Thursday, December 06, 2007

Would internists be better off without the ABIM?

More and more I am beginning to think that is the case. Dr. Faith Fitzgerald,who I love to quote when she said regarding P4P doctors do not need to bribed to do their jobs (paraphrased), has criticized the ABIM recent moves regarding certification and re-certification.

Her essay can be found here.

She finds a disconnect between the notion of certifying a "comprehensive general internist" and their recent proposal to certify a type of cardiologist who treats severe heart failure and cardiac transplantation. OK transplant medicine is another world but has treatment of heart failure not been a regular activity of internists since forever.

She really nails it saying :

It is disingenuous of the ABIM, I think, to feign support for the so-called “comprehensive internist” while simultaneously depleting the general internist's portfolio of certified legitimacy in some of the more highly valued components of recognized expertise, such as management of heart failure and of hospitalized patients. This threatens to further shift the work of general internists to a support function not only for the classic subspecialists of medicine but also for the “certified modular” subspecialists. It potentially leaves the so-called comprehensive internist, already beset and underappreciated by payers and systems, to do predominantly triage, health information technology, social services, counseling, prevention, screening, and general organizational and secretarial functions for the “experts.” I doubt that many young internists in training will aspire to this role, especially because its many components can be done better and more efficiently by nonphysician personnel.

3 comments:

Anonymous said...

yes! the abim needs to go. if they want to stay, at least make them demonstrate they provide some usefulness. make it clear that certification provides a difference in clinical outcomes. especially if reimbursement is going to be tied to certification.

at least empty their boards of people who are grandfathered in and not voluntarily recertifying.

Anonymous said...

Excellent post! The ABIM is a money making scheme wrapped in academic bullshit. General Internal Medicine is already dead...they just haven't buried the corpse yet. Thanks ABIM for your contibution to the demise.

Anonymous said...

The ABIM has gone away from internist it is run by all kinds of bureaucrats
the recertification is going to increase the gap of knowledge between the recertifiers and ''granfathered ins" the pracitse improvement module such a farce in fact people who called the board saying they did not have time to do it were told just to do it however they can encouraging them to make things up. It is time the ABIM was scrapped give recertification to national body controlled and adminstered by practising physicians and not academic busy bodies who have no clue of how private practise works and encourage recertification of everyone if the reason rally is for the good of the patients.