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Is the new professionalism and ACP's new ethics really just about following guidelines?

The Charter ( Medical Professionalism in the New Millennium.A Physician's Charter) did not deal with just the important relationship of ...

Wednesday, January 10, 2018

The ABIM Foundation, "a foundation dedicated to what?"

Following a revealing blog post regarding the ABIM  by DRWes, a  comment was made by Keith:

" This is what happens when a non profit organization loses site of it's true mission and becomes more focused on the dollars. Looks like they are generating so much loot from their plundering of physicians that they needed somewhere to hide it. Why not create a foundation (the ABIM Foundation) dedicated to what ????"

 So what is it dedicated to?

The key document which outlines the purported current missions of the  ABIMF is the 2002 publication of "Medical Professionalism in the New Millennium:A Physician Charter" .

According to the ABIMF's website: "The Fundamental principles of the charter are primacy of patient welfare,patient autonomy and social justice. "

The first two are long established principles of medical ethics about which there is little controversy  ,but the third is another matter

From a tactical point of view the use of term social justice" has a number of selling points.First, while everyone who would consider themselves progressive (or modern liberals) would support social justice, many of a conservative or libertarian mind set would not. The term social justice is loose and indeterminate and therein again lies is rhetorical value. To many social justice connotes helping the disadvantaged.and  conservative and libertarians are not going to be speaking out against helping the poor etc but differ from progressives in the permissible techniques to bring that about.But to the founders of the Charter helping the disadvantaged  may not be  the driving force.

 We are told that new new medical professionalism is about a "fair and equitable distribution of finite medical resources" and that physicians have an obligation to move toward that goal. At this point readers of the charter might well wonder how, as practicing physicians, how would they accomplish that move.  Well, we are told that physicians can practice cost effective medicine and that may well be best done by following guidelines.In that way they can be the stewards of the finite resources.So it seems that " fair and equitable" corresponds to "cost effective" which for an individual physician that translates to " follow the guidelines"

So  now the bait and switch, the bait is a obligation to promote social justice and the switch is to follow guidelines which is claimed to bring  about  fair and equitable distribution of resources.

Yet you have to ask is this striving for purported social justice the reason for the existence of the ABIMF or  is it to save money for third party payers?ABIM accumulated a significant amount of money by testing internists for board certification and found themselves holding many millions of dollars . This was profit in the sense of receipts greatly exceeding their costs but a non profit does not make a profit by definition even if their monetary intake greater exceeds their monetary output. ABIM itself is a non profit.

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