Monday, October 30, 2017

ABIM Foundation - Five Years Later

A new public relations push for the ABIM Foundation and its Choosing Wisely campaign recently circulated in the press and MedPageToday. This quote from Richard Baron, MD, president of the American Board of Internal Medicine (ABIM) and the ABIM Foundation (which created and promoted the "Choosing Wisely" campaign) caught my eye:
"Here we are 5 years later; today, 80 [medical] societies have lent their intellectual capital to thinking about this," Baron said. "How do we judge success? We go back to the idea that this is about supporting people having difficult conversations ... [and] health systems around the country are using this as a structure to have these conversations."
Health care organizations ARE using this as a structure to have these conversations. In fact, as has been systematically uncovered in this blog and elsewhere, the ABIM Foundation has spend the last five years spending our secretly funneled testing fees for themselves. Look at the data, pulled from IRS tax forms by Mr. Charles P. Kroll, to understand the magnitude of what has occurred:
While few can argue with the well-meaning effort to limit procedural overuse in medicine, but using physicians' testing fees to promote this program and to line its supporter's pockets without earning any program revenue could be one of the largest white-collar medical education Ponzi schemes (as Elizabeth Rosenthal, formerly from the New York Times, suggested) in the history of US medicine.



Ed Rico said...

Congratulations, Dr. Oblivious. A key reason that conversations regarding ABIM/ABIMF are difficult is because you promise "the opportunity to respond fully, accurately and transparently" while actually delaying, denying and obfuscating the truth, which is becoming painfully obvious to anyone even peripherally associated with ABIM. Hint: When someone asks you for information consistent with your fiduciary responsibility to Diplomates and taxpayers, the answer "See the website, we'll fully transparent" is not acceptable.

I believe you'll find, when the music finally stops at ABIM HQ, that the way ABIM Diplomates judge success is somewhat different than your view from Walnut St.

Anonymous said...

I'd like to know what the legal definition is of "having a conversation", when that "conversation" concerns alleged voluntary cost rationing. Choosing Wisely was an integral, yet undocumented, part of the Affordable Care Act. It comes as no surprise that all things once voluntary, and now mandated through trade restraints, such as MOC, comes from many of the same authors of Obama's team of health strategists who all got opportunistically rich in the health markets. Choosing Wisely was designed as a branch program of the ACA providing economic relief to their secretive, costly and highly subsidized health reform legislation, known as the PPACA. Don't read it, just sign it. The big trouble with the ACA is they let the insurance companies write most of it to benefit themselves.

They make money during its implementation and they profit as it fails.

Is MOC a "conversation" for physicians or a means of exploitation. There is only the latter and highly crafted public relations messages and clandestine lobbying that comprises their "conversation". Choosing Wisely has a murky provenance imo. It is not a transparent discussion as it is an authoritarian model imposed on physicians and patients. Neither are allowed to understand the backroom politics, just as we saw with MOC and the inclusion in the ACA. Just as we see with the authoritarian model of MACRA. You must do these things or you will not work.

Choosing Wisely smacks with the same taste in my mouth. It is a non-conversation, because there is no conversation with those same people who laundered our money behind our backs. Conversation must have trust at its core. Or it is not a conversation.

Cassel wise dollar foolish said...

Given Christine Cassel's proven track record for egregious conflicts of interest the "choosing wisely" campaign, launched during her ABIM Foundation presidency, should be renamed the "cheating wisely" campaign in her honor.

There is a saying in Britain, "penny wise and pound foolish". Cassel squandered millions of pounds (dollars) while at the ABIM and ABIM Foundation; at the same time she lavished herself with millions in compensation and a prepared a nice golden parachute and left the organization embroiled in financial, political and legal scandal.

Cassel spared no expense for herself in terms of a luxury condo, chauffeur, expensive Four Season Hotel retreats, Dana Point sun tans, massages and walks on the CA beaches. She flew her husband around the US with first class companion travel racking up free travel on the million miler programs for herself and husband. She spent millions more taking an Uzi to the US constitution when she launched her black ops mission against privacy and the fourteenth amendment. Chris Castle and Rich Baron made a lot of people suffer by making them pay her terror ransom for no purpose other than to show how Cassel and the other ABIM corporate moles, hired goons and unscrupulous army of attorneys could abuse power.

Chris (and Rich), next time, write a letter, lick the damn stamp and do some real work for a change. You will cost physicians, patients, and taxpayer a lot less money.

How can you trust a conversation about "choosing wisely" when you simply cannot trust the orginators of the campaign.

Priceless said...

How do we measure success? (

You create a thing veneer of nice sound words about patient safety. Then you shellac it with and opaque verbosity about quality measurement. You franchise it, include associates as ambitious and corrupt as you, and then copyright and trademark the whole thing.

To run the enterprise you appoint highly groomed executives and staff who have marketing savvy and cunning business acumen for schmoozing, lying, and smiling through their teeth while they rob you blind.

You also hire as many ambitious professional politicians, entrepreneurs and lobbyists as you can to create, infiltrate and populate as many foundations, quality assurance corporations and accreditation organizations as possible. Plus you float the same insiders from organization to organization to keep the money in the family and political bloodlines pure.

Then you create and ever-evolving and expanding measurement, ranking and scoring systems, like Leapfrog, to make the next financial and political leaps for you, the industry and the elites who run the show. (Leapfrog 2009)

Once you are "in", you can recommend that they "scrub the hub" and everything else with a ChloraPrep-like solution. (Or whatever benefits the highest-bidding stakeholder at the time.) Your name, Charles Denham and your organization TMIT, for example, can appear throughout the NQF quality measures, where you have a seat on the Safe Practices Committee. Of course, with half the citations dedicated to you and your evidence-based recommendations, it does not hurt that most of the measures around infections will benefit your company Health Care Concepts (HCC) and the company it serves. Carefusion/Cardinal Health. Pages 265 - 281

ABIM Foxes in the NQF Henhouse said...

ABIM Chairman Robert Wachter was Tapped in early 2014 to Audit NQF's 2010 Quality Measures in Light of the CareFusion / Charles Denham Kickback Scandal.

They utilized reviews and guidelines from the AHRQ and CDC. (Robert Wachter is principal editor for the AHRQ.)

Placing an ABIM CEO in charge of the NQF is a serious conflict of interest, but in light of Christine Cassel's other conflicts it is a wonder that she was not indicted. And to place her ABIM fixit fox Robert Wacther to audit the CareFusion kickback allegations is utterly corrupt to the point of plunging the ABIM and NQF into two of the most untrustworthy organizations.

"Audit of 2010 Safe Practices for Better Healthcare
TO: NQF Members
FR: NQF Staff
RE: Request for Comment: Audit of 2010 Safe Practices for Better Healthcare
DA: March 31, 2014"

The National Quality Forum (NQF) is committed to providing accurate, unbiased, evidencebased
recommendations to improve the health and safety of patients. The Safe Practices for
Better Healthcare reports (2003, 2006, 2009 and 2010) have served as important resources for
more than a decade to help prevent adverse healthcare events, a leading cause of injury and
death in the United States.
As NQF committed to in its February 27 report, NQF Safe Practices and Related Processes, a
comprehensive audit of the 2010 Safe Practices for Better Healthcare was conducted.
The purpose of the audit was twofold:
• to assess whether the 2010 report included reference to any commercial product or
service, explicit or implicit;
• to assess the currency of the 2010 Safe Practices, in light of the four years that have
passed since they were last updated."

The audit of the 2010 Safe Practices for Better Healthcare is an objective, systematic and critical analysis of the evidentiary base underlying each of the report’s 34 safe practices. The audit was guided by explicit criteria to ensure consistency across internal and external reviewers. The audit relied heavily on recent systematic reviews and guidelines from the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Disease Control and Prevention (CDC). NQF convened eight nationally and internationally known health care safety experts, including key federal partners, as an Expert Advisory Panel to conduct the audit.
Audit criteria were developed to assess the benefit, specificity, evidence of effectiveness,
generalizability, and readiness for use, as well as absence of implicit or explicit product or service endorsement of the 34 NQF-endorsed safe practices.
The three-part audit process included internal review by staff, external review by an Expert
Advisory Panel, and member and public comment. The audit report is included as redlined
recommendations, updated reference citations, and comments that have been inserted into the
attached Table 1. As a result of this audit, the safe practices have been updated to reflect
current evidence.

The audited practices are now submitted to NQF members and the public for review and
comment. At the conclusion of this audit process, NQF will consider what are the most
appropriate next steps to take to continue providing the US healthcare community with Safe
Practices for Better Healthcare.
Action Requested
NQF members and the public are asked to review and comment on the audited Table 1
during the 15-day period from April 1 through April 15, 2014 at 6 p.m. EDT. The
comments will become part of the information that informs next steps for the Safe
Comments must be submitted using the Safe Practices commenting tool at
Please note that the comment period closes on April 15, 2014 at 6:00 pm EDT"

Anonymous said...

Safe Practices Audit (link)