Maryland Rejects Interstate Medical Licensure Compact … Again

Maryland’s Compact bill (SB0446) was withdrawn for 2nd year in a row after an unfavorable Senate committee recommendation. http://mgaleg.maryland.gov/webmga/frmMain.aspx?pid=billpage&stab=02&id=sb0446&tab=subject3&ys=2016RS

The Maryland State Medical Society testified that they are concerned about disciplinary provisions in compact. Since the Compact can’t be amended the society suggests fixing reciprocity problem at the state level. There are two bills pending that address license portability on a state level in lieu of joining the Compact: SB 1020 & HB 998.

The Maryland Medical Board testified against compact. There are too many details yet to be worked out. “We are worried about the bureaucracy.” The board also expressed concerns about the “extensive” disciplinary threats. “Fees could become quite excessive.” We are in wait and see mode. Physicians could get a license through the Compact without meeting Maryland’s licensing criteria. The board supports state-based reciprocity bills outside of the Compact.
http://mgahouse.maryland.gov/mga/play/d0306176-a3eb-4e70-bbeb-0c81c918dcca/?catalog/03e481c7-8a42-4438-a7da-93ff74bdaa4c&playfrom=1075000

For more on what’s being said about the Compact in other states see: https://goo.gl/obwZe3

Recertification: a test publisher’s attempt to take over authority in medicine

Guest post from Carlisle Holland, D.O.

The change to requiring recertification was demanded at the time by the younger generation of graduates, not the idea of those who had board certification for life. The cut off of requiring it was cited as unfair at the time, but the ‘higher standards’ were deemed worth the period of adjustment to such a change, as board certification was considered an intellectual achievement in itself, and worthy of the credit for knowing the information that well, a credential.

The recertification was a change in the intent of board certification itself and a perversion of its meaning. And it does not prove proficiency nor competency in a specialty to pass retesting every few years. What if they pass it and do not keep retaking it? Board Certified no more? And it confuses the meaning of Board Certified and changes it from a Lifetime Achievement like a Medical Degree, a CREDENTIAL, into a Temporary Pass, which is not an intellectual achievement, but a carrot-stick to force physicians to attend medical
meetings these organizations run. Continue reading

Total betrayal by AOA of ALL its members.

Your AOA dues are hard at work promoting the Interstate Medical License Compact.  This will mean mandatory certification for all new graduates before obtaining a license.  And the claim that OCC isn’t required for licensure through the Compact is pure smokescreen.  Does the AOA underestimate the intelligence of its members? Or perhaps AOA staff overestimates their own?

Is OCC required for licensure through the Compact?  “The answer to this question is ‘no,'” states the Commission. Yet a few sentences later they explain, “a physician must demonstrate current certification to be eligible for licensure via the Compact.”

Except for “grandfathers,” osteopathic physicians must pay in time and dollars for OCC compliance if they want to maintain their certification. OCC IS required for Compact participation.  Q.E.D. Continue reading

MOC: This Abuse Has to End NOW

Dr. Ken Lee weighs in on KevinMD blog post “The Real Cost of MOC is Stunning” :

This profession is too used to abuse . It begins in pre-med, medical school and our training as “students” where our US labor rights are violated. Even college athletes have won a Federal case to get classified as employees of the colleges that were using them as “students”.

We have to influence our colleagues to stop swallowing each cup of poison they want us to drink. The costs of MOC for Int Med exceeds what I get paid from any contract I have with United, Aetna or Cigna, making the MOC a huge loss anyway you look at it. The summer months are supposed to be slow for medical care but I was seeing 23 patients a day with another 90 minutes of computer work at night to just do the documentation, MU, PQRS etc.

The only way I could do MOC is to not sleep or sacrifice my family time which my wife says will never happen again as she has seen hundreds of hours lost in the past due to the re-certification exams. I have lost entire weeks of my life for this certification scam.

The human cost of MOC is not fully exposed and must be. The hundreds of hours of our scarce free time is lost for trivial pursuit that we all know does NOT improve patient care ( 2 JAMA studies 2014 prove this ) . The psychological toll of fear , potential loss of income and actual loss of money on this coercion is glossed over, as if we were all CEOs making $4million a year at a non-profit hospital.

I never see written interviews of the families who suffer the absence of a parent who is hostage to recertification /MOC; what does it do to them? This abuse has to end now . People call us doctor which seems to elevate us but in reality we have become almost slaves. One of my long times friends finally got his BA degree and he runs a hospital physician system that employs 22 MD/DOs ; they have to answer to him . So much for the doctor title.

Ken Lee , Internal Medicine, private practice.

Now here is an answer to the whole ABMS extortion racket!

Paul Kempen, MD, PhD writes:

Now here is an answer to the whole ABMS extortion racket! Tell them to shove their programs where the sun don’t shine!

Urology Times published this physician’s critique of MOC:

“I successfully completed the original certification process and the subsequent recertification process, but enough is enough. The ABU has strayed far beyond its original mandate to ensure excellence in urologic training and has added yet another onerous burden onto the backs of practicing urologists.

The 2002 Physician Charter, which served as the foundation of MOC, is a flawed and disingenuous document that has one surreptitious purpose: to give specialty boards more power and control over their diplomates. How dare the ABU question my demonstrated commitment to lifelong learning! How dare the ABU attempt to lecture me on professionalism and ethics! How dare the ABU place the “benefit of the public” above the welfare of its diplomates! The “public” doesn’t pay the ABU’s expenses.”

Viewpoint of Abandoning MOC Deserves Discussion & Publication

Paul Kempen, MD, PhD writes Howard Bauchner, Editor-in-Chief JAMA

Dear Dr Bauchner,

While you have taken great care to include various viewpoints on ways to perform MOC, you have never allowed a viewpoint that argues for abandoning MOC entirely. Instead, you use Tierstein and Topol’s work as an “opposing view” on MOC when, in fact, it is another permutation of the same concept-only industrial competition has invited this view. Therefore, I respectfully ask you to consider publishing a perspective piece (“viewpoint”) that makes a case for abandoning the “MOC” program entirely in lieu of a more conventional CME model. I would also emphasize the difference Between MOC and CME is that CME is self-directed and MOC is centrally-directed — hence, a VERY different concept that has large patient care ramifications (and not to mention the recently documented by the very salesmen of this product (ABIM/ABMS, Etc) to have been a mistake). Continue reading

Healthcare’s Biggest Spenders on Lobbying

bigspender

CLICK HERE for full list.

Anonymous commentary regarding lobbying by “non-profits”: “And what construes “lobbying” is vaguely defined. Advocating on behalf of the nonprofit/mission doesn’t necessarily equate to lobbying. So, if the Baron, chooses to have lunch with a few key people, like Pelosi, or Boehner, it’s lunch – and he was just advocating the mission. If he happens to mention to add ABMS to certain bills like HR2 in “passing”, that’s not really lobbying unless you can prove it. Influencing legislation without stakeholder input, primarily the physicians they certify, is in my opinion, an infringement of the “duty of care” that is required by nonprofits via the IRS. The dollars weren’t disclosed at all — that’s significant b/c ABIM is a 501c3. They can say a variety of things regarding what the money was used for when the spent it for these “consulting firms.” http://www.irs.gov/Charities-&-Non-Profits/Lobbying

$8.5 Million Judgement Against MDVIP, Is ABIM Next?

Paul Kempen, MD, PhD writes in:

Please check these stories from Feb Modern Healthcare (links below). I think application of this information to the ABIM and ABMS would be a new and possibly very effective strategy. If a concierge firm can loose $8.5 million for essentially false advertisement-the ABMS “higher standards better care” is also false advertisement and THEY actively sell their certification based on “quality indicator” to patients and CONGRESS! Hundreds to Thousands of ABMS certified docs commit malpractice each year-not better medicine!

The second article indicates the FTC and the US Justice Department’s Antitrust Division should also be willing to investigate the ABMS for clear waste of funds as the same “Quality indicator” lie. The AAPS could stand to win MiIlions from a Qui Tam suit BECAUSE the FEDs PAID millions to doctors for nothing under the 4 years of PQRS-MOC and because it was now discontinued before the feds could introduce large penalties for NOT doing MOC, this was all a waste of federal Medicare dollars. I demonstrated per CMS FOI data the $1 million was spent in 2011 alone on MOC PQRS.

Antitrust enforcers study impact of new models on competition
http://www.modernhealthcare.com/article/20150221/MAGAZINE/302219947

Concierge firms rattled by med mal award
http://www.modernhealthcare.com/article/20150221/MAGAZINE/302219969

PQRS MOC Incentive Program Eliminated

Via Dr. Paul Kempen:

Good news! Even the ACA and the congressmen have listened and destroyed the PQRS-MOC incentive-if we can only believe the ABIM and they probably are telling the truth on this one. The continued decline of ABMS and ABIM power base is evident!

“As of January 1, 2015, the PQRS MOC Incentive Program will no longer exist. The Affordable Care Act (ACA) enacted the program as a way to encourage physicians’ participation in the Physician Quality Reporting System (PQRS), while also recognizing the value and importance of American Board of Medical Specialties (ABMS) Maintenance of Certification (MOC) programs. ABIM participated as a member board from 2012 through 2014. The ACA ended the PQRS MOC Incentive Program after 2014 (though the underlying PQRS program continues).”

https://www.abim.org/maintenance-of-certification/additional-credit-for-earning-points/physician-quality-reporting-system.aspx

“It is up to us,” writes Doc Chip

Guest Post from Dr. Chip Smutny

Folks,

Physician history has been to turn away from that which we don’t like and leave it alone. That brought us to where we are today.

That has to change now if we are to survive.

The way the government works in 2015 is by money first, period. We need to address that as a group. We might call this government now a Democratic Republic run by lobbyists, not voters. Continue reading