The ABMS Spider and the Fly

Mary Howitt

“Will you you walk into my parlour, said a Spider to a Fly;
'Tis the prettiest little parlour that ever you did spy.
The way into my parlour is up a winding stair,
And I have many pretty things to shew when you get there.
Oh, no, no! said the little Fly; to ask me is in vain:
For who goes up that winding stair shall ne'er come down again.

Said the cunning Spider to the Fly, Dear friend, what can I do
To prove the warm affection I have ever felt tor you?
I have within my parlour great store of all that's nice:
I'm sure you're very welcome; will you please to take a slice!
Oh, no, no! said the little Fly; kind sir, that cannot be;
For I know what's in your pantry, and I do not wish to see.

Sweet creature, said the Spider, you're witty and you're wise;
How handsome are your gaudy wings, how brilliant are your eyes!
I have a little looking-glass upon my parlour-shelf;
If you'll step in one moment, dear, you shall behold yourself.
Oh, thank you, gentle sir, she said, for what you're pleased to say;
And wishing you good morning now, I'll call another day.

The Spider turn'd him round again, and went into his den,
For well he knew that silly Fly would soon come back again.
And then he wore a tiny web, in a little corner sly,
And set his table ready for to dine upon the Fly;
And went out to his door again, and merrily did sing,
Come hither, pretty little Fly, with the gold and silver wing.

Alas, alas! how very soon this silly little Fly,
Hearing his wily flattering words, came slowly fluttering by.
With humming wings she hung aloft, then nearer and nearer drew.
Thinking only of her crested head and gold and purple hue:
Thinking only of her brilliant wings, poor silly thing! at last,
Up jump'd the cruel Spider, and firmly held her fast!

He dragg'd her up his winding stair, into his dismal den,
Within his little parlour; but she ne'er came down again.
And now, my pretty maidens, who may this story hear,
To silly, idle, flattering words, I pray you ne'er give ear;
Unto an evil counsellor close heart, and ear, and eye,
And learn a lesson from this tale of the Spider and the Fly.

~By Mary Howitt, 1829
* * *

If you do Maintenance of Certification, you are just a silly little Fly.

It is chillingly apposite: for the American Board of Medical Specialties (ABMS) and their 24 member boards' to live, autonomous independent-thinking physicians must die.

Spiders can never stop being Spiders.

"And now, my pretty MOC maidens, who may this story hear,
To silly, idle, flattering words, I pray you ne'er give ear;
Unto an evil ABMS counsellor close heart, and ear, and eye,
And learn a lesson from this tale of the Spider and the Fly..."

... then donate to Practicing Physicians of America's expanded legal fund drive.

-Wes

Happy New Year, MOC!

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.

-Wes