Friday, September 27, 2019

Federal Judge Dismisses MOC Class-Action Lawsuit, For Now

On 26 September 2019, a Pennsylvania judge has dismissed the current claims filed by the four internists challenging ABIM’s Maintenance of Certification (MOC) program (The full opinion here). The judge, however, has invited the plaintiffs to file amended claims on the monopolization and racketeering claims in the lawsuit in the next 14 days and, in contrast to what the ABIM said in their public statement, the case is far from over. Even if the plaintiffs are ultimately unsuccessful at the trial court level, all available appeals will be pursued.

No one ever thought this would be an easy fight - it is a David vs. Goliath effort after all - we remain committed to do whatever we can to bring an end to MOC.



Anonymous said...


It appears the ABPS is offering a MOC product (alternative/possibly a separate product) to ABMS certified physicians. They have a certification that is nationally recognized. They appear to be offering a separate or specific MOC product, an offer tailored to attract ABMS certified physicians.
Less onerous/burdensome/8 year test.

ABPS discussion of physician opposition to MOC. Too much time spent away from patient care.
Early retirement. Rural physician deficits from ABMS' requirements.

ABPS BC physicians are not recognized by California and there is no recognition in New York.

C. O. I. said...

There must be a moratorium on MOC until there is sufficient study of its negative effects on the healthcare system. We can easily see the harms to patients and physicians, but there is no evidence of the value. If MOC were a drug it would be pulled from the marketplace and placed under review. There is no oversight only seeking of profit by the ABMS umbrella. The ABMS receives millions of dollars from the MOC revenues via membership fees from the medical specialty boards. The ABMS is not protecting the public it should. (It's bylaws state it has oversight over the medical boards.) ABIM is producing harm with it MOC product. Instead of serving the public, the ABMS is engaged in for profit activities that feed into the executive largess. ABMS Solutions is only one of those lucrative reasons to turn one's head and pretend not to see the dangers they are posing to the profession and the public. Sundry conflicts of interest muddy the already murky for-profit nature of its activities. They spend more on advertising their brand and consulting with business partners than they do in acting as a watchdog for the public. (Nil.)

Anonymous said...

All of the case precedents cited by the judge in behalf of the defendants (ABIM) concern for-profit corporations whose primary purpose is to make money. The ABIM is a not-for-profit quasi-regulatory body (in theory) that "self-regulates" physicians. "Voluntarily".

The judge (or his legal team) creating the "opinion" apparently has little comprehension of the real ABIM or its history and the dangers that is poses to the profession and the public. Physicians and patients stand on a precipice, forced there in part by the ABIM, their associates and corporate partners. There is a great deal of collateral damage as patients and physicians fall into the pseudo quality chasm invented and propagated by the ABIM, associates and its corporate sponsors. Immediate injunctive relief is necessary.

Judge's Opinion Misses the Mark. Why? said...

I truly believe the ABIM is harming the public and the profession of medicine through a calculated cunning deception. They are profiting by this deception. MOC is a lucrative centerpiece in that cunning deception. The real ABIM hides behind a respectable shadow play with a lot of PR, pseudo science, and window dressing.

This case is in a different category involving one corporate body (ABIM), which in a peculiar relationship with a "franchise" of non-profit NGOs (ABMS). The ABIM/ABMS are in a peculiar relationship with other NGO, whose relationship with the healthcare industry is little understood by the public and the profession.

The case is unprecedented and unique and cannot be compared with the cited cases and other legal situations. The opinion is therefore biased toward the ABIM as it misses the mark entirely.

The question for me is who/what does the ABIM/ABMS really serve, and why have four physicians (representing a class of nearly a million) been harmed by MOC. How did we get to this sorry state of affairs where the media, IRS, and DOJ have not done their jobs by investigating and fulfilling their obligation to inform and protect the public.

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

ABIM President, CEO, and Minister of Propaganda Herr Doktor Richard Baron must surely be sporting a jackal-like grin these days.

Spewing forth his repugnant lies about the "voluntary" nature of MOC. Only in the sense of someone being a "gentleman physician" and not having to earn a living. Not to mention equating the ABIM entity as being a shining example of physician self- regulation. "Individuals... are appointed to serve on ABIM boards or committees" seems to be the extent of any participatory democracy in an organization that purports to represent the now clinician-serf. Dick, who died and left you King? Oh pardon me, the Democratic Party did, with their passage of the ACA (and modification of Section 1848 of the Social Security Laws), which gifted ABMS (and hence the ABIM entity) with regulatory authority in matters pertaining to MOC. With the power to curtail or terminate outstanding physician careers , especially painful in this era of physician shortages.

It should be noted that the ACA employed the standard tactic of creating market power by listing specific requirements that only the ABMS program could meet. Though Medicare does not require ABMS Maintenance of Certification, hospitals and health systems interested in collecting the Medicare money may require specialty physicians to participate in the ABMS MOC program as a condition of employment, reimbursement, and hospital staff privileges.(

This lawsuit dismissal should not go unchallenged. And with due respect, of course, if the Honorable Robert F. Kelly still believes MOC is a "voluntary" process, might I suggest he retake the Bar Exam (again & again I might add) to verify his ongoing legal competency. An arduous task right up there with MOC, the latter he wholeheartedly seems to support for physicians.

Anonymous said...

I am very disappointed with the Pennsylvania Federal Courts today, but even more so with the ABIM -- disgusted really.

Anonymous said...

Could not agree more with you W.O.R.M!

I see MOC as another form of "spoofing" (charade) which has consciously manipulated healthcare markets and reduced the public's access to care. MOC has the decades-long effect of manipulating the professional workforce and has created bottlenecks (increased wait times leading to possible adverse outcomes) and decreased access to care in countless under served areas and even in the well-healed parts of our country. We are all witness to this dangerous situation involving physician shortages and patient access.

Remember the VA scandal and deaths! Where is the outrage about the MOC-induced shortages/bottlenecks as the VA utilizes private physicians more and more adding to the chaos and deficiencies in care -- deficiencies the ABIM appears to support along with their cohorts.

Spoofing Schemes said...

The racketeers in this "MOC spoofing" scheme are not the corrupt Wall Street trading firms conducting the illegal day-to-day illegal manipulation of precious metals, but the equally respectable racketeers involved in the disgraceful manipulation of precious human lives -- precious lives that are being advpersely affected by MOC.

JP Morgan traders are being charged with RICO after a 10 year investigation. The ABMS and the underlying fraud/corruption in the medical industrial complex would take more than 10 years to investigate and punish, but MOC is a clear case. MOC should end today, as it clearly does harm to all. (Except the professional medical politicians and so many others who have become dependent on MOC's golden teat.)

Anonymous said...

The ABMS and ABIM, because of their greed have chosen poorly. They decided to help make each of us (patient and physician) a victim of the underlying core corruption that it supports. The ABIMF's "Choosing Cheaply" (or choosing nothing at all) campaign is another conscious manipulation of the physicians and the patient relationship leading to possible adverse results. At first there were deaths, but that quickly got hushed up and buried.
Executives at the ABIM double dip taking additional compensation from the "Choosing Richly" Foundation "Piggy Bank". Remember the words money laundering assoiciated with the funding of the ABIM Foundation. Also quickly buried after being hushed up. The ABMS engages in this tacky non-profit foundation bonus plan also with their double dipping into their "research" foundation. They do it with profits from their for-profit subsidiary ABMS Solutions.

Condemned to MOC Hell / Locked Behind A Pay Wall said...

Everyone knows MOC® has dark sinister horns, loud kicking hoofs and a spiny corporate tail.

Seriously, any physician repeatedly inflicted with "MOC bites" and simultaneously choked breathless by ABIM's red tape -- not to forget the unforgettable experience of being sucked dry in perpetuity by their blood thirsty financiers -- knows there is a big difference between certification and MOC. Two very different and separate products. Two separate realities. The judge just did not have first hand experience that we all have. MOC's first bite and the peculiar sensation of not being able to breathe til death to us part, is worth a thousand legal citations and better tender than a dozen judge's opinions.

The honorable judge was born the same year as the ABIM, circa 1936. God bless this retired senior judge for offering up his quick opinion. We all make mistakes. He obviously does not know the ABIM and how corrupt, closed and legally flawed they really are. Any attempt to capture with words the whole of their egregious self-dealing, unethical and conflicted money-grubbing behavior is bound to be flawed, just as flawed as the ABIM.

Just as there has never been an adequate description of hell since Dante, we are incapable to describe the cast of characters and all that they have done to create this byzantine MOC Hell for us... a lifetime of intimidation and uselessly being tested to death. We all are forced to serve the ABIM in MOC hell and many of us are too numbed or suffering from PSD or SS to know how to describe it adequately, let alone find that moment of recognition where we realize we have to muster the strength to fight back.

I think we were hoping that this old Reagan-era judge could help provide some relief so we could serve our patients and families with more focused attention, but at the same time everyone knows the cards have always been stacked in the ABIM's favor.

Anonymous said...

its over. very unfortunate decision. the learning point is that ABIM is so entrenched that is cannot be dislodged- initial certification and MOC are the same according to the judge to be ABIM certified. if you sit for the initial exam that you are locked into MOC. there is no escape.

DrWes said...

Sorry Anonymous 10:03 AM CDT-

Don't be depressed. This case is FAR from over. The Plaintiffs still have a number of days to file amended claims, and the unconvincing nature of the dismissals so far make the grounds for appeal good, in my opinion.

Anonymous said...

Dr. Wes.
Wish I had something more positive to say by I agree with the other Anon. ABIM clearly runs the show. Cassel (who’s not even certified anymore but makes bank in Cali fir the Kaiser med school) and Baron have cared about one thing, perpetuating this travesty. It doesn’t matter how many doctors and patients get hurt.
I think more attention can be focused now on individual states. By Baron et al arguing the” voluntary” nature of MOC ( which is BS), then each state legislator should outlaw MOC being part of licensing, insurance, and hospital priv. It’s only fair King Baron. I’ll be contacting my rep as soon as I end MOC studying hell.

Anonymous said...

It's unfortunate that the legal system treats physicians this poorly but not unexpected. We should continue to keep up the good fight. Beyond the legal fight, maybe the fight should be done at also a grassroots level.

If you are mentoring medical students or residents, talk to them about MOC. If you are someone in the LA area, maybe the NBPAS can send the medical students can at the new Kaiser Medical School on who Dr. Cassel is and what is going to do them. They might note appreciate being considered a commodity or cattle for the elite. If she is ever a speaker, have individuals challenge her to a debate or ask her to question why she backs MOC and what gains did she get from it. Why is a non-practicing physician allowed to be a dean at a medical school.

At any meetings, can the photos of people, past or present who support MOC, ABIM, ABMS be put on posters to be announced to all who visit. It's easy to sit in anonymity but harder to face the music when the spotlight is on them.

Talk to your local university or hospital ethics boards and ask them why should this hospital or group support MOC. If they cannot justify the harm and ueselessness of MOC then it puts then in uncomfortable situations and forces them to confront their colleagues.

If Dr. Barron is going to another TED talk or Aspen talk. and if you know someone there, ask him to answer tough questions about the harms it causes, the money he makes, and the lack of evidence. Challenge him to an open debate. Maybe that Perry Wilson who interviewed before will not ask such softball questions.

Keep going with the legislative attempts like in Oklahoma to ban MOC from being a part or reimbursement. Get the data with the ban from outcomes from Oklahoma and most likely there will not much of any physicians who are not performing MOC to other physicians around the country.

Report MOC supporters such as those on the ABMS vision to their local medical boards of the harms they have caused and force the boards to to comment on the validity of MOC and if this is professional behavior. I suspect that most of the medical boards would not wish to condone this behavior and find out later they condoned racketeering and a ponzi scheme. The boards would also be asked why be a second banana and give up authority to a false bureaucracy such as the ABMS..

If you donate to your medical school charity or residency program, tell them you will withhold your money until they disavow themselves from MOC.

Tell the wellness groups and HR of your local hospital that MOC adds to physician burn out and ask what do they think about this and then ask them for a plan to combat it. Ask the credentialling committees do they condone such systems of physican harm and de-credential those who profit from MOC.

Ask the ACLU for help as MOC seems discriminatory.

Keep shining the light on them

Anonymous said...

Sadly, our society no longer values or respects physicians. MOC is only one example of how much our lives do not matter. Only those inside medicine truly know that physicians are overworked and current health care systems are conducive to more medical mistakes. MOC will not help it; on the contrary, it will put additional stress on those providing care. Who in their mind could really believe that the ability to quickly memorize and quickly retrieve multiple bits of information makes a good physician? Honorable judge, how dare you talk about voluntary MOC? It is very simple – no board re-certification – MD will not be hired. MD can forget decades spent in medicine, his/her clinical experience and patients’ appreciation for saving their lives/health. He/she goes elsewhere, but where?... This is very discriminatory, especially for older physicians or the ones with health problems.