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.