Wednesday, January 27, 2021

Is ABIM Ending Its "Knowledge Check-In" MOC® Pathway?

The following (redacted) email was received from Morgan Allen, Customer Relationship Advocate at the American Board of Internal Medicine (ABIM), in response to an ABIM diplomate that was unable register online for their every-two year Knowledge Check-In "continuous" Maintenance of Certification (MOC®) product.

According to this email, it seems the ABIM has decided to end its Knowledge Check-In recertification pathway and only permit its every-10-year high-stakes recertification examination for physicians to remain ABIM Board Certified.

At the time of this writing, I could find no public notification of this policy change on ABIM's website. Once again, working physicians are irresponsibly left uncertain of the latest requirements to remain ABIM Board Certified in good standing.

ABIM has a long history of changing the rules for the names and requirements for physician board recertification/maintenance of certification/continuous certification. But despite the many name and rule changes of this racket, each rebranding becomes more expensive and serves to perpetuate the discrimination against younger physicians and physicians of color from senior "grandfathered" physicians who are not required to purchase these products to retain their ABIM Board Certified status. The Knowledge Check-In recertification pathway was no different from its predecessors in this respect. But the Knowledge Check-In pathway also suffered from a plethora of technical, security, and (undisclosed) privacy issues for physicians. (See my earlier video that critically reviewed this recertification pathway and the people who created it.)

One thing is a constant, however. Ever since the ABIM changed Board certification from a lifetime to time-limited physician marketing accolade, this unproven repeated testing of working physicians remains a career-long psychological and economic stressor that distracts from what matters most: patient care.



Anonymous said...

Just checked. The ABIM site now tells me that I have to earn 100 MOC points every 5 years and I have done that (through the other CME that I do that transfers over to MOC). I paid for the ten year plan taking knowledge check in every 2 years....The site shows me that I am on the 2 year plan , but will not allow me to schedule an exam on either certifcation (internal medicine or my subspecialty). To be honest, with COVID, I haven't even looked at my ABIM status. I don't think the brain drain from wearing a mask all day would let me do that. (Actually, it is the emotional drain, but....) I am at the place where I can retire, and too many games by the powers that be will get me there.

If you dig further in the ABIM site, it says "coming soon, longitudinal assessment". ( The every 10 year exam will remain in place, but now they will have this thing......From the ABIM site:

"Longitudinal Participation Requirement
Expand/Collapse Content

ABIM understands that “life happens,” sometimes unexpectedly. That’s why the longitudinal pathway participation requirement includes built-in flexibility to allow for life’s circumstances, such as short-term medical issues, vacations, weddings, funerals, or other personal events.

Over the course of five years, you will be offered 600 questions (120 per year, delivered periodically) and can skip up to 100 while still meeting the participation requirement.

You’ll have four minutes to answer a question and, each year, have access to a 30-minute time bank you can draw from if you need extra time on a particular question. This amount of time was derived by analyzing data from previous ABIM exams that allowed physicians to access an external resource. It also aligns with the construct of a longitudinal assessment in that it measures what physicians should know to provide high-quality patient care and emulate the finite time they have to look up information in practice.

If you choose to skip a question, you must decide before you open it, so the question won't count against you in scoring. Any questions not attempted will count as skipped."

Thanks for the update ABIM.

Anonymous said...

What a surprise. ABIM moving the goalposts again. I find myself 'astonished' that more current, practicing physicians will have to leap through hoops that the 'grandfathered' generation will never be concerned with. It's never enough for these clowns at ABIM to just pay them their extortion money, take a test and then disappear for the next 10 years.

I am starting to wonder if they see the writing on the wall and realize that the appeals court is going to order the lower court to proceed with discovery on the lawsuit and they're trying to think of new ways to jack up their cash flow for a war chest.

I keep waiting for an update on the appeal because I so desperately want ABIM to be taken to court and have to explain all their shady manipulations in discovery. ABIM is like the current hedge funds and retail brokers trying to stop folks from buying Gamestop stock so they can short sell and make out like bandits. Ethics go right out the window when you're talking about ending this huge money making scam by ABIM.

Pamela Karasik said...

As a cardiologist who is due to recertify this year I too was mystified by the options on the ABIM site, and I didnt even see this new "plan" of 600 questions and a time bank? Really, you must be kidding. The ACC SAP plan is equally onerous with yearly exams, tracked hours of "learning engagement", should I just retire??

DrWes said...

Pam -
So sorry you are caught in this scam. You are a friend and colleague who has always cared for our veterans with an amazing commitment and effort. I hope you don't retire simply because of this rip-off (but I would understand). Let's see what happens with the Appellate Court ruling on the ABIM case. It could be a game-changer if they rule in favor of the Plaintiffs and the case goes to discovery.

~ Gordon Pasha said...

And now AACE is getting into the time limited fellowship option. SMH

Anonymous said...

I got the same message from ABIM and am FURIOUS. Beyond furious.

I am contractually required to maintain board certification and to be told suddenly that the 2-year option I signed up for and PAID FOR is now gone and I have to take a high-stakes 10 year exam during a pandemic year is beyond ridiculous.

Pearson Vue and OnVue on Trust Pilot said...

ABIM's Collapsing Contract With Physicians And The Public

ABIM has a long term multi-million dollar contract with Pearson Vue. For online proctored exams like ABIM's KCI they used Pearson's "OnVue".

OnVue is/was a failed product from the start. Pearson bought a failing company in 2015 called ProctorCam and rebranded it. Apparently the program still can't deliver.

How bad is Pearson's products and services?
See TrustPilot for some consistently bad reviews of Pearson Vue and OnVue. Lower than the one star minimum would allow.

Also read Dr Wes' publication "Doctor's Right to Privacy: Is MOC Collapsing Under Its Own Weight" for further evidence of ABIM's abysmal failure with KCI and MOC. Longitudinal Assessment is the next MOC debacle that will possess one's precious time, money and attention.

With ABIM's long-term contract with Pearson Vue (8 years left) it is more likely than not that they are scrambling to get "Longitudinal Assessment" ramped up and ready to sell prematurely to the captured clients (and captive courts) before the ABIM and ABMS collapse under the weight of their own pathological lies, greed and incompetence.

Note: ABIM only commits to the 10-year MOC exam "beyond 2021".
That is not very reassuring for those docs who paid for 10 years of respite from the high-stakes testing nonsense only to find that they will be forced to do the higher-stakes "longitudinal assessment" with annual/quarterly testing, which will include an all-in-one dashboard to keep track of you with unknown capacity/requirements for data collection. And a whole lot more.

Privacy died with the ABIM; constitutional rights negated for everyone except the rich ABMS executives who willy-nilly control the lives and destinies of a million hard working physicians. Men and women struggling to survive during a relentless pandemic and collapsing economy. Especially the small business owners/independent practitioners.*

*While the ABMS "not-for-profiteers" play broker with everyone's money buying real estate, stock portfolios and maintaining offshore hedge funds. Endless bonuses while everyone else is out of work or getting pay cuts.

Good luck to all. Hope the PA courts have some common sense and do what is right sending us on the path of discovery, jury selection and a fair trial.

Larry Hater said...

Dear Christine:

I am writing to you to request your assistance with a very urgent matter. I have heard you are an expert on physician burnout and hope you can help me. I don't want to belabor the point but us physicians need all the help we can get right now. You have done an extensive amount of research...oh, you haven't? Then how do you know what will help us physicians? Is there any research in this regard? Oh, there is. What does it say? Oh, it says that physicians are burnt out due to the electronic health records and a plethora of other issues that are plaguing them really. And what do you think Christine? Oh, you think we should do some yoga. I have to be honest here Christine, I have tried yoga and I feel like a pretzel really. All twisted up and pointing in different directions. The "relaxing music" almost gave me an aural seizure. The Half Lotus pose was pretty harsh on the bursitis and the Downward Dog pose well...let's just say I'm not lovin' the damn Dog. Have you ever done the Downward Dog Christine? Well, that would be something to truly see. (For a bit of comic relief, the readers of this post should visualize a group of doctors of all ages and body types simultaneously doing the Downward Dog pose in one big room on their off-time. You can bet they are all hoping bean burritos weren't on the lunch menu in the doctor's lounge that day. Pretty funny, huh? Okay, back to Christine.)

It actually increases my stress rather than decreases it so what else do you have for me? Oh, you have your own electronic medical records that can help us. But they don't really. They just help to make some money for you. Don't you have enough money already? How much do you need? When will it be enough? How much is enough for you and the other esteemed leaders of medicine? What do you all do all day really? This is the question I really want to ask you and the other leaders right now. What do you do all day long?

Well, I can tell you what I do all day long when I go to work in a community mental health center. I basically type and click ALL DAY LONG. Oh, I do a few other things like sign useless treatment plans that make JCAHO happy and check never ending emails. More clicking there. Do you know I have to click about ONE THOUSAND times and type about NINE THOUSAND times per day to get through my workday? I imagine other doctors have to do the same. Why don't you do some research there? That is a wonderful research idea really (I am full of great ideas. You will see.) Do some research to find out the amount of clicks and keystrokes physicians are doing per day to get through their workday. I will be your first subject. Please mark down 1,000 and 9,000 for me. Thank you.

ABMS MOC® Digital Gaslighting Project said...

Longitudinal Assessment

MOC is the gaslighting of physicians. It involves surveillance, data collection, maintenance of ABMS/ABIM cash and control. The professional medical labor force is being manipulated through MOC. This is an undeniable fact.

Longitudinal assessment under development is a far worse form of MOC gaslighting that docs must be proactive about stopping now. It must be stopped/ended along with all forms/iterations of MOC and the gaslighting of the ABMS/ACGME.

Longitudinal assessment, a global project, is a movement toward ultimate surveillance, data collection enlisting a uniquely "totalitarian technocratic platform". "LA' aims to create a highly sophisticated form of radical online testing, surveillance and novel new forms of gaslighting. Robust technologies will be deployed to create a new force of doctors and providers. (The costs will rise, possibly exponentially.)

Counting on the passivity of their professional clients, ABMS hopes to seal the fate of physicians getting them to accept total maintenance of cash and control. Longitudinal assessment is going to be duplicitously offered as a superior alternative to the current MOC.

Wage compression and rationing of healthcare are the aims of the ABMS executives. Not for themselves but for physicians and all healthcare providers.

Through the ABMS/ACGME blind policies and greed, we can all count on increased burnout, depression and suicides.

Who does the ABMS serve?

Physicians? Certainly not?

The public? Never.

Attorneys and the courts are necessary to put a bridle on these unaccountable failing organizations of new formation who wield so much power.

Larry Hater said...

Oh Christine, I am getting a bit tired but I really want to share some more good ideas with you because I know that you will really appreciate them. How do I know this? Because you think that other people want to hear your great ideas so I would assume you want to hear others' great ideas. You don't? Why not? Oh, because yours are better of course. But what makes your ideas better than any other doctor like me for instance? And why do the leaders think their ideas are better than any other doctor? They have about the same amount of education and training for the most part. What makes the leaders ideas better than any other doctor out there Christine? Christine thinks she is better than most doctors out there really because she is more educated and accomplished than most doctors. Well, that is because you are obviously OLDER than most doctors out there really. Right?

But does age alone make you more knowledgeable? Well, it certainly could make you wiser but, in this case, that is not true. You are not wiser Christine but you have definitely clawed your way to the top of the heap so to speak. I am sure you have stepped on a lot of heads to get there really. Who in particular? Well, mine for one. You and the leaders have conspired to make the ABMS powerful and corrupt to make lots of money for yourselves and you don't care who has to go down for it to happen. Doctors, patients, yourself...just kidding there. But who has to go down for it to happen? Why do so many people have to go down in so many ways so a few people can make obscene amounts of money? How do you all sleep at night?

You know Christine, years ago I was offered a lot of money to do legal work and I declined because I like to sleep at night. How do you leaders sleep at night knowing that you are ruining the careers of doctors who have worked very hard for their careers? And depriving patients of good doctors just because they couldn't keep up with confusing recertification requirements or pass tests with no real merit and may not even apply to what they are doing for their jobs? I ask you again Christine. How do you all sleep at night? You must sleep of course because you are presumably alive and reading this letter. Do you have to take sleep medication? I do sometimes due to the anxiety associated with working my tedious and demanding job. I know many doctors have problems with depression and anxiety due to practicing medicine in the current climate in which they are forced to work. It is very difficult to practice medicine in today's climate but the leaders don't care. They just ignore the problems their colleagues are dealing with on a daily basis when they go to work. How do you think this affects the patients Christine? Well, not in a good way of course. What do you suppose is happening right now if you had to guess?