For the past seven years, I have devoted a significant amount of my time to investigating and telling the true story of US physician "board certification." That story has been one of deceit, private back-room deals, profiteering, and (worst of all in my humble opinion), the exploitation of working physicians and the patients for whom they care.
This writing has not come without its personal and professional costs, but when the story is one that affects the corruption of the largest single contributor to the US economy, what else should I have expected?
As I reflect on what this side job has exposed, it would be naive and dishonest to suggest that physicians are exempt from bearing some responsibility for rising healthcare costs in America. But it may go much further than that: our medical profession and its hallowed physician education regulatory system comprised of the unchecked Accreditation Council for Graduate Medical Education (ACGME) might be the very reason things were allowed to become so out of control. Our non-profit tax laws with their opaque reporting requirements have allowed huge "non-profits" to go unchecked in America - and most of those "non-profits" are in healthcare. (Just take a stroll by the American Medical Association (AMA) building in downtown Chicago sometime to get a feel for the magnitude of the problem.)
Why should the physician education and credentialing systems in America be exempt from such corruption?
Well, they are not.
From the earliest reports of a multi-million dollar condominium purchase by the same non-profit organization that created the "Choosing Wisely®" campaign to promote health care cost savings, the hypocrisy of US board certification was laid bare. With not-so-difficult internet Google searches, it was just a matter of time before the multiple deep-pocketed corporate ties between US physician board certification and Big Tobacco, Big Insurance, Group Purchase Organizations, and the Health Care Quality and Safety Industry became evident. Even our most widely respected health care journals, many of which were owned by state medical societies or physician specialty societies, published innumerable articles with an editorial blind eye to these financial conflicts. Even the Chief Medical Officer of the American Board of Internal Medicine is just a hired corporate consultant. To that end, is it any wonder that the so-called "voluntary" ABMS board certification product is now anything but voluntary for physicians, as trillions of health care dollars exchange hands in hospitals and insurance companies whose corporations believed the published propaganda?
This is why the "Maintenance of Certification" (MOC) story must be told and understood. Continuing the cover-up only serves to fan the flames of physician burnout and risks loss of more frontline highly-trained physicians to other professions.
Thankfully, the true history of AMBS board certification was recently published online. But it was not published in a medical journal. It was published in the public Siva v. American Board of Radiology antitrust lawsuit case docket.
And what a complicated and tortuous story it tells.
It is a story of public deception.
It is a story of physician exploitation.
It is a story of greed.
It is a story of trying to use Maintenance of Certification to control state's sovereignty over medical licensure.
It is a story of money for bureaucrats, hospitals, and numerous corporate interests at the expense of the youngest and most vulnerable physicians.
It is a story of a sophisticated self-serving physician education and credentialing racket.
And now, you can read the 79-page story here.
Let's hope Judge Jorge Alonso (who initially dismissed the case against the American Board of Radiology) reads it, too.
P.S.: Please consider supporting the Plaintiffs in their ongoing David vs Goliath MOC legal battles.