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Thursday, March 12, 2015

Newsweek article echos practicing internists concerns about the ABIM and the ABIMF

 Rising criticism about the American Board of Internal Medicine and its twin, the American Board of Internal Medicine Foundation is getting wider coverage.

The leadership at the ABIM-ABIMF cannot be happy with this recent article in Newsweek by Pulitzer :Prize winning investigator journalist, Kurt Eichenwald.

Most of the article highlighted the activities of the ABIM but he did say the following about the ABIM Foundation:

"And there is another organization called the ABIM Foundation that does...well, it’s not quite clear what it does. Its website reads like a lot of mumbo-jumbo. The Foundation conducts surveys on how “organizational leaders have advanced professionalism among practicing physicians.” And it is very proud of its “Choosing Wisely” program, an initiative “to help providers and patients engage in conversations to reduce overuse of tests and procedures,” with pamphlets, videos and other means."

As to the growing opposition to the actions of the ABIM and questions about what the ABIMF is all about , I wonder if Dr Benson,emeritus CEO of ABIMF  might wish the following comments had not been published on the AMIF's blog: I have added the bolding.

" CMS, which has the ultimate negotiating position in the form of reimbursement for Medicare services, could only accept negotiated bundled charges. It could also refuse payment for non-compliance with the Choosing Wisely recommendations."...ABIM could require candidates to achieve a perfect score on questions related to costs and redundant care as a requirement for admission to secure exams for initial certification or MOC."

Apparently , in Dr. Benson's eyes the Choosing Wisely pronouncements are ( or should be) more that a few talking points that physicians and patients can focus on as they discuss what might be "the right treatment for the right patient at the right time" .There should be requirements for Medicare payments and demonstration that a ABIM exam candidate has mastered them before they would even be "allowed" to take their "secure examination".  Comments such as these suggest more is going on at ABIMF than harmless mumbo-jumbo. It is worthy of that  other medical policy wonks are sending up trial balloons for proposals  giving Choosing Wisely regulatory teeth. See here.

The more light shined on the folks and activities at ABIM-ABIMF the less likely they will be able to preserve their phoney-baloney,self appointed positions. 

H/T Dr Wes

Addendum Walter Bond on his blog asks will the ABIM board members, present and the recent past,defend what they did or argue that they fought against all the bad stuff and blame as much as possible on Dr. Christine Cassel.See here


Anonymous said...

Thank you for this. This is exactly what I suspect as well. Interesting that Tom Daschle is speaking at the upcoming ACP national meeting in Boston (Richard Baron will be there as well). He proposed a national group to make nuts and bolts health care policy in a proposed single payer model
. Tha ABIMF may be the covert equivalent. Perhaps your post could be linked to the anti-MOC site. It needs to be circulated.

Walter Bond said...

Thanks for the link.

This is a very interesting post. Even if "choosing wisely" recommendations were pure as the new-fallen snow and otherwise perfect in all regards, I share your position that it is impossible for MDs to care for real people in the real world using top-down algorithms in place of clinical judgment. This simply misunderstands reality. Clinical judgment, however, requires the education of physicians capable of exercising it.

And of course "choosing wisely" recommendations may not be pure as the new fallen snow. Indeed, public choice theory would suggest that the more weight is given to them the more they will be corrupted.

james gaulte said...

Great point about the more weight given to them the more likely will there be corruption in the process.