The Certified Deceit and Exploitation of US Physicians

Guest Post by Wes Fisher, MD

For the past seven years, I have devoted a significant amount of my time to investigating and telling the true story of US physician “board certification.” That story has been one of deceit, private back-room deals, profiteering, and (worst of all in my humble opinion), the exploitation of working physicians and the patients for whom they care.

This writing has not come without its personal and professional costs, but when the story is one that affects the corruption of the largest single contributor to the US economy, what else should I have expected?

As I reflect on what this side job has exposed, it would be naive and dishonest to suggest that physicians are exempt from bearing some responsibility for rising healthcare costs in America. But it may go much further than that: our medical profession and its hallowed physician education regulatory system comprised of the unchecked Accreditation Council for Graduate Medical Education (ACGME) might be the very reason things were allowed to become so out of control. Our non-profit tax laws with their opaque reporting requirements have allowed huge “non-profits” to go unchecked in America – and most of those “non-profits” are in healthcare. (Just take a stroll by the American Medical Association (AMA) building in downtown Chicago sometime to get a feel for the magnitude of the problem.)

Why should the physician education and credentialing systems in America be exempt from such corruption?

Well, they are not.

From the earliest reports of a multi-million dollar condominium purchase by the same non-profit organization that created the “Choosing Wisely®” campaign to promote health care cost savings, the hypocrisy of US board certification was laid bare.

Read full article: https://drwes.blogspot.com/2020/01/the-certified-deceit-and-exploitation.html

Federal Judge Ends Mandatory AOA Membership Tied to Board Certification

“A federal judge in Camden has granted final approval to an $84 million settlement of an antitrust class action against the American Osteopathic Association,” related to the tying of AOA membership to the ability to maintain specialty certification through Osteopathic Continuous Certification, reported the New Jersey Law Journal on December 4, 2018.

The lawfirm leading the case, Duane Morris, LLC, earlier reported on what is in the settlement:

In addition to agreeing to end its practice of conditioning AOA board certification on purchasing annual membership in the AOA, which was at the center of the lawsuit, the AOA has also agreed to provide a host of other economic benefits to the more than 45,000 class members, such as:

• for three years reducing its annual dues by $90 and
• waiving a $90 board certification fee;
• for two years offering AOA members two free CME courses of up to 12 aggregate credits;
• contributing not less than $2 million to an osteopathic awareness campaign;
• eliminating distinctions between online and in-person CME for purposes of AOA membership;
• lifetime board certification is restored for all those certified prior 1997;
• committee of independent private practice physicians will be created to represent independent practice considerations to the AOA board; and
• physicians will not lose membership in the AOA as a result of failing to meet the CME requirement, provided that the physicians meet the CME requirements for the state(s) in which they practice.

Weighed against the uncertainty and expense of protracted litigation, the valuable benefits the AOA has agreed to provide to resolve the claims against it demonstrate that the settlement is in the best interest of the class and sub-classes, as well as the AOA, stated Duane Morris.

https://www.duanemorris.com/pressreleases/osteopathic_physicians_class_action_settlement_0718.html

For a full copy of the settlement agreements, see:
https://www.duanemorris.com/site/static/AOA_joint_motion_for_certification_0718.pdf

For a full history of the suit, see:
https://www.duanemorris.com/site/osteopathclassaction.html

Here is the wording from the motion on the key items:

Washington State Passes Bill Outlawing MOC for Licensure

Friend of IP4PI, Ken Lee, MD writes in:

There is some good news from WA state. The Legislature just passed with NO opposition in either house HB 2257 that outlaws MOC for MD /DO licensure. It is veto proof. It sits on the Governor’s desk and in my state of WA if he does not sign it in a few days it becomes law automatically. Click here for the bill. The next step would be to do the same for insurance payments, hospital privileges. Several years ago I had my state medical association adopt my resolution to ban MOC for MD licensure; the state medical licensing body agreed to this idea but it was never made into law until now.  Fight on ! The impossible only seems that way.

We Need Your Feedback! U.S. Physician Board Certification Survey

Practicing Physicians of America is excited to bring you an important survey to gather information needed to provide data backed, counter arguments to the unsubstantiated claims used by the American Board of Medical Specialties to continue to promulgate their MOC product.

This survey has the potential to be the largest and most authoritative of its kind but not without your help.

Please take 10 minutes of your time to complete this survey and provide us data to defend practicing physicians at a national level against intrusion into our profession. Then share, tag, copy and email this to colleagues. You may use my words and my name. I will fight tooth and nail to be unfettered from those in healthcare that put profits over patients.

We wish you good health, prosperity as we all negotiate the changing environment of 2018!

https://www.surveymonkey.com/r/PPA_MOCSurvey

Marion Mass, M.D. 

Philadelphia area Pediatrician
Practicing Physicians of America, co founder/VP http://practicingphysician.org

UPDATE: AOA BOS fails to gut HOD policy opposing OCC MOC Mandates

Breaking: American Osteopathic Association (AOA) House of Delegates (HOD) affirms member opposition to use of OCC MOC as condition of licensure, hospital privileges, employment, and insurance reimbursement.

Special thanks to delegates:

Jeff Davis DO
Sheila Page DO
Kelli Ward DO
Sam Urick DO
Leroy Young DO

---

Here’s our original post with details about what the HOD successfully defeated:

Can you say “tone deaf”? It seems the AOA is not hearing the message that physicians and patients across the U.S. continue to drown in a sea of red tape.

While opposing ObamaCare repeal and replace, the AOA is attempting a repeal and replace of its own.

In a brazen act of self dealing, the AOA Bureau of Osteopathic Specialists is sponsoring resolution H-227 at the AOA House of Delegates, currently underway at the Chicago Marriott Downtown Magnificent Mile Hotel.  H-227 would repeal established AOA policy opposing OCC mandates and replace it with the following:

The AOA opposes any efforts to require OCC as a condition for medical licensure, 12 insurance reimbursement or network participation, malpractice insurance coverage or as 13 a requirement for physician employment  RESTRICT THE USE OF BOARD CERTIFICATION AS A MARK OF EXCELLENCE, AND SUPPORTS ITS USE BY ENTITIES TO PROTECT THE PUBLIC AND ASSURE THE DELIVERY OF HIGH-QUALITY PATIENT CARE.

Click here for a link to the full resolution.

Here are a few powerful ways you can voice YOUR opposition to this harmful change!

1. Use Twitter hashtag #AOAHoD to encourage the HOD to oppose H-227.
2. Tweet your opposition to @AOAforDOs.
3. Retweet this Tweet:

AOA House of Delegate resolution H-227 would gut existing AOA policy opposing OCC/MOC mandates! NO to H-227 #AOAHoD pic.twitter.com/VMliP32vez

— Association of American Physicians & Surgeons (@AAPSonline) July 21, 2017

 

Lawsuit against AOA restriction of trade will proceed

On June 12, 2017, the U.S. District Court in NJ denied the AOA’s motion to dismiss a suit brought by osteopathic physicians to end the requirement tying AOA dues to the ability to remain board certified.

The lawsuit will continue. Here is the link to the court order:
http://www.almcms.com/contrib/content/uploads/sites/292/2017/06/MTD-Order.pdf

For more information visit: https://www.duanemorris.com/site/osteopathclassaction.html

Anti-MOC Victories at Michigan State Medical Society House of Delegates

Friend of IP4PI Dr. Meg Edison writes in:

Michigan State Medical Society House of Delegates was last weekend, Martin Dubravec and I ran around like crazy, testifying in support of 4 anti-MOC resolutions and against a resolution to join the FSMB Compact. The outcome was very successful:

1. The delegates reaffirmed strong opposition to the FSMB Compact (making me very happy, since it was my resolution from 2 years ago that we oppose the compact).
2. We passed a resolution to engage legal counsel to investigate anti-trust violations against ABMS/insurers/hospitals in Michigan.
3. We passed a resolution calling for an end to the direct-to-consumer advertising of the ABMS MOC product.
4. We passed a resolution calling for public access to initial board certification status on ABMS websites.
5. A resolution asking the AMA to amend their MOC policy to require informed consent from patients before conscripting them into ABMS MOC QI projects was referred to the board for more study, disappointing…but not surprising given how many academics are delegates. Ken Fisher was on the committee that heard this, he fought like mad and got it approved…but the delegates extracted it and referred it to the board on the house floor. Still, the conversation on the ethics of MOC & research was started.

I’ve attached the resolutions (see links embedded in list above) for your future reference if you’d like to share and pass similar resolutions in your state medical societies. I want to point out, it is a small handful of us (me, Martin Dubravec, Ken Fisher). There were no other docs testifying. We don’t need an army to make change…just a few can do this. Yes, it’s a pain to give up a few hours on Saturday, these meetings are confusing and intimidating, but find a friend, become delegates and make this happen.
-Meg

I’ll add a 6th victory that came from years of getting the right people involved in organized medicine and our House of Delegates…

6.) On the same page as the “Oppose IMLC” resolution attached below, the resolution 24-17 to “study single payer” was “amended” to remove all language on “single payer” and approved with broad language to study all alternative payment models…which includes DPC and other free market innovations. Just 3 years ago, this same body voted to approve single payer…we’ve come a long way.

I should not be mandated to PAY-to-Practice this great noble profession of Osteopathy.

IP4PI supporter Gina Reghetti, D.O. shares correspondence regarding continued attacks on the osteopathic profession.

Just a note to let you know that I received a letter today from the AOA, dated 1-9-2017 and signed by Jeffrey L. Weaver, O.D., yes, OD, not DO, an Optometrist who is the Vice President, Certifying Board Services, and from Eunice Lee, Associate Vice President, Client and Member Services, informing me that I have until February 1, 2017 to renew membership to keep my AOA board certification active. My board certification is wrongfully time-dated to expire in December 31st, 2022.

My scanner isn’t connecting to my PC wifi so I am unable to email the letter to you currently.

I called Jeffrey L. Weaver, O.D., this morning to confirm that he is not a DO, and I had a conversation with him for more than an hour regarding my views and concerns of the wrong agendas that the AOA has enforced on their doctors, such as re-certifications, and OCCs and membership dues connected to certifications.

Principles for individual healthcare freedom

IP4PI Physicians support the following resolutions for the legislative, executive and judicial branches of the US:

1.  The full repeal, nullification or reconciliation of ACA/Obamacare as it was:

A. ACA passed by a partisan Congress (one party) by reconciliation. B. Changed by the executive branch 43 times without appropriate congressional action. C. Changed by SCOTUS to be a tax bill. D. Tax bills must originate in the House and ACA originated in the Senate. E. ACA has changed healthcare from a professional physician-patient interaction into merely an act of government HHS/CMS unelected bureaucratic compliance. F. ACA lead to an uncontrolled rise in costs for all citizens through increased taxes, insurance costs, hospital costs, physician costs, use of narrow networks and severely limited ACA approved options. G. IRS and tax penalties for any American citizens violate the US Constitution. H. Mutually accepted individual customer-vendor purchases are the ideal way to allow personal choice, encourage excellence and establish price competition for best citizen consumer value.

ABA Has Failed to Stand Up to ABMS on MOC

Friend of IP4PI, Jef Fernley, DO shares his correspondence with the American Board of Anesthesiology.

Esteemed colleagues of the ABA,

You should have left well enough alone. For decades it was believed that being “Board Certified” was actually a hallmark of a quality Physician, something to set himself/herself apart from the rest, something to inspire confidence, a feather in one’s cap, and print on one’s business card.  The field of Anesthesiology has a proud history of independence and innovation.  The ABA used to be a reflection of that. But you failed to stand up to the ABMS on MOC. I think everyone understands that staring a novel multi-million dollar stream of revenue in the face is a very hard thing to reject.  You should have rejected it.  With the absence of any unbiased supportive evidence for MOC, and let’s be realistic, anyone who has a job taking care of patients rather than publishing papers knows that physician quality can’t be measured by any single test, therefore there won’t ever be any such real evidence.