Saturday, March 31, 2018

AOA Agrees to Settle Antitrust Claims

According to the court docket, the American Osteopathic Association (AOA) is in talks to settle the anti-trust claim (Case 1:2016cv04644) made against it on August 1, 2016, by four osteopathic physicians. The terms of the settlement are still being negotiated, but the case has been dismissed on an administrative basis without prejudice. Perhaps the evidence of the AOA President's address in July 2017 that attempted to spin the benefits of decoupling AOA membership to certification and the evidence that the AOA stood to lose over $1M in revenue each year as a result of the decoupling made it clear to all that the AOA was caught with their hand in the regulatory capture cookie jar.

US Doctors of Osteopathy deserve to have the terms of the settlement disclosed publicly.



Chiquita said...

I love the part below that you can voluntarily suspend your right to board certification if you choose not to participate in OCC.

I don't see the decoupling of certification/OCC and membership yet. When, if ever, will they do that?

If they ended OCC they could boost that interest in AOA certification to nearly 100%.

The ACGME would never allow them to have an independent policy.

Nor would the monopolies and juntas (corporations and special interests) in charge of it all allow the AOA to break out.

That state legislatures are going to have to get tough and pass comprehensive anti-MOC anti-restraint of trade legislative relief in all 50 states and territories. Outside the US nobody is required to do MOC or OCC. Soon physicians will be free of this bane and menace to public health.

"What is OCC?%
Osteopathic Continuous Certification (OCC) is a process through which board certified DOs maintain current status and demonstrate competency in their specialty area. The goals for OCC are to provide certified physicians with a process to continually assess and improve their skills and to assure patients and the public that certified physicians are being assessed through reliable and valid measures. Learn more and get details on the five components of OCC.

Who is required to participate in OCC?
All diplomates with time-limited certification are required to participate in Osteopathic Continuous Certification (OCC).

Will I remain certified if I don’t participate in OCC?
By choosing not to participate in Osteopathic Continuous Certification (OCC), you are voluntarily suspending the rights to your board certification.

Who has the option of participating in OCC?
If you have a non-time-limited certification, you are not required to participate in Osteopathic Continuous Certification (OCC) at this time; however, you are strongly encouraged to participate. The Federation of State Medical Boards (FSMB) has agreed to accept OCC for Maintenance of Licensure (MOL). If you do not participate in OCC, you may have additional requirements for MOL as prescribed by the state(s) where you are licensed. Diplomates with non-time-limited certificates will still be required to maintain their license to practice and to maintain AOA membership, including meeting all CME requirements for their specialty."

Elliot said...

The settlement should be public imo. Likewise I'd like to see the settlement of the ABIM with Rajendr Arora. Arora never had a chance to properly defend himself. What the ABIM did to Dr. Salas Rushford was unconscienable as well. Plus, I'm still asking myslef why there was a gag on the Benjamin Mannes deposition (ABIM Director of Investigations), when all other depositions were made public.

What is going on with these medical boards? Are they as corrupted and money-grubbing as they appear to be? How many more revelations of the graft do we have to bear before the quality assurance cartel is cleaned up and some of the cabal members are sanctioned, placed behind bars and fined?

I've really had it. There is no place for such corruption in charitable non-profit organiztions that should be comprised of ordinary decent people donating their spare time and not thugs and corporate shills making a market out of the medical boards and societies via MOC/OCC. They are abusing all just for themselves and the industry.

Their is no place in medicine for such larceny as we are witnessing today. Patients lives and welfare are on the line. It keeps going on and on. It's like we are forced to live through Godfather I, II, III, IV where we are the victims of this protectionist racket. If one prefers less harsh words to describe the intolerable situation than racketeering, we can call it a form of prostitution.

Executives, board directors and officers holding up a thin facade of prestige have sold themselves out for obscene amounts of money. Over and over we see many of the same faces making clandestine deals and appointments working for their corporate pimps in the healthcare industry. We see them taking advantage of shadowy political networks and webs consisting of a cartel of societies, NGOs and foundations.

If it really is about self-regulation, then physicians must step up and work with their legislators to clean it up and make sure the safeguards and checks and balances are put back in place. Bylaws have been gutted and completely rewritten to allow for unlimitied conflicts and dualities of interest, and the suffering that has resulted for patients and physicians can no longer be tolerated or ignored.

Anonymous said...

We'll see what they work out . . . if they can agree . . .


"The Court noting the parties are currently working towards
a resolution of the case; and the Court noting that while this
is occurring the litigation is stayed; and good cause existing
for the entry of this Order,
IT IS HEREBY ORDERED this 14th day of March, 2018, that the
Clerk of the Court shall administratively terminate this action
without prejudice to the right of the parties to move to reopen
the proceedings by written request to the Court. Thereafter, the
case will be restored to the active docket."

- United States Magistrate Judge

Anonymous said...

By looking at the settlement, it looks like the case can be reopened by written request. Keep the heat up on them!! In reading that the AOA is losing money to the competition of the ABIM, is there a way to persuade the AOA to drop their requirements for continuing education except CME's and make them more desirable for DO's to be board certified with the AOA thereby weakening the financial grips of the ABIM as long as insurance carriers and hospitals recognize them. This should allow for more competition such as the NBPAS to become more competitive. This may force the ABIM and the ABMS to prove if they are the so called "gold standard" I am sure they would not to do that in a public forum as they know they would be skewered. Keep the heat up!!

Anonymous said...

The 2018 Annual Meeting of the AMA House of Delegates (HOD) is June 9-13 at the Hyatt Regency Chicago in Chicago, Illinois. Officials and members will gather in Chicago for the AMA Annual Meeting to elect officers and address policy.

I know the survey on how physicians view MOC will be presented. Will someone ask why is the ABIM/ABMS going against the wishes of the working doctors who pay for these oligarchs? Is there anyone who is a delegate or a speaker who will help address the AMA on the issues of MOC and pin them down on what they are going to do? Will anyone who is going, address the obstructionists who are colluding with the ABIM/ABMS in a public forum? Will any one address why the ABIM has not released their taxes and force the ABIM to talk about why the finances are draining like a sieve and how the executives are lavishly paid? Will someone ask the ABIM why they feel entitled to be the so called gatekeepers of self regulation? Ask them how they can push MOC without any phase 3 evidence that there is good for patients and physicians? Ask them on the known evidence that MOC interferes with patient access, care and that there have been individuals who have been harmed by this? If this was a drug or procedure with this knowledge the FDA would have rescinded these treatments.

Ask them do they think Dr. Richard Baron, Dr, Christine Cassel or Dr. Robert Wachter with their checkered pasts and transgressions are more qualified than Dr. Paul Teirstein and the NBPAS? I would love one of them to debate him. Dr. Nora tried and was too scared to put her side of the debate in the California legislature on you tube.

Hopefully Dr. David Johnson will debate Carlos J Cardenas, MD, President of the Texas Medial Association, and Bradley D. Freeman, MD.

Have the state medical societies be there and representatives from the each states medical boards be there. Invite the IRS and DOJ.

"So through the night rode Paul Revere;
And so through the night went his cry of alarm
To every Middlesex village and farm,--
A cry of defiance, and not of fear,
A voice in the darkness, a knock at the door,
And a word that shall echo forevermore!
For, borne on the night-wind of the Past,
Through all our history, to the last,
In the hour of darkness and peril and need,
The people will waken and listen to hear
The hurrying hoof-beats of that steed,
And the midnight message of Paul Revere."

Liesell said...

MOC and OCC are just so yesterday. The ABMS and AOA are just not keeping up. Time for MOC and OCC to go away.

Chelsea said...

The ABMS is a billion dollar bully with a dangerous weapon in its hands.

We need serious anti-MOC legislation to protect physicians and patients.

It's time for MOC to end as the AMA House of Delegates resolved.

Sweet Plenty (for them but less for me) said...

If the ABMS is all about self-regulation why don't they allow us (the real self) to nominate and vote on the board members?
And how about giving us electronic access to any documents, emails and files that we need to inform ourselves for good self-governance.

Now THAT would be a step in the right direction of having real "self-regulation".

In the abscence of transparency and because the ABMS fortifies itself from having any outside scrutiny and participation (other than its own designates), perhaps we can request camcorders to be placed everwhere at the ABMS and medical specialty boards so we can keep an eagle eye on them and their shenanigans.

How about body cams for their country club business meetings, lobbying activities, legal and financial consultaions? What about letting us listen in on the chats with healthcare industry executives, grants writers, and political cronies.

What if we could access all their files and financial documents and really knew what they were doing?

If the past is an indication of the future, which it typically is, I suspect the ABMS and their corrupt partners are only looking to do more of the same. Pocketing lots of money to increase their personal wealth and political power and adding to the ABMS' investments and real estate holdings.

The ABMS and their cronies are positioning the same revolvers to consolidate and merge companies and personel in order to maintain control.

Shuffling some of their corporate backed politicos from the AMA, ACP to the ABMS and ACGME. And round and round the shell game goes. In what ever direction the current financil or political wind blows.

SotoVoce said...

Who blocks an investigation of the collusion involved in maintaining ABMS MOC?
OCC and MOC are part of a broad-based educational Ponzi scheme defrauding physicians and the public out of billions of dollars and diminishing access to healthcare.

Anonymous said...

Where is the voice for practicing physicians and patients today? It is ironic how the memberhsip societies speak for the industry and not the physicians or patients anymore.

Principlals of Restraint of Trade said...

The FSMB is another bully profiting from collusion in the restraint of trade.
Lots of clam shells in the interstate chowder with the ABMS, ECFMG, ACGME, NBME and AMA.


Statistical Anomalies That Don't Add Up said...

Match day for Qatar's Weil-Cornell Medicine graduates of 2016

How does an advertised 90% match rate - 19 out of 21 medical school graduates - applying to prestigious US medical programs equate to anything other than a 42% overall match rate for Qatar (or another country) because there were actually 33 graduating medical doctors?

Where did the remaining 14 graduating doctors go? Are stellar US matches and statistics going to solve Qatar's physician shortages? What is the mission of WCM-Qatar when they appear to be exporting so much of their talent to the States?

Standing up to fight MOC said...

The corporatized fascist boards of America and the nose ring of the FSMB

Has the FSMB become too overbearing, aggressive and arrogant? Why have they bought a mulitmillion dollar property from the Coumbian government in Washington DC. How did they swing that deal. Who has that kind of money to toss around?

Does this make the FSMB a full -fledged member of the ABMS/ACGME/JCI international junta?

70 Boards. One Mission.
FSMB supports America’s state medical boards in licensing, disciplining and regulating physicians and other healthcare professionals. Our end goal: keep patients safe."

Why does the FSMB leadership feel the urge for international travel and adventurism in patient safety circles when there is plenty of opportunity to focus on the suffering here in America from a lack of physicians to provide medical care and a bureaucratic bottleneck which the FSMB and ABMS are co-creators in.

More executive largess? Another example of an appointed shill for the medical industrial complex thrusting poltical agendas on the states and the world that appear disingenous and megalomaniacal?

There are a lot of reasons why physicians and patients abhor the FSMB. It's not engaged in patient safety; none of the nongovernmenatal regulatory propagandists care at all about the public. If they talk about patient safety, it's just a fancy breeze coming off the sides of their mouths. The FSMB and their close affiliates are all about grabbing more money and getting their chakras turning and fired up spinning elitist political theories and expounding adventurist policies for the US globalist corporate agenda.

Not bad if you own stock, but not good for the poor patient and their humble providers.
Another organization throwing bags of kittens off the bridge in the dark, while preaching humanity and egalistarian philosophy. Who pays them to be such ruthless asses?

The AOA could stand up to the FSMB about MOC and the licensure games the FSMB plays, but they don't. That's an opportunity for someone to stand on the side of the patient and physician taking a moral lead and not the typical monetized politicized lead.

Mythos of ABMS MOC studies: an analogue said...

Myths about population health and research grants - who pays and who does the study determines the outcomes. What we can learn from the Qatar experiment in population health.

As it is with fairy tales, so it is with research studies in population health, whether funded by the RWJF or Qatar Foundation. It is easier to see the paradigm/analogue when the suffering protaginists live in a distant far-off land from long ago.

This attached population study is the same type of "research" that the ABMS or ABIM Foundation does. In this present case, we present a study from 2013 on migrant workers and their effect of health statistics. What WCM-Qatar did was hire one of their employees, government funded, of course, and you get your sponsoring foundation, also government funded, to pay for a study to overlook 88% of the findings, which they even admit are left out due to limitations of the study. In other words they could only study the citizens.

In such a study you cherry pick your way to a perfect bag of cherries leading to the conclusion that the state of the country's health is good. Or in the case of the ABIM you get your employees and the sponsoring foundation that has one of your own appointees in place for over the past fifteen years to state that MOC makes better docs.

Or jumping back to the referenced case of Qatar's PH you make 12% of the inhabitants glow with health and longevity while you conduct social research on 1000 cherry-picked migrant workers living in the beset labor camps, who work in Qatar primarily to send money home to third world and developing countries to support their families. These are primarily males who do not give birth to children or stay working into old age if they live that long.
Like many workers they may find it difficult to take time off (long hours) to go to their designated medical center miles away or get to the health truck.

"Demographic and health indicators in Gulf Cooperation Council nations with an emphasis on Qatar

The high migrant stock in Qatar makes comparison difficult within the GCC nations and other countries around the world. For example, the annual growth rate in Qatar seems to be more influenced by financial and industrial factors than by demographic factors such as birth and death rates. For example, a large scale project (such as the Asian Games in 2005 in Qatar) caused a spike in population figures.
On the other hand, the financial crisis of 2008 had the opposite effect on population in the UAE, which also has a very high migrant stock, causing a decline in its population numbers in the years that followed.
Migrant workers in Qatar have a unique profile: most of them are young to middle-aged male adults, single and with low education level. 5 This migrant stock can alter the demographic balance in the country, whether its gender with a 3:1 male to female ratio, or age profile with very low percentages of population under 15 and over 65 years. This can also impact other demographic indicators, birth rate, fertility rates, crude death rate, and possibly adult mortality rate, to name a few. These statistics require an extensive evaluation that is beyond the scope of this paper. Additionally, specific information on migrant worker demographics will be helpful to draw meaningful conclusions.

This work is supported by the Biomedical Research Program funds at Weill Cornell Medical College in Qatar, a program funded by Qatar Foundation."

Anonymous said...

Nothing wrong with wanting MOC (OCC) off our backs.

JasperB said...

The end is near for MOC.

Anonymous said...

Whenever power is concentrated in the hands of a few it is a recipe for disaster.

The power that is concentrated in the ABMS' hands along with its partner organizations is not only a recipe for disaster, the situation is far worse.

We have ABMS member boards refusing to investigate and sanction its own executivies. There have been clear examples of those within the organization and even entire ABMS member boards have clearly displayed and continue to display behavior unbecoming of physicians. These organizations, their executives, and boards of directors have displayed behavior not in keeping with professional values. Some allege there have been violations of rights that have transgressed American laws, constitional rights, privacy and kicked to the wayside the commonly held values of decency. Honesty, financial responsibility, transparency, and responsiveness to those who pay for the huge executive overhead is a thing of the past. The far distant past as they have consolidated power and made business deals that have nothing to do with patient safety or physician accounatability. In short the ABMS and many of its partners have placed themselves beyond reach and consider themselves to be unaccountable.

Checks and balances have been replaced with concentrated power where executives control the purse strings and political agenda with a board of directors and officers, many of whom have taken every opportunity to display their conflicts of interest to the public which they have betrayed. Examples abound. Read this blog and do your own research by reading SEC filings and news reports of the harm that has resulted from such exceptional examples of profligacy and immorality.

We have seen egregious conflicts of interest ignored with great sums of money involved passing between the industry and ABMS executives. We hear over and over of them receiving outrageous sums of money from corporations that directly benefit from the ABMS executives' position and political rank and reputation. We have seen unbelievable abuses of power and oeverreach. Ignored by our government officials and agencies. Mmember boards with submissive and even energetic directors have participated in what we can only call crimes. MOC as a Ponzi scheme is a criminal enterprise that has not yet been investigated by our DOJ, IRS and no congressional committee has looked into it as far as I know.

It is an odd and peculiear travesty that there has been no investigations of these abusers and ethical violators.

It is no surprise that there have been no suspensions/revocations of certifications involving their own people at the executive level and on down for every kind of wrongdoing. We have seen entire boards as in the case of the ABIM and ABP turned into a strongmen flagships for personal gain, intimidation of physicians in the name of market expansion and political prowess. No sanctions or probations when the evidence and violations are so overwhelming.

Why not? How far does that concentration of power really go? How corrupt have things become? Who are all the entities involved?

Anonymous said...

Here is a list of ABMS affiliates and those who have become closely partnered with the organization that have conflicted financial and political relationships. It is not a complete list.

"ABMS Associate Members
ABMS works in collaboration with its Associate Members to improve the quality of graduate medical education, the standards of medical practice, and the physician certification process. The Associate Members of ABMS include:

Accreditation Council for Continuing Medical Education (ACCME)
Approved as an Associate Member in 2004
ACCME sets and administers standards and criteria for providers of quality Continuing Medical Education (CME) for physicians and related professions. It has the responsibility for accrediting institutions and organizations offering CME and developing standards by which state medical societies will accredit local institutions and organizations.

Accreditation Council for Graduate Medical Education (ACGME)
Approved as an Associate Member in 2002
ACGME is responsible for the accreditation of post-MD medical training programs in the United States. Accreditation is accomplished through Residency Review Committees (RRCs) which process the actual accreditation of residency programs. The ACGME approves the standards and deals with appeals and administrative issues.

American Hospital Association (AHA)
Approved as an Associate Member in 1970
AHA is the national organization that represents and serves all types of hospitals, health care networks and their patients and communities. Through its representation and advocacy activities, AHA ensures that members' perspectives and needs are heard and addressed in national health policy development, legislative and regulatory debate, and judicial matters. AHA provides education for health care leaders and is a source of information on health care issues and trends.

American Medical Association (AMA)
Approved as an Associate Member in 1989
As the nation's largest physician group, AMA advocates on the issues vital to the nation's health and health care system.

Association of American Medical Colleges (AAMC)
Approved as an Associate Member in 1970
AAMC is a non-profit association of medical schools, teaching hospitals, and academic societies. The AAMC seeks to improve the nation's health by enhancing the effectiveness of academic medicine.

Council of Medical Specialty Societies (CMSS)
Approved as an Associate Member in 1973
CMSS serves to represent the views of specialist physicians in influencing policy, medical education and accreditation from a broad, cross-specialty perspective. Its membership is primarily comprised of United States medical specialty societies that represent physicians certified by an ABMS Member Board.

Educational Commission for Foreign Medical Graduates (ECFMG)
Approved as an Associate Member in 2002
Through a program of certification, ECFMG assesses the readiness of international medical graduates to enter accredited residency or fellowship programs in the United States.

Federation of State Medical Boards (FSMB)
Approved as an Associate Member in 1970
FSMB serves as the national voluntary association of all United States licensing and disciplinary boards. The organization promotes the adoption, maintenance and advancement of effective and uniform standards for licensure and discipline in medicine and the healing arts.

National Board of Medical Examiners (NBME)
Approved as an Associate Member in 1970
The central mission of NBME is to prepare and administer qualifying examinations, either independently or jointly with other organizations, of such high quality that legal agencies governing the practice of medicine within each state may, in their discretion, grant a license without further examination for those who have successfully completed such examinations."

Official ABMS "Display Agents" said...

Other financial partners with the ABMS including the AOA and their affilitates

"ABMS Licensee Product or Service Licensee Contact Information
ABMS Solutions CertiFACTS Online™

ABMS Certification Profile Service™ (sales
agent)(800) 733-2267

American Medical Association AMA ePhysician Profiles and AMA
(800) 621-8835

American Osteopathic Association American Osteopathic Information
Association (AOIA) Physician Profile
(800) 621-1773

Applied Statistics & Management, Inc. MD-Staff (800) 736-7276

Computer Technology Corporation,

Cactus Electronic Primary Source
Verification (ePSV) Reports
(800) 776-2305

CredentialSmart CredentialSmart Electronic Primary Source
Verification (ePSV) Reports
(877) 847-3499

CredSimple CredSimple Platform (310) 435-1418

Elsevier BoardCertifiedDocs and supporting
physician data file
(866) 416-6697

Federation of State Medical Boards

Federation Credentials Verification Service

Federation Physician Data Center (PDC)
(817) 868-4070

MedAdvantage MedAdvantage MCO Users Provider
Search Reports
(407) 282-5131

Morrisey Online MSO for the Web™ (MSOW) (312) 431-0123

Vistar Technologies Vistar Technologies System (888)266-4532"