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At least the condo is really nice.

March 11, 2015

As an anesthesiologist, and a recently retired one at that, I have looked upon the battle between the American Board of Internal Medicine (ABIM) and internal medicine doctors about Maintenance of Certification (MOC) with a sort of interested detachment.  I’m interested because the corresponding anesthesia society is having the same arguments, and detachment because I’m not an internal medicine doctor.  In case you haven’t heard, credentialing societies within medicine are having a bit of an argument with the doctors who are credentialed over re-certification exams and other MOC requirements.  The societies say they are necessary to maintain standards, the doctors say they are pointless and expensive.  I have talked about MOC on this site before and readers have generally either sided with the doctors or decided that all doctors are whiners who just don’t want to be held accountable.

Believe what you want about the actual educational value of MOC requirements.  A new report out in Newsweek suggests that there is no question as to the monetary value of MOC requirements.  (http://www.newsweek.com/ugly-civil-war-american-medicine-312662) And you don’t have to believe me, or Newsweek author Kurt Eichenwald.  Wes Fisher, a fellow MD blogger and a leader on the social media front of the ABIM battle, has a very in-depth piece about it on his own site (http://drwes.blogspot.com/2014/12/the-abim-foundation-choosing-wisely-and.html).

In 2001 (just before the new exam requirements) the ABIM had revenue of around $16 million, and the boss got about $230,000.  In 2013 ABIM raked in $55 million, and paid the boss $645,000.  But that’s not all.  The ABIM Foundation, a somewhat murky organization founded in 1999 dedicated to “professionalism”, has $74 million in assets and brought in $20 million on those assets.  Both the ABIM and the ABIM Foundation are non-profits.

OK, you say, but the ABIM needs the money to help it’s physicians with educational programs, continuing education, and so forth.  And the foundation does good work with it’s Choosing Wisely campaign (a program designed to encourage appropriate use of diagnostic testing and other interventions).  Well, OK, but there is that $645,000 salary for Christine Cassel (the boss).  And the fact that 97% of ABIM money comes from physicians paying fees while only 14% of the money goes to physician education programs.  And of course there’s the condo.  Oh, you didn’t know about the condo on a posh street in Philadelphia?  Yeah, it’s super nice.  $2.3 million bucks.  It comes with a chauffeur.

What has happened to medicine?  How have we come to this place where doctors don’t trust patients, patients don’t trust doctors, and doctors can’t even trust other doctors?

 

 

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