BS has an unmistakable sour taste with a twist of larceny added in. You can feel in their careful choice of ABMS-speak the deceit being squeezed to the max and stirred in.
"Lobbyists from the American Board of Medical Specialties (ABMS) and the American Hospital Association (AHA) will claim 'the legislation puts patients at risk' and that 'patients deserve to know their physicians are up to date' even though this statement flies in the face of the ABMS's own data and that of independent researchers. They even have the nerve to make statements like this: 'Faced with a physician who was certified after residency who has not kept the certificate current, patients will be in the dark.'"
"The Framers of the Constitution knew very well that whenever and wherever democratic governments had failed, it was because the people had abdicated their responsibility as guardians of freedom. They also knew that whenever in history the people denied this responsibility, an authoritarian regime arose which eventually denied the people the right to govern themselves."
- John Whitehead, constitutional attorney
More Window dressing. Only partners who profit are chosen. Total sham commission.
MOCMOB: The new "commission" on MOC announced by the ABMS will be comprised of all ABMS member associates and financial/political partners. Here is another one of those organizations which will be on the commission. It is the Coalition for Physician Accountability, another newly formed ABMS creation/ABMS associate funded NGO that nobody needs. The ABMS and member organization created "CPA" in 2009 when the ABMS/ABIM and members felt particularly intense about the need to strong-arm/violate constitutional guarantees of physicians in order to maintain and strengthen their financial monopoly and political hammer. What the world needs now is not this kind of farcical MOC comedy show of greed and power, but more understanding of how to end MOC and create a united front to stop the ABMS and their cronies from harming physicians and patients ever again. In a world where ABMS executives and other NGO affiliate heads suck in the big bucks through their silver straw with a rate of increase that is unimaginable, it is high time that we have organizations that are essentially a Coalition for ABMS Accountability! Physicians have a surfeit of accountability, but the ABMS has none.
Read about this deceitful ABMS coalition and be prepared to feel your stomach turn somersaults.
The Coalition for Physician Accountability
"The Coalition’s membership is committed to identifying opportunities to enhance communication and coordination along the continuum of medical education, training and practice. Through the collective efforts of the Coalition, the membership will continue to seek to advance the quality and safety of patient care by providing a forum for dialogue among its membership about ways to enhance physician accountability in education and practice."
The Coalition for Physician Accountability is a membership organization that convenes on a regular basis to engage in discussion and collaboration on matters of common relevance to improve the quality of healthcare."
"The Coalition began in 2009 after the last Physician Accountability for Physician Competence Summit which was sponsored by the Robert Wood Johnson Foundation and the participating members, with staff support contributed by the Federation of State Medical Boards (FSMB). In 2010, the Coalition was reorganized into its current structure. The current membership consists of senior leadership and governance representatives from the Association of American Medical Colleges (AAMC), AACOM (American Association of Colleges of Osteopathic Medicine), American Board of Medical Specialties (ABMS), Accreditation Council for Continuing Medical Education (ACCME), Accreditation Council for Graduate Medical Education (ACGME), American Medical Association (AMA), American Osteopathic Association (AOA), Educational Commission for Foreign Medical Graduates (ECFMG®), Federation of State Medical Boards (FSMB), Liaison Committee on Medical Education (LCME), National Board of Medical Examiners® (NBME®), and the National Board of Osteopathic Medical Examiners (NBOME). In addition, the Joint Commission and the Council of Medical Specialty Societies (CMSS) serve as liaison members. The Coalition also appoints public members to its membership to ensure adequate representation of the public voice in the deliberations of the Coalition."
- © Coalition for Physician Accountability 2014-2016
ABMS: Racketeers trafficking in trade restraints involving a physician's right to work and a patient's right to care.
That is the diagnosis.
The prescription is statutory relief and a complete and thorough DOJ/IRS/OIG investigation of the ABMS umbrella, medical specialty boards and their illicit collaboration with it's numerous non-profit affiliated NGOs.
Many of the profiteering perps are named above in the newly announced commission on MOC.
Any rebranding of MOC to call it LLL (Lifelong Learning) is bound to fail. Not only is LLL just "lipstick on a pig", it is beating a dead horse.
Read about the push in 2009 by "the alliance for continuing medical education" and "others" with secret meetings held by the IOM and others with massive funding by the Macy Foundation.
Where was ABIM's CEO flying to every week on the physician's dime and what political agendas was the IOM darling lobbying for?
Cassel got first class travel paid by the ABIM. Let the public have access to the accounting records to see where ABIM executives travelled to and how much was spent for Cassel's commutes. Don't you just love the transparency and the ripe political context for MOC and LLL. MOC is a story of secrets, deceit and betrayal.
Did you know the ABIM purchased a very heavy duty shredder the year before Christine Cassel "re-registered" the American Board of Internal Medicine Foundation in 1999. I understand it must have been a real workhorse as it cost nearly $10,400. LOL on that transparency! How many million dollar bills were Hank, Harry, Lynn, Rich and Chris tucking into that big piggy? 80 million?
Were the ABMS member boards hiding their profits from the taxman? Certification prices among the specialty boards were way too high. It all looks like price fixing when you look at the huge payouts to the execs and boards. MOC became whipped cream on top of their huge profits.
What else did the ABIM do with their surfeit of cash besides personal wealth building?
They remodeled and expanded their offices. Ma$$ive amounts of cash on construction, computers, plush leather furniture. Surveillance equipment to protect their domain. Too much to list. They spent millions with all those extra millions.
The ABIM spent $80K investing in artwork the year before Cassel signed the ABIM Foundation's "fraudulent" paperwork in 1999.
We presume that art is still on someone's walls. (We aren't talking about the glasswork in the waiting area or historical photos.)
These people are a piece of work!
To say that MOC is a scam is an understatement when you look at the totality of their behavior.
ABIM/ABMS behavior is certainly not in line with a charitable non-profit or their professed values.
I came away discouraged after viewing the Medscape interview with the CEO/President of the ABIM and ABIM Foundation. Dr Baron has been with the organization too long, officially since 2001. When I review all that has occurred under his watch it is disheartening, because so much has worsened for physician and patient since that time. One thing that troubles me most is the fact that the ABIM/ABMS is now a house of collapsed trust. The cunning advancement of their lucrative MOC program is only a fraction of the disruption and chaos they have caused in medicine. The revolving door positions with the corporate, government, and non-governmental entities that many of them have held at the ABMS, including Rich, smacks of deep conflicts of interest. It is painfully clear after watching this highly scripted interview that the medical specialty boards and many of the corresponding societies do not want to give up the root cause of most of the problem. That root is the money involved in MOC and the products and services it generates with its pernicious and entangled root.
What is crystal clear in the interview is that Dr Baron is deeply conflicted inside, but continues with the masquerade party that all is well and that MOC as a mandate of deeply conflicted colluding partners has "value".
The only thing that is transparent about the ABMS is how they have deceived and betrayed their clients and the public for years.
The only thing that is seamless in their failing organization is how they continue to extract money from physician credit and debit accounts and from sitting on corporate boards or other self-dealing activities behind closed doors and too often in secret with profiting highly conflicted financial partners.
MOC is financially and politically driven along with so many of their other ABMS projects and agendas. It is improper and unnacceptable, and many would call what they do with MOC illegal.
I see disgust for the abuses and violatory acts of the ABMS growing daily.
Mandated MOC is quickly leading the collapse of the ABMS. It is negligent not to respond to this core reality and end it as the AMA body of responsible delegates so resolved.
Rich Baron as head of the flagship ABMS specialty board ABIM has not ever addressed the highly problematic partisan nature of the specialty board he administers and how scandalous status quo cronies keep getting aopointed to run ABIM. And not to forget the outrageeous methods they've used to politically control/strongarm physicians and coerce them into paying for services and products that they neither need or want.
I have never heard it said the the ABIM is an apolitical organization or that it boasts a non-partisan leadership.
Why is that?
The simple reason they are mum on such politically charged issues is the ABIM management is totally partisan and they instruct their political operatives not to draw attention to this fact or to themselves.
I have observed, and this may sound unbelievable, but the only Republican ever hired by ABIM was used as a pasty and fall guy.
Don't you just marvel at the sheer cunning and hypocrisy of the ABMS when they say they are listening How they are transforming. How illicit data collection in their apologies for "a bridge to far" is the only thing they ever got wrong. It is simply amazing how corrupt politicos and white collar criminals tend to get away with it all the time.
MOC mandates and use of tactical coercion is not only a bridge to far, it is a road to nowhere that leads to the abyss of error and the deep chasm that only divudes.
This was written by the Washington Post in 2005....
"Unfortunately, we have no precise way to gauge the revenue impact of these issues," Everson said, though he noted that the nonprofit sector, including pension plans and the like, now totals roughly 3 million entities controlling $8 trillion in assets.
"It's a seminal letter that rips off the rose-colored glasses with which we usually look at tax-exempt organizations," Senate Finance Chairman Charles E. Grassley (R-Iowa) said yesterday. "What's going on isn't a pretty picture in the harsh light."
When will Congress and the IRS look into the ABIM tax abuse? Their overhead is 77cents on the dollar....any business with a 77% overhead margin immediately goes out of business.
Hey, "Non Profit Tax Abuse":
I wonder how many physicians or members of the public at large have rose-colored glasses about the ABMS or their close-knit corporate partners, underling societies, and elite masters.
Let's dispel the myth about the public having any opinion about the ABMS. The public do not even know the ABMS exists. Physicians know of the ABMS first as a slowly-growing number through voluntary participation in certification, and now a majority of physicians through corporate mandate and regulatory capture.
Let's take the rose tinted glasses off and look at the ABIM/ABMS. It is abusing the tax structure like other cheaters who refuse to pay their part of the ten-trillion dollar tax-exempt industry's tax boon. They are not a charity as they do zip for the community of Philly or states of Pennsylvania and Iowa.
Any time the CEO has an interview he tells obvious lies. For example, when Kurt Eichenwald quizzed ABIM about tax forms. Lie after lie. Obfuscation after obfuscation. Recently Dr. Baron said that they had no access to capital markets. He was justifying laundering 70+ million dollars into the ABIM Foundation saying that they needed the money for lean times as they have no access to the capital markets. What a blatant fib.
Take the American Association of Medical Colleges (one of the ABMS partners), they got over a hundred million dollars from bond issuance for real estate purchases and to lease some of that space out to partner organizations. AAMC even acted as piggy bank for the former president. A hefty amount of money loaned out totaling over a million dollars. Money that he never even paid back as far as we understand.
The president of the AAMC also made good use of that bond issuance to hike their executive incomes. If Dr. Baron doubts this he can talk to the CEO of the ABMS, Lois Nora, who served on the AAMC board during the former presidents long tenure. Nora knew the finances intimately. She was required to sign off on them. Go to Pro-Publica's nonprofit explorer and examine the AAMC tax records for yourself.
Another example of capital markets issuing bonds to these non-profit ABMS affilited boards, associations or societies is the American College of Obstetrics and Gynecology. They got millions in preferential low interest tax exempt bonds. Higher compensation for executives ensued.
Perhaps what Dr. Baron meant to say was that the capital markets have access to the ABIM as the Chief Medical Officer is not a practicing doctor, but a PriceWaterhouse Coopers Wall Street type for decades. What a scam to call a financial broker a CMO at ABIM.
Also the captial markets have access to the ABMS through their financial folks and merger and acquisition advisors. Ask for a complete list of the people who are employed or on contract with the ABMS umbrella. Anyone with rose-colored glasses will take them off quickly.
Speaking of private equity and corporate influence at the ABMS here is the egregiously conflicted "planning dean" speaking about Kaiser Permanente's new "start-up" medical school going straight to virtual reality and holistic medicine . . . right out of the box!
KP presents longtime KP/Washington DC insider Christine Cassel: impacting the future of the national healthcare system
Next step, ACGME-approved holographic physicians using AI and tele-medicine by the year 2030?
The new KP medical educational model is: "just you and your personal life coach in a world that transcends burnout and depression."
Bring your yoga mat to the roof yoga garden here in Passadena and meditate on your future, while your holographic understudy completes the learning for you.
We at KP are eliminating the burden of seeing a physician, bringing down healthcare costs while we improve medical education on a global scale.
Robert M. Wachter and IPC, The Hospitalist Company/UCSF Scandal Timeline
As Dr. Fisher mentioned above Bob Wachter's self-dealing practices in the corporate world are a large story and almost too complex to follow. Wachter's company IPC, that he was advisor and safety chairman for/to, was confronted with billing fraud by the DOJ in conjunction with the OIG of the HHS and other federal agencies investigating officially in 2014. Patients, the federal government and the taxpayer were systematically overcharged by Wachter's company's hospitalists, whose leaders Wachter helped train and even was commissioned to advise.
Up-coding was encouraged by IPC management and even rewarded by IPC management at the expense of Medicare, Medicaid and other federal reimbursement programs.
According to testimony it was conscious and deliberate and systematically practiced. Emails from the company coached on how not to draw attention to this practice and trigger an audit.
Wachter was very intimate with the innovative software that monitored the physicians and patients. IPC was billing in some instances for an hours work when only five minutes of patient time was recorded by their system.
According to the DOJ documents and the whistle blower, IPC management "pressurized" the hospitalists employed with Bob's company to have a superhuman ability to see lots of patients in a day and after a few months on the job most of their patients would be billed at higher levels of reimbursement. IPC physicians in the DOJ complaint saw up to 56 patients in a day.
Patients were treated by Adam Singer's/Wachter's company hospitalists working as contractors to hospitals all over the country. The up-coding was documented from 2003 onward "and continuing today" according to the landmark DOJ billing fraud case. The federal government did not pursue any patient harm that might have occurred resulting from what many victims claim was a deviation from safety standards while IPC hospitalists up-coded their documentation, thus cheating the federal government and taxpayer out of millions of dollars.
Robert Wachter's involvement in the corporate deceit and fraud was concurrent with the timeline of the DOJ's 2014 claims.
Here is the timeline and story according to the public record of Robert M. Wacther/IPC The Hospitalist Co./Adam Singer/UCSF/ABIM/ABMS and the brewing scandal leading up to the DOJ filing a lawsuit claiming Medicare Fraud in federal court. (Chicago)
Wachter first met Singer in 1996. Wachter got more interested in IPC and Singer after the IPO (stock shares were offered to the public) and the company showed steady stock growth. Bob understood very well the lucrative co. shares were given to directors and management. He was privy to discussions/plans to sell the company to he highest bidder, thus making the shares even more attractive and unloading the liability of the whistle-blower lawsuit filed in 2009 that was taken over by the feds in 2013.
"IPC The Hospitalist Company Partners with UCSF To Create Leadership Program in Hospital Medicine July 23, 2010" [Before being appoined as IPC's board as safety chairman, Robert Wachter was a paid advisor to IPC and also represented UCSF. Dr. Wachter was under federal contract with AHRQ. ]
Robert Wachter Named Chair of ABIM's Board of Directors, July 06, 2012
Robert Wacther and IPC billing fraud scandal continued (Wachter was ABIM Chairman, Trustee, Director, ABIM 20-20 MOC commission)
Robert M. Wachter, [appointed} Safety Chairman of IPC, The Hospitalist Company August 1, 2013
Dr. Wachter noted, “My entire career has been focused on improving the quality, safety, and efficiency of the care we deliver to our patients. This mission has never been more important than it is today, and hospitalists must be at its cutting edge. For the past several years, my UCSF colleagues and I have collaborated with IPC to deliver a world-class training program to the Company’s emerging leaders, and I have been impressed by the organization’s steadfast commitment to improvement. IPC’s 1,400 hospitalists now have more than 6 million patient encounters each year – about 16,000 each day – in hospitals and post-acute care facilities throughout the country. Joining IPC’s board of directors provides me an unmatched opportunity to help shape the future of healthcare – to make things better for patients, for physicians, and for the healthcare system. I look forward to doing what I can to help the company reach its full potential.”
ABIM Foundation Announces New Members of Board of Trustees, July 1, 2014
U.S. Files Lawsuit Against IPC The Hospitalist Company, Alleges Overbilling Of Federal Health Insurers For Physician Services
More ABIM Tax Omi$$ions
Transparency and genuine communication appear to not be within ABIM's ability, even though the former chief of staff Suzanne Biemiller claims to have transformed the organization "from
an authority based model to one that actively engages its community with project design AND A SHIFT IN HOW IT COMMUNICATED WITH ITS STAKEHOLDERS."
In her own words:
"Biemiller worked as the Chief of Staff at the American Board of Internal Medicine (ABIM), a $56 million national nonprofit organization. As the ABIM’s “internal CEO,” she executed the organization’s new strategic stance, moving ABIM from an authority-based model to one that actively engages its community in program design. She also led a shift in how ABIM communicated to its varied stakeholders."
Who are the stakeholders and who comprises that community? It is as vague as it can be what all this means to an 81 year old crafty ogre identified with golden harps and gold-laying geese to ensnare in his lair.
Here's the big rub. It's all fable. The tax forms are a myth of loss and deferred income that is impossible fathom.
Are we expected to really believe that the big bad bully on ckoud bLock #9 has really changed? Or even could? Not in your life.
Communication? What a joke. When Biemiller left the ABIM in 12/16 the CEO did not even thank her publicly for over two years of hard labor getting the big MOC bully to grasp the principles of communication and community.
And let's also mention that CFO kept her compensation unknown for the first tax year until someone on this blog squawked about it. Nkanta Hines the VP of operations hired at the same time was included in the tax forms, but not Beimmiller. Why?
The answer to the question of why is that even though the AMA HOD voted to end MOC immediately and the new ABMS CEO is coming back to the ABMS from the AMA, the ogre is still deaf to real change.
Will the new ABMS CEO listen any better? Or do the AMA delegates have no more voice than the majority of ABMS certified physicians who oppose the abuses of being chained to ABMS MOC.
MOC is coerced funding from physicians which goes to pay for executive profligacy, politicized agendas and patent negligence. MOC needs to end.
Let's examine the problem of the ABIM/ABMS and money.
How much do executives and officers pay themselves at the ABIM? Way too much for a nonprofit charity that used to be run by an all-volunteer group of practicing and academic physicians from the AMA and ACP.
It is incredible to see how far these organizations have fallen.
Let's see why they force MOC on physicians.
It is clear when we analyze earnings and compensation for executive and employees at the ABIM. We don't even know how much they spend in first class travel conducting political business on the side. They won't release the figures and activities list. Just like they would not show us who stayed at the luxury condo with the multi-million dollar view overlooking the parks and Philly skyline.
Look at the black and white pie chart in the pdf (link above) regarding ABIM's revenues.
Total revenues in the most recent tax filings (mid yr. 2015-16) were $55,571,566.
MOC's proceeds as charted are 45% of all ABIM revenues. How much money is that?
According to tax documents, ABIM MOC brought in through coercive methods to this nonprofit charity $24,258,526.
Let's look at how much this nonprofit organization hands out to its ABIM version 2.0 "volunteers" who run this medical testing charity (domiciled in Iowa and operating as a foreign agent in Pennsylvania).
According to the most recent tax documents ABIM version 2.0 pays out $31,326,434 to its executives and their employees. That was an increase of (-$1,441,341) over the previous year's payout even though there was a decline in total revenue of (-$2,049,001) from the year before.
Now we see where all of the MOC money goes. To pay these "volunteers" and their contractors.
In most companies' the directors would call an emergency meeting and might suggest a cut in pay for the executives and other highly paid officers of the company. But it appears no such fiduciary responsibility exists at the ABIM.
And it gets worse. I am not going to harp on their increase in losses of roughly $7 million in net assets over the previous year or what the baffling negative numbers on their net assets with minuses year after year mean.
The most recent negative asset balance was (-$57,568,474). One can only defer to a forensic tax auditor as to what these staggering losses in the millions might mean for this company's balance sheet and prospects going forward. Is it a going concern? The CEO says they are on solid footing financially, but it appears that they are doing quite a lot of hobbling.
Additionally, one must mention that ABIM's total expenses were $62,512,167 for the recently reported fiscal year ending in mid 2016. Their total revenue remember was $55,571,566. That's an incredible operating loss of (-$6,940,601).
It is clear from a CFO's perspective that the company is bleeding. I would not be surprised if Mr Mandes (CFO) is quietly looking for other employment like so many others who come and go at the ABIM. Many were tired of harming physicians with a sham economic scam called MOC.
The financial numbers are a mess and they bury their heads in the sand chasing MOC revenues hoping, hoping, hoping that they can keep their "windmill finances" turning and prevent the organization from falling to the ground at the speed of gravity.
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