Saturday, February 16, 2019

Grifters Will Always Be Grifters

On 12 Feb 2019, the American Board of Medical Specialties (ABMS) Vision Commission created 25 September 2017, issued its Final Report to the ABMS Board of Directors on its controversial and very lucrative "continuous certification" programs.

Not surprisingly, the self-appointed Commission thumbed its nose at the overwhelming majority (88%) of US physicians who find no value to continuous certification,  and instead relied on testimony of many ABMS Boards, members of the ACGME including the Association of American Medical Colleges, the National Board of Medical Examiners, "psychometricians," ABMS Portfolio Program Sponsors, eight (of 50) state medical associations, five subspecialty societies (Anesthesiology, Family Medicine, Internal Medicine, and Pediatrics), consumer groups like (AARP-funded by UnitedHealthcare, the conflicted Consumer Reports, and the problematic Leapfrog Group). Nowhere was the possibility of ending continuous certification ever discussed or considered.

In the end, this was the conclusion from 17 months of testimony for ABMS Vision Commission:
"The Commission thanks the presenters who came and provided valuable testimony about their perspectives of continuing certification. The information will inform the next steps of the process. What is clear is the majority of the presenters recognize the necessity of lifelong learning. While they appreciate the innovation and engagement of the Boards as changes are made to continuing certification programs, they look forward to seeing how the programs continue to evolve. All are interested in being part of the future of continuous certification."
In other words, grifters will always be grifters.



Anonymous said...

Move forward with the lawsuit. Support the lawsuit.Take names of all those who stood for MOC, for when finally criminal actions are taken, they will be held accountable. Shame on the state medical boards for idly standing by and conspiring by omission. Dr. Wes and Dr. Tierstein for physicians of the year.

W.O.R.M. said...

ABMS "Vision" Commission? What an ironic name for a group that are so out of touch with mainstream medical professionals to be blind as bats!

ABMS Vision Commission: Winners of 2019 Doublespeak Award said...

The ABMS Vision Commission "report" is a highly deceptive, confused morass of dodginess from the beginning. As in the beginning so it is in the end. VC 2019 by design has been little more than a corporate laundry list of as-expected questions and answers. The whole "commission" has been comprised of a messy self-centered process to arrive at foregone conclusions about MOC and its continuity not its ending.

The "report" appears as a consummate display of political and corporate doublethink and doublespeak reflecting the corrupt character and nature of the ABMS enterprise.

One of the most blatant examples of ABMS doublespeak occurs with the repetitive use of the word "WE" in order to get their propaganda programs/agendas implanted in the passive parts of the brain. To say that "we all want MOC to continue" is a clear untruth. This false statement repeated ad nauseum smacks physicians and patients in the face with steamy "proof is in the pudding" examples of how the distortion of language and facts works in unethical dystopian societies. The ABMS and it enterprises comprise imo just such a sick society, in this case claiming falsely on their tax form stop be serving public safety. In fact they are doing harm.

Reading page after page of the ABMS VC 2019, we leapfrog over rift after rift of political propaganda. We end up in the end where we started seeing the ABMS "thought leaders" jumping straight into the abyss making even more flagrant corporate lies to continue the MOC gravy train and maintain political control over "their" labor force. Keeping tight control over who works and who doesn't in America, the land of the free. Creating over the past few decades through their social engineering a newly marginalized indentured group in US society - the highly educated, skilled, and extremely intelligent US physicians. MOC is one of the most important levers of control over physicians. Control over their right to work and speak out and a patients right to advanced healthcare.

The euphemistic "we" occurs most dramatically when ABMS and proxies proclaim with a boldface "we all want MOC to continue." The plain truth is nobody wants or needs MOC, except the self-appointed unaccountable "ABMS enterprisers" who rolled out this predetermined political show in the first place. MOC and the Vision Commission are farcical. What we really want to know is when will MOC end, not how many new, bizarre and onerous ways the ABMS can keep torturing their captured customers.

Gary M. Levin said...

YThis article from ReachMD solidly supports arguments against MOC

Annually, there are around 150,000 certified activities produced in the US annually. However, meta-analyses and research estimates that less than 20% of those educational activities drive behavior change and probably less than 5% lead to improvements in patient outcomes. With a vast array of continuing education (CE) activities available to healthcare professionals (HCPs) and the delay in data on the effectiveness and outcomes of CE activities, it's difficult for HCPs and CE stakeholders to determine the most effective education that has the greatest potential to lead to behavior change thus improving patient care.

During the Alliance for Continuing Education in the Healthcare Professions annual meeting host Alicia Sutton speaks with guests Hilary Schmidt, PhD, John Ruggiero, PhD, MPA, CHCP, Gregory Salinas, PhD, and Nili Solomonov in a two-part interview covering:

The current state of CE activities and address the lack of objective, reliable, and empirical assessment available to prospectively identify CE activities that have the greatest potential to lead to improvements in health care practice.
The development of a new Instructional Design Rating Scale and its reliability and predictive validity in driving behavior change through rigorous research methods based on the science of human learning.

Philly corruption: on being well-connected said...

Chicago v. Philly - self-enrichment scoreboard

I don't know if you follow Philadelphia corruption, but of those who do, some might say that ABIM's adopted foreign city of operations (in the city of brotherly love) might surpass Chicago for the top title of "most corrupt city in America".

Whichever city or affiliate one considers to be the most corrupt, it seems apparent that the ABMS with its Chicago domicile feels quite at home in the 'city of racketeering'. But the ABIM, an unaccountable foreign agent in Philadelphia, PA after five decades of establishing rich political/legal connections, may hold the same home field advantage with the referees thanks to their turning a blind eye on local racketeering.

That must be part of the reason that many of the 24 affiliates don't get flagged during quarter after quarter of obvious engagement in repeated foul play. Look at the obscene money they give to themselves ("with board approval"). Rich payout after payout to themselves with MOC MONEY. It is madness to keep the risk and exposure going. Don't they have advisors?

They just keep going with their MOC money-making scams, buying into partnerships/investing into the medical industrial data registry complex wearing scant more than fig leaves. What is surprising is that these ostriches still pretend to be a "self-regulating" MD-led franchise and that initial certification and the insidious MOC programs are "voluntary".

They continue to bury their heads even though the MOC scandal gains in media attention. Even though there are lawsuits that could bring the whole house of cards down. They busy themselves erecting 24 huge tombs for themselves. Those expensive shrines dedicated to continuous profiteering and self-enrichment are called MOC®, KCI®, CertLink® and whatever other seriously stupid name they can invent to promote their lucrative pipeline.

Whatever name they give to MOC, eventually the wind will blow those silly fig leaves off and reveal the truth in all its nakedness. The self-dealing fig-leaf MD's in charge of the ABMS programs are little more than shills working for corporate special interests. And the illegal control they wield over physicians (and the harm it does to patients) is a figment of their diabolical imaginations.

Where is the ABIM/ABMS on Burnout/Suicide Rates? said...

If there were true "self-regulation" there would be no need to initiate a class action/mass action lawsuit against the ABIM (ABMS®).

Who would ever choose to bring suit against oneself?

The course the ABIM/ABMS has taken is a bridge way-too-far forcing to physicians to divert time, energy and resources from patient care. This growing recognition has create a backlash where countless physicians are saying enough is enough.

MOC distraction has led to a diversion of time and money. This has been shown to be true independently. In turn the MOC distraction and scandals surrounding the use of the money it generates for the ABMS/ABIM and their cronies has caused physicians and concerned citizens to go to court making extreme efforts that divert even more time, energy and resources away from patient care. Doing more things that cause stress and increase burnout. May lead to worse outcomes for physicians and patients.

And what is not talked about enough. Physician suicide: the US has the highest rates in the world. Highest among the professions that are studying this.

It's time for the ABMS/ABIM, Dr Baron (especially) along with medical societies to start admitting that increasingly onerous and difficult to follow requirements such as MOC adds to the causal forces creating burnout and suicide. Along with regulatory burdens/EHR/insurance red tape, the loss of autonomy, are a strong components leading to physician burnout and suicide. The ABIM should rush to congress and get legislation overturned that is killing our healthcare system and patients literally. It is a mess and we have to admit it and do something about it. The ABMS did not hesitate to create the regulatory capture and support other onerous burdens.

One of the first wellness programs for physicians in the country?

2012 Lane County, Oregon Medical Society Wellness Program (Suicides prompted swift action.)

"The Lane County Medical Society (LCMS) was the first county society in the nation to create a physician wellness program (PWP) in 2012, that appears to mitigate the barriers that have traditionally kept physicians from seeking the care they deserve. Those issues are: confidentiality, privacy, reportability, time constraints, concerns about an electronic record breach, locating a psychologist, psychiatrist or physician coach who understands physicians’ issues, any association with 3rd parties, and the cost of care if insurance wasn’t billed.

The Society also sought to change the culture of silent suffering and shame around asking for help to one where stress, strain and burnout are openly discussed and the PWP is readily recommended."

But these efforts do not go far enough imo. We have to stop fighting each other and work together responding to the healthcare crisis. There are a thousand distractions, but health should be at the center.

Anonymous said...

I see the ABMS medical boards as broken system with need to be transformed by throwing out the current leadership/executives. Or the entire gulag should be abandoned altogether and let non-conflicted universities/residencies/fellowships step up and issue certifications for life with the diplomas. MOC, greed and politics killed the Chicago umbrella. Money, politics, the abuse of power destroyed all faith in the ABIM along with the rest of the boards. Totally conflicted.

The lawsuits alleging graft (racketeering and profiteering/unjust enrichment) and obvious trade violations are the only way to establish normality to the profession and correct the blatant errors of the medical specialty boards. The ABMS appears to be on the warpath against doctors beating their furious drums to the tune of "corporate masters" in order to destroy medical specialties and increase systemic chaos. They are doing a fine job of it.