Opposition to ABIM — A tipping point for physicians?

I know physicians. They are smart, hard-working and prideful. They do a lot of good in this world. But one thing we have been utterly incapable of doing is organizing together and speaking as one voice.

The American Board of Internal Medicine may have changed that. The hubris, overreach, and tone-deafness of ABIM may have gone too far. Now, there may be a glue strong enough to hold physicians together.

Dr Wes Blog
Dr Wes Blog

My colleague Dr. Wes Fisher culminated a 2-month investigative journalism adventure yesterday. He published his piece on the inner workings of ABIM, its foundation and its $2.3 million condominium in Philadelphia. Wes’ work uncovered such things as domiciles in other states, $840K expenses for the condo, big salaries for executives, among other things. I’d recommend reading the entire piece.

Another influential voice in ABIM opposition appeared this week. Internist and author Dr. Danielle Ofri, writing in the New York Times, suggested that board certification has gone too far. Stop Wasting Doctors’ Time is also worth a read. Dr. Ofri reviews two recent studies in JAMA that showed board certification had little to no effect on quality measures and costs. This has been my take as well: that there is no data to confirm that the ABIM brand (an expensive one) of medical education is effective or safe.

When I was preparing for my Top Ten Cardiology piece, I reached out to colleagues to ask about their views of the big stories of 2014. Every one of them mentioned the onerous new mandates from ABIM.

State medical boards, the American College of Physicians and the AMA have now pulled back from the idea of tying medical licensure to certification. Thousands of doctors have signed anti-MOC petitions. The opposition crosses specialty lines. Social media has amplified these voices.

This, my friends, may be a tipping point. I believe there’s a bigger story here than just medical education and opposition to an overreaching organization.

Doctors coming together to speak with one voice. That is something I would not have predicted.

I’m just wondering: if we can come together to oppose ABIM, could we also come together to oppose other nonsensical notions that impair the doctor-patient relationship or threaten our professionalism?

JMM

5 comments

  1. John,
    You are spot on. As egregious as the ABIM/MOC story is, it is just the tip of a much bigger iceberg: the use of a humanitarian façade to enrich special interests’ pockets. Sadly, this is happening in many venues and has stretched its tentacles to our new health care law. Patients paying their $10,000 deductibles and copays should understand why and who is profiting as a result. Hopefully doctors will have the courage to expose more areas that threaten our ability to fully advocate for our patients and those that work to prevent us from doing so.

    1. This unsavory, irregular behavior by Drs Baron, Dr. Cassel and the ABIM will spark a war between the non-clinical, administrator physicians who are parasitically living off the sweat equity of all clinically active physicians. I would hope that during this time of clinical austerity and calls for effiency and cost accountability that the ABIM will have its suspicious financial behavior vetted by a Federal Agency like the Department of Justice or the Pennsylvania State Attorney General’s office. I am hoping that the allegations of misuse of funds for some type of $2M Center City pleasure palace condo are wrong. However, if it is indeed true that the ABIM spent $2M+ on some type of real estate venture that benefitted its Board Members, it would behoove all hard working physicians to demand that their respective societies disengage from the ABIM. Enough is enough.

    2. Thanks Wes. To my readers, Wes Fisher has been, and is, a tireless leader in the anti-MOC movement. He stands up for the working-stiff doctor. Thanks friend.

  2. Agree.There are too many medical organizations that require certification.Their requirements are often arbitrary and the organizations are often self serving.They serve the investigators that want a vehicle through which they can provide paid CME to other physicians and a vehicle to publish often repetitive and redundant research papers.
    Thanks.

  3. The ABIM has unfortunately transformed itself into an opaque quasi-regulatory organization whose recent sloppy decision to subject physicians to odious “recertification” burdens, at a time when the profession is already under massive amounts of redundant oversight, has provoked a violent reaction from physicians across the nation. There is no reason why we, as cardiologists, need to be subjugated by the ABIM. I would suggest that the ACC, HRS, TCT organizations, who have all had a strong track record supporting clinical activity and clinical physicians, lead the effort to offer our own recertification process totally independent of the ABIM. Why do ACC members need ABIM certification when the Steering Committees for the Cardiology Exams are all ACC members anyway? The ACC has the resources, the background and the talent to construct our own Board Certification process that is more economical, more relevant, less onerous, more common sense filled, and most importantly more respectful of our sub speciality. I find it oxymoronic that the ABIM leadership relies on overpaid, aloof non-clinicians to adjudicate what makes a competent cardiologist, interventional cardiologist, cardiac electrophysiologist and transplant cardiologist. I would like to appeal to my colleagues, peers and friends to lobby the ACC to construct an independent Board Certification process that is not reliant on the ABIM – See more at: http://blog.cardiosource.org/post/an-inside-look-at-abim-certification/#sthash.XQmRRjmq.dpuf

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