Wednesday, April 25, 2018

ABIM Struggles to Keep MOC Relevant and Meaningful

Both MedPageToday and Medical Economics covered the latest American College of Physician (ACP) meeting and know how to drive traffic to their site - just mention Maintenance of Certification, Richard Baron, MD, and their pals at the American Board of Internal Medicine (ABIM).

Their pieces suggest the ABIM is trying to keep their corrupt "Maintenance of Certification" program, born from a collaboration between the ABIM and ACP years ago, "meaningful and relevant."

And in a way, they are.

Nothing brings doctors together more than the topic of the mandated Maintenance of Certification® (MOC®) program and great quotes like:
"Grandfathering is a really vexing challenge," said Baron. "It's pretty difficult to defend ... I would not see those doctors as equivalent to doctors who rectify."
I'd like to thank the editors of both journals.

You are the bomb.



Remember Me said...

ABIM's CEO/President Rich Baron caught on candid camera revealing an attitude and policy of discrimination based on age:

What's next, Rich, public statements on ABIM's unwritten policy of discrimination against physicians and employees based on their race and sex?

Time for this vexing man to leave and their MOC Ponzi scheme to go!

"He [Rich Baron, ABIM CEO] also responded to a question about some older diplomates who were "grandfathered" into the maintenance of certification and whether they would be of equivalent quality to other board-certified physicians; these grandfathered doctors don't have to take ongoing exams.

'Grandfathering is a really vexing challenge,' said Baron. 'It's pretty difficult to defend ... I would not see those doctors as equivalent to doctors who recertify.'"

Anonymous said...

Yeah, I'll bet the Robber Baron is really vexed that he can't get into their wallets also! So he disparages them. Slime ball.

Anonymous said...

"I would not see those doctors as equivalent to doctors who recertify.'

He's right. We're a lot better.

Measurement and Accountability said...

One has to wonder how culturally competent Dr. Baron is and whether he is a right fit for the ABIM.

Anonymous said...

I am not surprised that a man who sat on the NQF board of directors through "patient safety's first scandal" without saying a word about his involvemement with Chuck Denham, would be as crass and insensitive toward millions of senior citizens, poor, politically spurned and disabled Americans who through the miracle of medicare and medicaid get treatment from many of these "vexing grandfathered physicians" mentioned by Dr. Baron. The grandfathered physicians he maligns may be some of the best and last vestiges of decency left in America.

Anonymous said...

Dr Baron has certainly proven himself to be incapable of leadership by means of example. He chooses not to practice or care for the poor in Philadelphia. There really is nothing charitable left about the organization or the man who leads it. they are all air and carefully prepared press.

Non-profit Revolving-Door Political Action Groups in America said...

NQF gets funded through 2019, but just barely. After Chuck Denham's NQF kickback scandal was settled with the DOJ, TMIT funding and advertising was no longer permissable. The NQF is another organization with revolving door lobbyists and market makers for the healthcare industry. Look over their tax forms. Dr. Baron as a director of the NQF approved the tripling in the budget for "intelligence gathering"/data analytics software, which has a great deal of revenue generating potential. Does the NQF really need public/taxpayer money?

"The Bipartisan Budget Act of 2018 passed by Congress and signed into law by President Trump on February 9 sustains funding for federal healthcare quality efforts and NQF’s work through 2019.

Making Measurement Count: The Importance of NQF

'We applaud the leadership of the Senate and the entire Congress for taking important action to stand for quality,' said Shantanu Agrawal, MD, MPhil, NQF’s president and CEO. “Congress took a stand for Medicare beneficiaries and all Americans—as well as the clinicians who care for them—with a funding commitment that puts patients first.'"

Under Baron's Watch IT Happened said...

What is Booz Allen Hamilton doing with the NQF, Dr. Baron? You approved huge payouts to BAH under your watch at the Quality Forum for "consulting" fees.

What is Pantheon Dr. Baron, and why does NQF need to spend millions of dollars in support of them? What do they do for the NQF and the American taxpayer? Again under your watch, Dr. Baron.

"These organizations trust us to do good for them.
But knowing technology is not enough. Technology might offer a solution, but it takes curiosity, creativity, and careful thinking to determine how to make it work. We build tools that make change happen seamlessly, so that what happens behind the scenes can remain behind the scenes and the mission be front and center." - from the Pantheon website (NQF is a major client. Under Baron's watch tripling the expenditures in surveillance/data gathering/analytical technologies.)

And under Baron's watch at the ABIM he and others secretly created the offices of the Director of Investigations and even got his armpits wet in the process of surveiling physicians, managing dirty lawyers, invading doctors' privacy and shredding our constitution in the name of industrial spying and corrupt acts of abusive power and egregious overreach. Again under Baron's watch he increased, with an unbridles purse, the continuous spending in "intelligence gathering" and data collection technologies. Where did all that money come from?

He and the others even hired a double-felon to be in charge and did not inform physicians, the taxpayer or congress that they were going to bend the laws of the land.

And what about the rules of the game with the new "Knowledge Check-in". Buyer beware of the ABMS, take it or leave it contracts and unvetted third party vendors.

I am surprised that physicians and the public have not shut the ABMS down by now. How can anyone with reason possibly entertain this new and latest round of MOC talk and put up with it.

Anonymous said...

Great tag line: "Maintenance of Corruption (MOC)"

Beta testing where you are the test. said...

Physicians are in for several unpleasant surprises with ABIM's untested 2-year testing.

Buyer beware. You are the test. This is a beta version. It is also another unproven costly metric. Docs are giving relevance to the ABIM's unproven MOC scheme out of fear. Fear of losing one's livelihood.
The ABIM says the first test does not count. Don't let them fool you. Every test you take goes on your record and they keep it in a file to distribute to their partners. They get more data from docs every two years. More data to sell. Hospitals and insurers may ask you in the future how many times you failed your MOC exam(s) as a reportable event. Try to explain it in an addendum that it did not count to your employers three month insurance queries. It is all recorded. Everything about a physician is documented and you must give completed accounts every time you seek new employment. It is not just about paying for MOC it is about control of the work force.


1. Privacy: cyber security issues may lead to personal data breaches
2. Unexpeted costs: new expensive upgrades to home/office computers, increased bandwidth
3. Inreased risk of failure: using UpToDate will slow down diplomates and crash computers
4. Criminal and civil liability: renewal of ABMS everchanging contract opens docs up to criminal and civil prosecution
5. Unvetted third party proctors: you will be watched remotely for irregular behavior; going to the restroom, head turning, eyeball movement keystroke anomalies may find you in court like so many have already experienced.
6. Retesting and paying again: the likelihood is high that ABIM/ABMs will not give any statistics/data on how many passed and failed the beta tests because 2018 is only the first beta version offered and they don't want people to know that many failed.

No one has ever taken their test before, and therefore it is untested. Anything can happen. This is the ABIM where most of the money goes to executive and the board. Not to perfecting a test that has no proven value anyway. This is the ABIM with golden parachutes/retirement accounts from the offshoring of investments to avoid US taxes - higher returns. Luxury condos with chauffeurs for their personal pleasure and to avoid paying for a house or apartment like every other worker in the US must.

The Galluping Rich said...

Rich Baron quotes two Gallup polls on physician trust revealing a high of 80% in 1975 and low in 2015 where 37% of patients trust doctors

"Fast forward to the future, where data from Gallup indicates a drop in trust in the medical system from 80 percent in 1975 to 37 percent in 2015. Baron said it is important to both patients and peers to have an indicator of quality healthcare."

But can we trust these polls without knowing the typical behind-the-scenes political manipulation and what was intended to be the outcome by those who paid for the poll?

It seems everything that ABIM and their CEO's touch is somehow connected to corruption - cheating, illicit political activism and scam. Gallup is no exception.

Gallup has a stained reputation and was sued by the DOJ for billing fraud, which they settled and paid over $10 million to stay out of jail. Dr. Baron took the helm of the ABIM in 2013, the same year that Gallup settled with the DOJ. Just to show how politcially motivated these polls can be, here is one from 2004 below. This is around the time that Christine Cassel was appointed to be the ABIM CEO 2003, just in time for the 2004 presidential election. Cassel was hoping to get into the White House again, but did not make it that election cycle. She had to wait until the 2008 elections.

Here's the earlier Gallup poll - a snapshot of the "healthcare provider industry" from 2004 that was designed to show high patient satisfaction for their healthcare providers. It was corporate sponsored and it shows high patient satisfaction. So, what happened to create the 37% for physicians in 2015. The answer is partly in the 2015 poll was specifically designed to target physicians and not healthcare professionals as a whole as the 2004 poll did. Baron is politically motivated and he quotes from a politically motivated poll intending to malign physicians and their reputation.

We can thank the quality assurance cartel and their need to control physicians for this degredation of physicians. Dr. Baron opened his jaw too wide on this topic in New Orleans and out flew a bird he could not get back in his mouth. What an embarrassment to show their cards so strikingly on how they have maligned grandfathered physicians with actions and words, while at the same time discriminating against the majority of diplomtes by mandating MOC.

Nixonian Politics @ ABIM.CERT said...

Watergate-style thuggery and coverup at a Democrat Party NGO - we've seen it all

What's it all mean?

The story behind the Gallup polls mentioned by Richard M. Baron is ironically connected to the MOC scam and the advent of the qualtiy assurance cartel. The quality cartel is a big reason for the ABMS' rapid rise to power from their artificailly created new revenue source - the invention of a time-limited medical specialty certification and continuous testing.

We can trace the seeds of this story of continuous testing back to the mid 1970's when the ABMS medical boards' certification markets reached a saturation point. They were no longer finding enough new candidates to pay themselves and run the organizations in the fashion they grew accustomed to. The cash flow problems arose for them as the certification market reached a mission critical juncture. Their market peaked and started to decline. The ABMS "mission" was complete and their revenue growth came to a screeching halt.

So they started increasing fees for testing, but it was not enough to pay for their high compensation packages and paying for the black tie events. The clever scam to fix the financial crunch was not new but it involved deceit. It involved getting patients to not trust physicians or healthcare organizations. A campaign against doctors was initiated. The campaign that was also responsible for propagating the distrust of docs are many of the same same folks who came up with the "Quality Chasm" and the new patient saftety experts and their credentialing affiliates of new formation who colluded with the ABMS to create and maintain continous testsing and MOC.

Their were no credible objective data to justify continuous testing in the 70's and 80's and their is none today. In fact there is a surfeit of physicians and patients who feel the harmful effects of continuous testing. It's all for the sake of revenues, political adventurism with executives pocketing hiding the huge profits and overcharges in the form of obscene compensation packages, outrageous investment accounts and real estate holdings. The ABPN is breaking ground on a luxurious new mulit-million dollar corporate office/conference center designed to overlook a serene lake to illustrate the point.
Christine Cassel had the ABIM Foundation purchase a 2.3 million dollar condo with the best views of Philadelphia for her personal use in 2007. She did not pay income tax on the property or the use of it. She paid no condo HOA fees, utilities, taxes or insurance. How did they get so much money to purchase a private mansion for an active medical politician/lobbyist who rarely showed up for work in Philadelphia?

Look at the Nixonian-style politics the ABIM employed and how they broke-in to physicians' offices, businesses and homes to maintain their corrupt power and financial streams.

Fake Polling Bills said...

Gallup and ABIM/ABMS

What do the ABIM/ABMS and Gallup have in common? They both overcharge their clients and pocket the money.

Gallup and the DOJ 2013 - Gouging its Fed. clients, State Department, FEMA, and US Mint

"Alleged violations of the False Claims Act and the Procurement Integrity Act
In July 2013, the United States Department of Justice announced that Gallup had agreed to pay $10.5 million to settle allegations that it violated the False Claims Act and the Procurement Integrity Act for conduct involving several of its federal government contracts and subcontracts. The settlement resolved allegations in a complaint filed by the United States in November 2012. The complaint alleged that Gallup knowingly overstated its true estimated labor hours in proposals to the U.S. Mint and State Department for contracts and task orders that were to be awarded without competition. Because of Gallup’s conduct, the complaint alleged, the two federal agencies awarded Gallup contracts and task orders at falsely inflated prices. The settlement also resolved allegations that Gallup engaged in improper employment negotiations with a then-Federal Emergency Management Agency (FEMA) official, Timothy Cannon, in order to obtain a FEMA subcontract at an inflated price and additional FEMA funding after the subcontract had been awarded. The allegations against Gallup were originally brought in a lawsuit filed under the whistleblower provisions of the False Claims Act by Michael Lindley, Gallup’s former Director of Client Services. As a result of the settlement with Gallup, Lindley will receive $1,929,363 as his share of the government’s recovery. Under the settlement, there was no prosecution and no determination of liability.[32][33][34]"

Camp MOC said...

Selling MOC? What a show!

Price rigging, regulatory capture, restraint of trade - unimaginable abuse of "customers".
We are not customers, we are captives, being force-fed ABMS propaganda and products.

What an exhibition

Did someone say ACP and ABIM are partners in the game of corporate monopoly

Vxxng Vxxns said...

Utilization Management

ACP president Christine Cassel*** speaking on ACP healthcare reform policy and healthcare cost reduction in DC 1996 followed by Kaiser Permanente leadership speaking about HMO's and promoting the largest healthcare organization in the world.

What did Cassel say bout "integrity", ethics, HMO's, cost savings in care, endorsement of Jack K. and Patrick Henry's second choice?

ABIM's historical founders were ACP members
ACP Presidents (1929, 1934, 1939 ACP Presidents were co-founders of the ABIM

Christine Cassel was 1996 President and later CEO of the ABIM

The ACP was helped by the ABIM in "promoting" its certification board review courses in New Jersey/Pennsyvania/New York markets by purging ABIM's human resources department to hire a felon that would organize and use strongman techniques to take out the ACP's board review course competition. Fear and regulaltory capture is their insurance policy in maintaining the board/board review markets.

***Not keeping up with MOC

Anonymous said...

Not a peep out of the Colorado Medical Society regarding MOC reform. Kaiser Permanente is overly represented in Colorado's Medical Society leadership. Go figure - perhaps they are as conflicted and preverse as the ACP.

Good, bad, and ugly said...

Kaiser Permanente is massive corporation with a complex structure and not without its scandals - a $65 billion heavyweight

"Kaiser has had disputes with its employees' unions, repeatedly faced civil and criminal charges for falsification of records and patient dumping, faced action by regulators over the quality of care it provided, especially to patients with mental health issues, and has faced criticism from activists and action from regulators over the size of its cash reserves."

Non-profit or for-profit? It's non-profit KFHP supports the for-profit PMG

"Two types of organizations make up each regional entity:

1. Kaiser Foundation Health Plans (KFHP) work with employers, employees, and individual members to offer prepaid health plans and insurance. The health plans are not-for-profit and provide infrastructure for and invest in Kaiser Foundation Hospitals and provide a tax-exempt shelter for the for-profit medical groups.

2. Permanente Medical Groups are physician-owned organizations, which provide and arrange for medical care for Kaiser Foundation Health Plan members in each respective region. The medical groups are for-profit partnerships or professional corporations and receive nearly all of their funding from Kaiser Foundation Health Plans. The first medical group, The Permanente Medical Group (TPMG), formed in 1948 in Northern California. Permanente physicians become stockholders in TPMG after three years at the company.[7]

3. In addition, Kaiser Foundation Hospitals operates medical centers in California, Oregon, Washington and Hawaii, and outpatient facilities in the remaining Kaiser Permanente regions. The hospital foundations are not-for-profit and rely on the Kaiser Foundation Health Plans for funding. They also provide infrastructure and facilities that benefit the for-profit medical groups."

Goveranance: Christine Cassel was on the board of KFHP from 2003-2013. Cassel and her cronies groomed and placed Bernard Tyson to lead the operation in 2012. It is no wonder Cassel was shortly thereafter "appointed" to be "founding dean" of KP's new medical school.

"Chairman and CEO George Halvorson retired in December 2013, after serving since 2002.[4]
[Christine Cassel was appointed to the ABIM shortly after Halvorson became CEO of KP]

"On November 5, 2012, the board of directors announced that Bernard J. Tyson, Kaiser's president and chief operating officer for the last two years, would replace Halvorson[5] — the first time an African American was appointed to that position.[6]"

Union leaders cry foul about Cassel's coi (actually UCOI - unlimited conflicts of interest)

2010 Christine Cassel and Sibelius with the HHS introduces Bernard Tyson at a PCAST presentation on healthcare technology (EHR)

Anonymous said...

KP as largest healthcare organization in the world will do everything it can to sabotage anti-MOC legislation.

Anonymous said...

What is relavant

ABIM claims to be a testing company offering a "voluntary" certification in internal medicine and its sub-specialties.
How can something voluntary be used to determine employment, reimbursement and licensure?

Rich Baron and other medical board heads tell us that certification is all about "self-regulation" of physicians.
How can there be "self-regulation" when there's absolutely no representation of "self" in the process - only mandates created by ABIM in collusion with ABMS associates and their affiliates?

If MOC is presented as a "voluntary" continuous testing program to maintain certification, how can non-participation in MOC cause one to lose one's certification, which can cause one to lose one's job or get reimbursed by insurers. How can MOC as a "voluntary" metric/test of learning create hireability and re bollards, and state licensing obstacles.

Is the ABIM a test company/medical board involved in self-regulation, or is it in reality a strong-arming flagship protecting a self-serving greedy corporate regime?

Insolvent: defunct data analytics firms said...

ABMS MOCSTERS take the money and run - the politics of money

Cambridge Analytica colluding with Facebook "stole" personal data using it for political purposes and profited by it. With Cambridge Analytica still under investigation and failing as a business the executives have declared bankruptcy. FACEBOOK CEO Zuckerberg voluntarily faced committees of both legislative bodies in Washington.

With looming lawsuits and state legislatures slamming the door on discriminatory MOC giving statutory relief to physicians and patients, will ABIM be the first of the 24 medical boards to declare bankruptcy?

Many people still fail to see that the ABMS medical boards are not regulatory bodies. They are simply corporate enterprises led by clever entrepeneurs making huge profits pocketing the money along with their colluding partners.

They all enojoy the benefit of non-profit status, but do they deserve it?

The ABMS boards have been hiding behind a mask of "professionalism" and the veneer of "self-regulation" for decades. The masks have fallen off as the stark reality of corruption and scanda have been exposed.

The veneer of MOC is eaten away ironically by greedy political parasites at the head these organizations. The ABMS executives are acting as if they were on a time-limited mission to destroy the organziations from within by robbing them blind and failing to keep up with the original core mission of offering and maintaining a voluntary lifetime certification.

Those executive parasites eating the organizations alive are MOCSTERS. These greedy MOCSTERS with both fists clutching physicians hard-earned money (and valuable time) have dropped the ball and chain on their own feet. They are already imprisoned. There is no freedom for such individuals; they are slaves to their own wicked desires.

The ABMS MOCSTERS are destroyoing themselves. The more they take, the more they want.


It's the middle of the end for the ABIM.

Was it their appetite for power and money that destroyed them? Or was it that their self-appointed genetic 'brain pool' became totally corrupted by 'incestuous professional medical politicians' like Christine Cassel, Robert Wachter, Richard Baron, Lois Nora, Kevin Weiss, Eric Holmboe, Richard Hawkins and the rest of the revolving door gang?

ABMS Orwellian Statements on Accountability and Transparency said...

The future is here - who is going to protect the public from the ABMS

State legislatures may protect physicians and patients with anti-MOC legislation, but who is going to protect the the public from fraud and corruption within the ABMS organizations and their affiliates who do far more than make "dumb political decision".

Some of the most heinous violations were committed by the ABIM/ABMS against human beings who deserve much better treatment than they are currently getting, and these crimes/abuses need to be addressed fully. Those involved need to be held accountable. They should not rewawrded with lucrative revolving door contracts from "in-network" financial providers.

There should be no safe-havens for those who commit crimes and act without proper moral restraint. The medical boards behave as if unlimited conflicts or interest and financial self-dealing were normal par for the ABMS cartel course. Just because they think so does not make it right.

An Ounce of Prevention is Worth a Pound of PR said...

The ABMS/ABIM corruption needs to be dealt with today, not tomorrow.

Private Equity Moves Right Into the ABMS

Look at who they appointed to lead the American Board of Preventive Medicine and study everything online about their burger king franchise attoreny with the awful sanitation and horrific safety record.

It more of the same shenanigans offered up by men and women with cartel-like instincts and gangland mentalities doing everything they can to survive and prosper off of the MOC gravy-train.