“Continuing Board Certification” sounds swell but harms patients.

Dr. Walter Wood writes:

I board certified prior to 1991 and have “lifetime” certification equivalent to an academic degree. I can attest that my younger colleagues and their patients are being harmed by costly and time consuming “requirements” to participate in “re-certification” and “maintenance” of certification, soon to be renamed “Continuing Board Certification,” which is not needed and not only does not help patients but harms them. Patients in need are harmed when a doctor is not taking care of patients because the doctor is busy preparing for or repeatedly jumping through hoops such as what lawyers experience once in a lifetime with their bar exam. I was somewhat stunned that an anti-trust judge thought it was necessary to demonstrate “harm to consumers” as a result of the egregious behavior of the ABMS and its colluding member boards. That judge needs to be asked whether s/he repeats the bar exam every ten years.

Walter Wood, MD, FAAD

P.S. I have posted these comments at certificationharm.org.

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Pioneers and Powerhouses of DPC launch new organization

The Direct Primary Care Alliance launched on January 1, 2018 as a physician-led organization exclusively focused on growing the Direct Primary Care (DPC) movement. The Alliance was born from a grassroots network of practicing DPC physicians looking to provide a unified voice and resources for fellow DPC physicians. The motivations for launching the Alliance can be found in remarks from our inaugural president, W. Ryan Neuhofel, DO, MPH:

We now realize the transformative potential of the DPC model and are at the advent of moving beyond novelty.  But, many hurdles exist for us to achieve that vision. The challenges ahead of us are immense. Yet I can think of no better group of people to overcome these odds.


Trump Executive Order Births Sweeping New Rules Allowing Association Health Plans

From our friends at D4PC:

The Trump administration, encouraged by Senator Rand Paul, circumvented Congress with Executive Order 13813 to create rules through the Department of Labor that allow approximately 44 million Americans to create and/or join Association Health Plans (AHP).

These AHP are exempt from many of the ObamaCare mandates that have been cost drivers for the insurance policies offered to self-employed and small businesses that often doubled rates.

“The proposed rule is designed to make it easier for groups of individuals and small businesses to band together and buy the kind of insurance that large companies offer their workers. That kind of insurance is regulated under federal labor law and isn’t subject to all the requirements and consumer protections that apply to individual and small business insurance under ObamaCare.” -NYtimes.com

The sweeping new rules have been published for public comment for 60 days before they are implemented with the force of law.

Click here to read more.

Not news to physicians, but the media is finally seeing through EHR smokescreen

Others’ eyes are finally opening to what physicians have been seeing for years: EHR billing and compliance IT only adds to healthcare costs not quality, economy or patient satisfaction.

In 2016 Forbes reported that “U.S physician costs to keep up [with HIT] have reached more than $32,000 per doctor annually.”

https://www.forbes.com/sites/brucejapsen/2016/08/10/health-it-costs-surpass-32k-per-doctor-annually/amp/

IP4PI founder, Craig M. Wax, D.O., has been writing and speaking on this for the better part of this decade.  Here are just a few of his talks about EHR’s attack on patient care:

EHR privacy and security: mission impossible (patient town hall version 2012)

EHR privacy and security: mission impossible (physician version 2012)

EHR the Trojan horse (2014)

EHR remote control (2014)

Alexander-Murray Exacerbates Flaw in ACA’s “Catastrophic Plans”

DPC physicians and patients take note!

An aspect of Alexander-Murray will exacerbate an under-appreciated flaw in ACA requirements for plans considered “catastrophic plans.”

Alexander-Murray will allow anyone to have a “catastrophic plan” as such plan is defined by ACA. ACA limits enrollment in these plans to enrollees under 30 years of age or enrollees who have a waiver. Alexander-Murray would do away with these limitations. So far so good.

Another ACA limitation on these plans — found in  ACA section 1302(e) — is that the plans will provide no benefits until the enrollee’s annual out of pocket limit has been reached, except that the plan must cover “at least 3 primary care visits.”

This will harmful to patients of DPC practices and is bad policy. It essentially forces primary care to be handled in-network — great for the insurance companies but not for the patients orthe doctors.

Ideally the requirement should be struck from ACA.  Alternately, a small change along the lines of this or something similar [in brackets] might help fix this problem:

(B)the plan provides—
(ii)coverage for at least three primary care visits, [unless the enrollee is separately contracted with a direct primary care physician, in which case the plan will refund to the enrollee an amount equal to the value of such coverage.]

IP4PI to CMS: Exempt Independent physicians from ACA MACRA MIPS and APMs

CMS ACA MACRA MIPS and APMs discriminate against independent solo and small primary care practices, while unfairly advantaging hospital health systems who employ doctors. Please exempt solo and small physician practices of 9 or fewer doctors or less than 999 Medicare patients. CMS ACA MACRA MIPS and APMs will put small independent practices out of business and will deprive patients of their physician, jeopardizing their health.

Submit your comments at:

https://www.regulations.gov/comment?D=CMS-2016-0060-3944

The Real Reasons for the Trump Train

I challenge all to examine the real reasons that Donald J. Trump won the Presidency of the United States: 

1. Eight years of failed President Obama administration policies both domestic (Obamacare) and foreign (Iran, Middle East and Benghazi)

2. Democratic party embracing violent racist groups like Black Lives Matter while bashing Trump supporters and Republicans with false accusations of racism. 

3. Mainstream media liberal slant

4. Both Republican and Democrat parties leadership ignoring the will of the people for decades

5. The character, record and selfish profiteering of Hillary Clinton.

Now we must begin the task of the old and new leadership listening to the citizenry, unifying our people behind our founding principles of freedom and liberty, and getting our country back on task to champion individual rights and minimize government intrusion in our daily affairs. 

Craig M. Wax DO

Family physician

Media host

Member of congressional subcommittee National Physicians Committee on Healthcare Policy NPCHCP.org