Churning Pseudoscience

Recently, two papers published by authors at the American Board of Internal Medicine (ABIM) appeared in the mainstream medical literature that purported to provide evidence to the value of their Maintenance of Certification program.

The first was "Associations Between American Board of Internal Medicine Maintenance of Certification Status on a Set of Healthcare Effectiveness Data and Information Set Process Measures" by Bradley Gray, PhD, Jonathan Vandergrift, MS, Bruce Landon, MD, MBA, James Reschovsky, PhD, and Rebecca Lipner, PhD in the Annals of Internal Medicine. The other was "The American Board of Internal Medicine Maintenance of Certification Examination and State Medical Board Disciplinary Actions: A Population Cohort Study" by Furman McDonald, MD, MPH, Lauren Duhiggt, MPH, Gerald Arnold PhD, MDH, Ruth Hafer, BA, and Rebecca Lipner, PhD published in the Journal of General Internal Medicine.

Both of these studies' senior author was Rebecca Lipner, PhD, a testing psychometrican who currently serves as the Senior Vice President for Assessment and Research at the ABIM earning $435,990 per year. Last year's tax records also disclose Dr. McDonald, ABIM's Senior Vice President "Academic and Medical" earns $419,497 annually for his services. The other author's salaries are not disclosed, but we can imagine their salaries are not zero.

The first study by Gray et al, is a cross-sectional design and used observational data. As such, its results only reflect associations and not definitive indicators of a causal relationship (acknowledged in the limitations section by the authors). The second study by McDonald, et al. is another observational study and cannot determine causality either.

So why are ABIM diplomats funding so many "association" studies? Given the cost of producing these studies, might the ABIM be churning pseudoscience to forward their own agenda rather than forwarding helpful public policy or medical science? Not disclosed in their "Conflict of Interest statements is the fact that ABIM sells our board results and "status" via the American Board of Medical Specialties (ABMS) to others via ABMS Solutions, LLC. As such, these publications serve the organization's undisclosed covert agenda and should be called what it is: very expensive propaganda.

With our current era of the proliferation of predatory journals, it is clear we also have an era of proliferation of predatory publication that supports the needs of our ABMS member boards that is not in their diplomates' best interest as well.

-Wes