Become active in the battle against MOC at:

http://www.communitysynergy.com/cc/public/display/1474b05afa

Fighting MOC-the homepage!

After ANTI MOC petition HITs 10,000 signatures,ABIM CEO Baron debates Dr Wes

ANTI MOC petition causes ABIM concerns see and sign at:
http://www.petitionbuzz.com/petitions/recallmoc 

Dr WES: ABIM Thumbs Its Nose at Senior US PhysiciansYesterday, the President and CEO of the American Board of Internal Medicine (ABIM), in a moment that must have been heartbreaking for him, found himself in the position of having to<span>chasten</span> more than 10,000 unruly senior US physicians, thanks to a <span>petition</span> drive.  In his<span>statement</span>, the aggrieved Dr. Baron, in a plea for common sense, bemoans the fact that physicians do not care enough about patient care or safety to spend $200-400 dollars per year for the ABIM.  This is what the benighted ABIM is up against!  Senior physicians are nothing more than penurious whiners who fail to be appreciative of the Mothership.

Dr Wes summarizes further the ABIM problems at:
http://drwes.blogspot.com/2014/04/abim-thumbs-its-nose-at-senior-us.html?utm_source=feedburner&amp;utm_medium=twitter&amp;utm_campaign=Feed:+DrWes+(Dr.+Wes) 

After this statement was issued by the ABIM
Statement from Richard J. Baron, MD, MACP, President & CEO of the American Board of Internal Medicine regarding anti-MOC petition
Philadelphia, PA, April 28, 2014 - ABIM has heard from many diplomates about their frustrations to the changes to the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) process. They have concerns about relevance, cost and the time it takes to complete MOC. A <span>petition</span>, signed by more than 10,000 physicians, raises many important issues.  read more at: 
http://www.abim.org/news/statement-from-richard-baron-regarding-anti-moc-petition.aspx

MOC Deadline Looms Anew, as Resistance Mushrooms

PHILADELPHIA, PA (updated) — With just a few more days to register for their "maintenance of certification" (MOC), almost 9000 physicians have signed on to a cardiologist-led petitiondemanding that the American Board of Internal Medicine(ABIM) recall the changes it made this year to the MOC process.

After April 30, as previously reported by heartwire , the ABIM will begin publicly reporting that physicians who are not registered are "not meeting MOC requirements."

The petition, created by Dr Paul Teirstein (Scripps Clinic, La Jolla, CA) on March 10, gathered 200 signatures in the first day, and support has mushroomed.

"The changes in the MOC requirements have upset a large number of cardiologists," Teirstein told heartwire . "It seems that pretty much everyone I speak with is against these changes, and the main arguments against the changes I received are that they don't create value for physician—ie, they do not have significant educational value—and they take considerable time and increased expense."

from: http://www.medscape.com/viewarticle/824164?src=wnl_edit_newsal

American Board of Internal Medicine Policy Condones Keeping Conflicts of Interest Secret

This is very interesting how the American Boards regulate themselves (NOT) and have no trouble skirting all conflicts of interest!

SEE: http://hcrenewal.blogspot.com/2014/03/american-board-of-internal-medicine.html
for the full text!

The latest complication of the CareFusion/ Dr Denham/ NQF/ Dr Cassel/ ABIM case was the revelation that the current president of the NQF, Dr Christine Cassel, after resigning her position on the board of directors of for-profit publicly held group purchasing organization Premier Inc, was found to have been on the board of for-profit privately held predecessor of Premier Inc since 2008 (see post here).  Before Dr Cassel was CEO of NQF, she had been the president and CEO of the American Board of Internal Medicine for 10 years.  So apparently she was on the board of the predecessor of Premier Inc for about five years while she was leading the ABIM.

This relationship appears to be as serious a conflict of interest for Dr Cassel in her previous role as leader of the ABIM as it was for her current role as leader of the NQF.  Since she had this conflict for so long as leader of the ABIM without public disclosure, it seems logical to ask whether she was a long-term violator of ABIM policy, and hence sort of a long-term rogue CEO?

To answer that, one needs to review the ABIM conflict of interest policy.

What Sort of Conflicts of Interest Does the ABIM Ban?

The official wording is: 

It is the policy of the Board that Directors, Subspecialty Board and Committee members, consultants and other individuals involved in developing ABIM products will not be employed (as staff or as a consultant) at greater than fifty percent by a commercial entity, except in such instances where explicit exceptions to the policy have been made by the Board. Unless a compelling reason is presented for granting an exception, such individuals will be asked to resign their position of service to the Board.

Earth Day Activism a Model for Physicians Supporting Lifelong Learning?

Thoughts worth considering @ http://thepracticalpsychosomaticist.com/2014/04/22/earth-day-activism-a-model-for-physicians-supporting-lifelong-learning/

NOW the business of Paying physicians!

These are from the new CMS data on who gets paid what and of course anesthesiologists do NOT get reimbursed very well. you get paid the same for a CABG as you are charged to replace your windshield!

The Business of Testing Physicians

Wes Fisher posted this revealing information regarding the cost of MOC on his website at: http://drwes.blogspot.com/
It is well worth a read!!!

Friday, April 04, 2014

The Business of Testing Physicians

If you want to understand the world of professional board certification, it is important to understand the business and politics of testing professionals. Such testing is big business. So big in fact, that huge international media and education companies that trade on the New York Stock Exchange have been created to service this need. According to one article on Reuters from 2012, "the entire education sector, including college and mid-career training, represents nearly 9 percent of U.S. gross domestic product, more than the energy or technology sectors."

Part of the expense of "maintaining" one's professional board certification goes for fees for the testing center where the computerized testing occurs.  Because cardiac electrophysiologists must hold two board certificates (Cardiac EP and Cardiology), we must pay for two rounds of test-taking fees: the first is included with our cardiology maintenance of certification (MOC), then we must pay a second $750 testing fee for the second EP test.  (Each test contained 180 questions - $4.17 per question).  I am assuming almost all of this goes to the company that administered my test: Pearson VUE.

ABIM holds a contract with Pearson VUE, a professional testing subsidiary of Pearson Education, the North American subsidiary of Pearson, PLC (NYSE: PSO) - an 9 billion dollar British corporation that claims it is the largest commercial testing company and education publisher in the world. It boasts Penguin Random House publishing and the Financial Times Group as some of its other far-reaching subsidiaries. Mr. John Fallon is the 52 year-old Chief Executive Officer of Pearson, PLC and earns a cool $2.55 million dollars annually while holding 282,147 shares of Pearson stock and plently of stock options.  He is joined by Mr. William T. Ethridge, age 62, who serves as "advisor" currently, but was previously responsible for the North American Educational Division of Pearson.  According to one source, William Ethridge was once chief executive of Pearson's North American Education division in 2008. According to Forbes, his total compensation in 2011 was $1,390,000 and he held a half million shares of Pearson stock at that time.

Pearson VUE states it "is built on a foundation of experience in electronic testing."  My experience with Pearson VUE was parodied in an earlier blog post. As I reflect, it seemed that Peason VUE was more concerned about storing my biometric palm scans and a digital photograph as much as they wanted to assure a fair testing environment. While the ABIM discloses this process on their website, doctors unaccustomed to such paranoid security measures are caught off-guard by these tactics and should be concerned about how this information is stored and used. Are previously-certified doctors really this sketchy?

Pearson VUE earns a pretty penny from its professional testing and its physician testing in particular. According to Pearson's most recent SEC filing:

"Professional testing continued to see good revenue and profit with growth test volumes at Pearson VUE up 25% on 2012 to almost 12 million [pounds] ($19.9 million). Key contract renewals included tests for the American Board of Internal Medicine, the Association of Social Work Boards and the Pharmacy Technician Certification Board. "

But profitting from physician education is a politically hot topic, too. Not surprisingly, Pearson Education seems quite active in this space spending $2,100,000 to lobby Washington during the last presidential election cycle in 2011 and 2012, contributing 7:1 to the Democratic side of the political aisle. Also, 6 of the eight current Pearson lobbyists have previously held government jobs.

Doctors should understand how and where their money and personal information are being used in the ABIM's MOC testing process, since much of those funds seem to support the corporations and political aspirations of those who are doing the testing rather than the needs of patients that the ABIM is pretending to protect.

-Wes