As many of us head back to work to start a New Year, let's not forget that physicians have until January 15, 2019 to "comment" on the ABMS Vision Commission's (un-editable) Draft Report.
While Paul Teirstein, MD and his colleagues at the National Board of Physicians and Surgeons (NBPAS) did a nice job dissecting many of the problems with the Vision Commission's report and made it easy to "comment" to the Commission's Draft Report using SurveyMonkey, I would like to add a few important observations about the Vision Commission's report (and the response by NBPAS) that are not mentioned and remain stumbling blocks for me.
First of all, should physicians be bound by an adhesion contract (seen here) with Board Certification and MOC (or whatever "continuous certification" becomes called) that can change on the whim of the ABMS and their member boards "from time to time?" This gives unilateral control to ABMS and prevents appropriate checks and balances. How is this helpful to anyone except the ABMS member boards and their collaborating corporate entities - all of whom already enjoy a substantial position of power and monetary influence. Remember the history of MOC reviewed in the antitrust complaint (starting on Page 5) filed five days before the Vision Commission's "Draft Report" appeared.
Also, those corporate entities that collude with MOC are not mentioned and are extensive. A partial list includes ABMS Solutions, LLC, hospitals and the ABMS Multispecialty Portfolio Program, publishers like the Massachusetts Medical Society and Wolters Kluwer, Pearson LLC, CECity, Premier, Inc, PriceWaterhouseCooper, and subspecialty societies like the ACC and ACP - all who stand to benefit financially from MOC. Remember, a significant portion of the ABMS Vision Commission are not practicing clinical physicians and are deeply conflicted with corporate entities.
And let's not forget that the Commission's report leaves the harms already experienced by physicians and their families unmentioned (for obvious reasons) - again, see the recent antitrust Complaint filed. MOC was always about money and power for the ABMS and their member boards. The ABMS fully intends for MOC (soon to be rebranded as CertLink®) to shift from a desktop platform at a PearsonVue testing center to a mobile platform in the palm of our hands as "MOC pilots" become permanent in 2019! This translates to more distractive screen time for physicians away from patients and a lucrative life-long money stream to ABMS and their collaborators.
I would encourage physician to consider copying the content of this blog post and morph it into your own "comment" to the Vision Commission if you feel it would be worthwhile.
Also, consider donating to Practicing Physicians of America's legal fund. I believe you'll get more for your hard-earned money that protects your interests that way.
Proprietary MOC® research for proprietary MOC® products
We've looked at their methods and conclusions.
It is scam science CertLink® to promote scam services CertLink®.
No wonder, though.
The authors who who cherry-pick the data, tweak the results, and compile/disseminate the promotional materials are not fit for the clinic or the bench.
Plus, they've all been on the proprietary ABIM/ABMS Cert/MOC® dole for decades.
How can the ABIM suddenly arrogate to themselves the power to do these horrible things to physicians and patients? They impose onerous MOC demands that restrict patient access and take us from our family and friends. The ABIM/ABMS excises the educational process as though it was their sole property right. How can they mandate all these harms under the false banner of self-regulation?
Deception Heaped On Deception
MOC creates a psychologically distracting work environment for physicians and their patients.
MOC fragments the educational process with redundancies, confusion, and ever-changing policy perturbations with new and ever-increasing demands.
MOC sucks resources out of healthcare that could be used in far better ways. ABMS "MOC/CERT" demands limit access to vital healthcare services.
These are all harms.
So it is not enough to say that there are no independently validated studies proving "MOC improves outcomes" or makes a more "reliable physician". It is better to speak the whole truth about MOC.
MOC creates great harm, because it is based on deception and not truth.
MOC is a deceptive ABMS business. With its for-profit model it has become a lucrative enterprise mod that all member boards partake in. MOC is a for-profit distraction that does grave harm to all concerned. MOC bifurcates the certification process destroying the core mission and focus of the original specialty certification as a model of lifelong commitment to continuous education.
So many facts, aligned with common sense and reason, tell us that the MOC mandate with its conflicts of interest and extraordinary drain on healthcare resources needs to go away.
The AMA House of Delegates confimred with their resolution that MOC demands need to end.
The conflicting and debilitating emotions that the ABMS/ABIM creates with its non-inclusive fragmented approach to continuing medical education goes against the grain of the intelligence of physicians. It goes against the interests and needs of the public.
ABMS’ total identification with their MOC® money streams is problematic. This identification creates a profound conflict of interest, and precludes having an objective approach to inclusiveness which is vital to self-regulation.
Money shuts the door on the ABMS umbrella and member boards being inclusive. Executives have one fist tightly holding onto the revenue streams which pay their exceedingly rich salaries. This is core to the problem. MONEY. This monetary self-interest in itself is an egregious conflict of interest that needs addressing. Nobody feels good about paying these obscene packages with deferred golden parachutes invested in offshore accounts in the Caribbean.
The salaried executive position shut the door on self-regulation long ago, so it is a lie on the part of the ABMS executives to even bring self-regulation up. It is a false posture to threaten us that the government will regulate physicians if "we" don't do it "ourselves".
There is no we, only them. There is not self in self-regulation. No voice. They are the sole brokers of our money and sole arbiter deciding our educational fate. They say the money was theirs and always was theirs as it goes straight from the banks, foundations and "research projects into their greedy pockets.
So, inclusiveness and self-regulation are both just a another great ABMS deception.
The Birth of Deception and the ABMS' Depraved 20/19 Vision
Self-regulation died in 1965 when the bylaws were secretly changed at the flagship member board ABIM.
The inclusion of executive leadership was written into the bylaws. (Such as the creation of the CEO/President position.) We witness this full-time fully inured positions see maligning us today with increasingly mock "educational" inventions and illicit monetary demands placed on physicians through private and public policy manipulation/enforcement and customer capture.
Increasing conflicts of interest
Prior to 1965 there was no executive position written into the bylaws and therefore less possibility for serious conflicts of interest to arise or any of the copious commercial shenanigans we witness today, but nevertheless the ABIM has been fraught with conflicts from the beginning. The founder of the ABIM, Walter Biering was accused of conflicts of interest by the author the Flexner Report, so there is evidence of conflicts of interest, abuse of position/power brokering from the beginning.
In the beginning there were only nine board members and a few elected officers beholden to strict term limits at the ABIM. This was true at the ABIM and it was very similar for other member boards as well. But this simple structure was not without its problems as the ABIM board, and therefore its officers, were according to bylaws restricted and exclusively offered to only ACP and AMA members. Two very powerful incestuous organizations.
This exclusivity and conflicted nature of the organizations was problematic then and it has become even more problematic today. This early indication of exclusivity to AMA and ACP members warrants further study and investigation as we can easily see a great deal of politics, power brokering and financial conflicts of interest in play today within these ABIM parent organizations.
One of the most egregious offenders, Christine Cassel was ACP head prior to being appointed to the ABIM. Nobody squawks about this extreme conflict of interest and the monetary ties between the two. Money has flowed like a dirty river between the ABIM and ACP if you look at the tax filings and understand the lay of the land around these two troubling tributaries of coi. The ABIM Foundation is a potential source of dark money for many organizations and not just the ABIM and ACP. Heaven forbid if we suspect the RWJF to be a conflicted player as well if any investigative reporter wishes to follow the trail of money and influence.
I don't understand why physicians are not jumping up and down in the offices of their senators and congressman.
Why do we say this? Now there are no checks and balances at the ABMS or its member boards at all. Policies have been written for public show, such as coi policies, but they are never followed. The latter remark can be easily validated, because there has never been a single sanction or reprimand against any ABIM ABMS board member, officer or executive to my knowledge.
And there have been plenty of reasons to not just sanction but to turn some of their executives/state actors over to the DOJ for investigation on suspicion of abuse of power, misuse of funds, violations of privacy, and flagrant violatory constitutional acts levied against candidates' and diplomates' rights.
The Money Changers
There is nothing voluntary about the ABMS and its slippery member boards today.
The ABIM / ABMS is all closed door with self-appointment and conflicts of interests dancing across the money changers desks and their offshore investment accounts.
It's sickening to witness the mock commissions and task forces, which are for appearances only. Just as nauseous as hearing them say that certifications is voluntary. Or that MOC is optional. Blatant lies. The mechanisms of control are just as blatantly deceptive as are the lies about voluntarism and rights of self.
It is all show to cover the blatant conflicts of interest outlined here and the undisclosed conflicts that abound at these lucrative for-profit corporations under the umbrella of the ABMS.
MOC - or whatever rebranding the ABMS deceptively introduces such as CERTLINK® - is deception heaped on deception.
Is deception the only consistent product that the current ABMS/ABIM leadership can create?
Is the ABMS going to rebrand its MOC® avoid the overwhelmmingly negative repsonse to their MOC mandated products and services?
Not unlike what the ABIM Chairman Bob Wachter did with his company IPC the Hospitalist. IPC sold to TeamHealth as the DoJ whistle blower lawsuit/alleged billing fraud was destroying the brand name.
IPC was bought out by TeamHealth, which was repurchased by Blackstone, a private equity group and the former ABIM's chairman's fears of being personally embroiled with charges/innuendo of wrongdoing were diminished but not destroyed.
The ABIM had an interest in making the lawsuit and charges go away as well as they were involved in fathering the hospitalist specialty/movement.
2014 DOJ files suit against IPC, the Hospitalist Company
IPC changes its name with heat from the DoJ and their false claims lawsuit.
IPC Healthcare is the new brand name for IPC, the Hospitalist.
TeamHealth buys IPC Healthcare 2015
Blackstone aquires TeamHealth (IPC) 2016
ABMS chooses FIGmd to build out CertLink
[2016 who funded india expansion and buildout?]
If a lawyer or a law maker needs surgery or medicine, they come to a physician and they will receive help for a medical illness. When a doctor needs a lawyer or the DOJ or IRS to do their job when the ABIM/ABMS are acting illegally, they don't respond but want physicians want to work it out amongst themselves. One has learned that a physician won't get support from lawmakers or the IRS in exposing the crimes of ABIM/ABMS. You have to do it yourself.
What a Strange Website the ABIM Spins - even stranger the comments from their web-designers
ABIM's web-designer, Digital Wave, has allegedly spent seven years making ABIM's website more intuitive and UX friendly. Their assumption is that doctors want to get their busywork done quickly, pay for MOC with a minimum of pain, and get back to work. Or back to spending time with family.
Yet Digital Wave has acquired a very odd attitude about MOC. After becoming ABMS veteran contractors, conducting numerous tests and surveys over the years, this company associates MOC with death and taxes.
Digital Wave's content lead, Lamar Goodenough, has worked very closely with ABMS Board clients (ABIM, ABS, ABOG, and ABFM) since at least 2012. It was quite revealing that ABIM's top webdesign contractor and ABMS lead authored an essay associating "MOC" with the dreaded death and taxes. We presume this was meant to be read only by colleagues and not doctors, as that type of insensitivity would be considered way over the top.
The onerous MOC, with its annual tedium and fees has earned the distinctive notoriety of becoming a cliche fitting perfectly with our notions about the inevitable "death and taxes."
Digital Wave confessed that users do not want to linger in the unpleasant tax room (MOC room) for very long. To illustrate this for their UX audience Goodenough showed how "user-friendly" the Turbo Tax website is. Then Ms. Goodenough shared TurboTax's cute kindergarten-like figures for us to click in our imagination, hopefully making the whole MOC affair, at least in our minds, less dreadful and painful.
Digital Wave's lead concludes with some samples of how web-designers can test their handiwork on a few clients using paper and sticky pads. That was the best part of the whole article. The return to good old-fashioned paper and sticky pads making one feel normal or like a child again.
This shocking brave new world story is about how more and more of your MOC tax dollars are hard at work for you. Poured down the drain. According to the ABIM's own tax forms they dished out to Digital Wave a minimum of a quarter of a million dollars in 2016. $251,570 to be exact. If the ABIM is telling us the whole story, that's a lot of secret commercial research involving testing and undisclosed surveys that doctors were never informed about.
That payout for commercial research conducted on hard working and unsuspecting physicians is way too much for any candidate or diplomate to have to bear.
The outrageous gets more outrageous at the ABIM/ABMS
Death Taxes and MOC, by Lamar Goodenough
"I'm not (necessarily) saying that physicians rank MOC up there with death and taxes, but… we know they didn’t pull those all-nighters in med school just so they could navigate through Part II requirements, CME credits, and online payments.
The good news is, medical board content managers aren’t alone.
Let’s look at an example of a site that users want to be done with as quickly as possible: TurboTax. Even if I completely support the government’s use of my hard-earned dollars, I don’t want to spend my whole Sunday afternoon figuring out how much to shell over… and TurboTax knows that."
“But we have so many complicated requirements that doctors have to understand!”
"Yes, there is a lot to learn and understand about certification exams, MOC requirements, etc. etc. And… the IRS has ensured that the same is true for income taxes."
- Digital Wave UX team lead
It's refreshing to see the content lead at Digital Wave/Antech Systems is just as cynical about MOC as 860,000 BC physicians!
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