ACA: rewarding big corporates, punishing American doctors and patients

Guest post from Dr. Gina Reghetti:

I believe that our so-called medical peers which force that doctors re-certify will soon be failing us all due to the doctors’ refusal to practice medicine under the new ACA standards that aren’t about quality care for patients but more so about rationed care.

The boards will test us on ACA’s & Insurance Corporates’ standards which have nothing to do with medicine, only their profitable agendas. If we fail to adopt and go along with their ways then they will just not pass anyone. The control now lies all in the hands of the Enforcers. Continue reading

ALL DOs must read this now prior to AOA delegates mtg July 18, 2014

CLICK HERE to download this letter and table of resolutions in PDF format.

Dear Osteopathic physician,​​​​​ 7/10/2014

In recent years the American Osteopathic Association (AOA) has strategically traded away their responsibility to their constituent members bringing government and insurance industry regulation ever increasingly in between the physician and the patient. They have done so, in favor of corporate strategies and business models that have eroded patient quality of care, decreased physician efficiency, sacrificed private practice, buried physician offices in paperwork, and cost physicians tremendous expense and anxiety. Through all of this they have not only not provided additional benefit to the patient population but they have detracted from it. The result of their negotiations and agreements has been a collapse of healthcare delivery under the heavy hands of mandatory enforcement, the advancement of third party intervention, the reduction of patient contact time, the reduction of net income to physicians, the decrease in access to quality care for patients and the massive increase in bureaucracy. All this has added great expense for all premium payers and physicians while new corporate structures and businesses are created from that drain on healthcare delivery. They are about to now give away our professions control over our unique educational paradigm and in the contract, force us to give away our uniqueness and our more comprehensive educational requirements, our training sites, and our control of post graduate education to an organization that has no concept of the educational deficit they have regarding our approach to health rather than disease. Our original article “Saving Private Osteopathic medicine,” has been denied JAOA publication for over two years by AOA corporate leadership who are afraid to debate and answer memebership DOs questions. One author, George Watson DO died fighting the process. Read it here: Saving Private Osteopathic Medicine https://ip4pi.wordpress.com/2013/03/31/saving-private-osteopathic-medicine-2/

The proposed ACGME merger, is actually a takeover of OGME that will leave our profession without any autonomy in graduate medical education and will result in the loss of practice autonomy and eventually our Osteopathic schools through the process as it is no laid out over the next 5 years to 2020. This was written about extensively by Norman Gevitz PhD, Osteopathic historian and researcher. http://www.oucom.ohiou.edu/hpf/pdf/bios%20april%202014/2014-AODME%20Presentation%20The%20Unintended%20Consequences%20of%20the%20ACGME%20Merger.pdf

The House of Delegates (HOD) and all practicing DOs must demand the AOA stop their policies toward ACGME merger as proposed, OCC/MOC, MOL, and they must begin to support their osteopathic physician membership unconditionally against ALL competing interests.

Please read 10 point questions below that have been asked of the AOA for answers they have continued to not answer for 3 years this September 2014. If any of the questions raise your “index of suspicion”, contact your AOA State Delegates immediately and prior to the meeting next week, beginning Friday, July 18. The COMPLETE 168 resolutions pending are at the following link: http://www.osteopathic.org/inside-aoa/events/annual-business-meeting/house-resolutions/Pages/default.aspx Please read them and decide for yourself what you might be for or against.

A bulleted list below, of some of the relevant resolution agenda numbers and titles will be followed by recommendations “for or against” them in reference to a large body of physicians in the trenches whose voices are not being listened to by any of the “elected authorities for which our dues pay”.

We as individual Osteopathic Physicians, Osteopathic State Associations members, and as diplomates of Subspecialty Colleges, must take action to change AOA policy direction. Our Osteopathic practice of medicine, our patient populations and our ability to support our families hang in the balance.

10 questions for the AOA that remain un-answered by any executive officer thus far:

1. Why is AOA forcing ACGME merger (takeover of OGME)? What alternatives have also been explored? Why would any organization walk away from millions in government funding that maintain our own unique OGME?

2. Why is AOA pursuing osteopathic continuous certification and maintenance of certification (OCC/MOC) when they are time and money prohibitive for DO physicians? Osteopathic CME has always been flexible and more than adequate.

3. Why is AOA pursuing maintenance of licensure (MOL) against state board autonomy, DO state association preferences and physicians professional independence?

4. Why is AOA not fighting NP and PA expanding practice rights in each state? They are practicing medicine independently in increasing numbers of states without having to complete a full curriculum in medicine. That is condoning malpractice.

5. Why do AOA publications refuse to publish any articles that discuss or question AOA actions and policy?

6. Why is AOA embracing all HHS/CMS policies even before they are written, like pay for performance (P4P) when these policies are being used to deny payment to good practicing physicians instead?

7. Why is AOA complicit in the financial capture of medicine by so-called “stakeholders;” insurance companies, hospital health systems, government, HIT and corporate interests and insistent on excluding patients and physicians in private practice as stakeholders at all?

8. Why is AOA complicit in the regulatory capture of the practice of medicine by government, thus losing all true Osteopathic practice, their professional integrity, and our entire DO professions underpinnings?

9. Why doesn’t the AOA present it’s member DOs with all options of practice including private direct pay options where the patient-physician relationship is paramount and sacrosanct?

10. Why doesn’t the AOA support private independent Osteopathic Medical practice against the competing interest of all others?

40 of the most relevant resolution proposed follow. Please review those of interest to you and make your opinion(s) known to our representative this week.

RES. #

Title

FOR

AGAINST

H-201

Increase in Graduate Medical Education Training Opportunities

FOR

 

H-202

Ensuring Adequate Resources to the Future of Osteopathic Medicine

FOR

 

H-203

Osteopathic Medical Education

FOR

 

H-204

Reversal of Needs Assessment Requirement for CME Programs

FOR

 

H-205

Assure Graduate Medical Education Residency Positions to Graduates of U.S. Medical Schools

FOR

 

H-206

Goal of Osteopathic Graduate Medical Education

FOR

 

H-207

LCME Admission to AOA Residency Programs

FOR: WITH TIME REQUIREMENTS OF EQUIVALENCY IN OPP AND OMT TRAINING

 

H-211

Maintaining the Integrity and Mission of Colleges of Osteopathic Medicine (COM) and University Health Science Centers (UHSC) Granting the Doctor of Osteopathic Medicine Degree (DO) H279-A/09

FOR

 

H-215

Graduate Medical Education – Training Of Us Medical School Graduates (H315- A/09)

FOR

 

H-216

State Mandated Continuing Medical Education Requirements

FOR

 

H-218

Blue Ribbon Commission Report

FOR

 

H-304

Government Funding for Hospitals Not Accepting COCA Students

FOR

 

H-340

Unionization Of Physicians (H233-A/09)

 

AGAINST

H-347

Opposition to Implementation of ICD-10

FOR

 

H-348

Osteopathic Physician Compensation Tied to Patient Satisfaction Surveys

FOR

 

H-404

Correction of Public Information about the Osteopathic Profession

FOR

 

H-500

AOA Constitution & Bylaws – AOA Executive Director – Title Change

 

AGAINST

H-603

Opposition to Maintenance of Licensure

FOR

 

H-604

Dissemination of Evidence Based Osteopathic Medicine

FOR

 

H-607

Government Intervention in Private Practice H213-A/09 (H219-A/04)

FOR

 

H-609

Centers for Medicare and Medicaid Services (CMS) Communications With Physicians H216-A/09 (H222-A/04)

FOR

 

H-627

Industry Transparency Standards (H326- A/09)

FOR

 

H-632

Centers for Medicare and Medicaid Documentation Regulations

FOR

 

H-636

BSGA Report on H-623-A/2013 Opposition to Maintenance of Licensure

DEMAND ACTION ON THIS. PUT IT TO A VOTE

 

H-637

Collaboration to Protect the Integrity of the Physician Testing Process for Unlimited Licensure (H327-A/09)

 

AGAINST LETTING AMA RUN OUR TESTING

H-800

Unified Graduate Medical Education Accreditation System

 

AGAINST

H-801

AOA/AACOM/ACGME Single Unified Graduate Medical Education Accreditation System

FOR

 

H-802

AOA/AACOM/ACGME Single Accreditation System For GME

 

AGAINST

H-803

NJAOPS’ Support For ACOFP Resolution “AOA/AACOM Unified Residency Accreditation System”

WITHDRAWN

 

H-804

AOA / ACGME

FOR

 

H-805

Participation in AOA ACGME Merger

????

???? STOP THE MERGER

H-806

Accepting AOA Board Certification in AOA ACGME Merger

???FOR AOA RECOGNITION AS EQUIVALENT

???STOP THE MERGER AS IT IS PROPOSED

H-807

AOA / ACGME

FOR

 

H-808

Single Graduate Medical Education Accreditation System

???? AOA DOES NOT HAVE THE CAPACITY TO DO THIS

??? STOP THE MERGER AS PROPOSED

H-809

Unified Graduate Medical Education Accreditation System

 

AGAINST

H-810

Support of Unified Graduate Medical Education

 

AGAINST

H-811

Creation of an Osteopathic Emphasis Track for the Unified Graduate Medical Education (GME) System

 

AGAINST: THE EDUCATIONAL REQUIREMENT STANDRDS ARE LOWER THAN THOSE OF A FULL TIME OSTEOPATHIC STUDENT. UNACCEPTABLE

H-812

AOA/AACOM Unified Residency Accreditation System

FOR

 

H-813

AOA/AACOM Single Accreditation System

FOR

 

 

DOsCOMITT – DOs Committed to Osteopathic Medicine Today and Tomorrow

Craig M. Wax DO corresponding author
Carlisle Holland DO
Dane Shepherd DO
Richard Koss DO
David Zeiger DO
George Watson, DO, Emeritus
Steven Horvitz DO
David Dornfeld, DO
Robert Maurer, DO
Albert Talone DO
Brad Kline, DO
Gina Reghetti DO
Michael Ward DO
Kelli Ward DO
Charles J. Smutny III DO, Editor

 

 

AOA and Licensure boards conspiring on OCC/MOL

See below for AOA and licensure boards conspiring on OCC/MOL:
Paragraph 3 “Teamwork Among MOL/OCC Leaders”

IN THIS ISSUE of AOA Daily Report

Advocacy for Patient Safety

AOA Comments on HIT Plan

Teamwork Among MOL/OCC Leaders

AOF Elects New President

Loan Repayment Opportunity

Health Policy Notes

AOA Fact of the Day Continue reading

My MOC/OCC AOA ACOFP letter

ABOFP & ACOFP
330 East Algonquin Rd. Ste. 6
Arlington Heights, IL 60005

AOA
142 East Ontario St.
Chicago, IL 6061
October 31, 2012

Dear Osteopathic colleagues,

As actively practicing Osteopathic Family Physicians, we all believe in lifelong learning from our patients, experience, readings and personalized elective coursework. Traditionally, our process has included 4 years of college, 4 years of osteopathic medical school, 1 year of internship (PGY I) and at least 2 years of additional residency(PGYII, PGYIII) or a minimum 3 years residency post graduate training. After completion of the academic and practical curriculum, a physician passes a board exam to gain lifelong board certification with no expiration. For every three year cycle after that, a physician had to complete CME credits to indicate hours of practice experience, teaching students and residents, home reading study and personal choice of formal CME programs. This curriculum allowed flexibility, personalization and relative economy for each practicing physician as they could choose the courses within the AOA categories.

Osteopathic family medicine residencies developed in the 1970s. In the 1980’s, physicians who didn’t complete a family medicine residency were allowed to be “grandfathered in,” and become board certified without having completed 3 years of residency training. They gained all the rights and privileges of board certification and continued with their 3 year CME cycle.

Starting for ABOFP/ACOFP family medicine completing residency in 1997, each physician now had to be recertified by taking another board exam every 8 years (time limited certification). This cost physician’s additional time and money. Physicians board certified previous to 1997, even those “grandfathered in,” were still lifetime certified and never had to spend their time and money pursuing board recertification. This is discrimination against those who rightfully completed family medicine residency by those in leadership positions who themselves were “grandfathered in,” and not actually residency trained. Their previous training, although at least 3 years less than those who were residency trained, apparently have omnipotent superior lifetime skills and don’t require additional testing to maintain their board certification.

Starting for this same group of ABOFP/ACOFP board certified family physicians who completed residency in 1997, there is an additional maintenance of certification/osteopathic continuous certification (MOC/OCC) procedure that becomes mandatory on January 1, 2013. MOC/OCC now demands that in addition to all the foregoing time, retesting procedures and expenses, residency trained physicians must additionally enter patient data on two time periods to somehow measure a physician’s skill and participate in an online procedure requiring many hours and cost an additional $3,000 at minimum. This is burdensome, expensive and not statistically proven to improve care. Further, it does stand to generate significant money profit for the ABOFP, ACOPF and AOA which makes it a conflict of interest. Furthermore, once again, those board certified previously to 1997 in osteopathic family medicine, remain lifelong board certified without additional testing or the requirements of MOC/OCC. This too is discrimination against those who have spent the time, effort and money pursuing residency training and initial testing for board certification.

All requirements for all practicing DOs should be consistent throughout and not required for some but not others. All MOC/OCC roads seem to lead to MOL – maintenance of licensure and the regulatory capture of osteopathic medicine. As a practicing osteopathic family physician, I refuse to participate in MOC/OCC and time delimited certification as they are:

1. MOC/OCC and time delimited certification are only required for those board certified finishing residency on or after 1997 and not required for those board certified finishing residency prior to 1997.

2. MOC/OCC and time delimited certification are not required for those who did not complete residency, but “grandfathered in,” to board certification.

3. MOC/OCC and time delimited certification are burdensome in practice by taking time away from disappearing patient care time.

4. MOC/OCC and time delimited certification takes time away from disappearing personal health and family time.

5. MOC/OCC and time delimited certification are not statistically proven to improve care.

6. MOC/OCC and time delimited certification are based on a discriminatory procedure that exempts residency trained physicians who completed training before 1997.

7. MOC/OCC and time delimited certification are based on a discriminatory procedure that exempts non-residency trained, “grandfathered in,” physicians who were in practice prior to 1997.

8. MOC/OCC and time delimited certification are financially burdensome to practicing osteopathic family physicians.

9. MOC/OCC and time delimited certification creates and maintains new procedures the ABOFP, ACOPF and AOA will gain significant sums of money from and is therefore a conflict of interest.

10. MOC/OCC may be used by insurance companies to discriminate against DOs on payments and network participation

11. MOC/OCC may be used by hospitals to discriminate against DOs for staff privileges.

12. MOC/OCC may lead to MOL and the regulatory control of osteopathic medicine.

13. MOC/OCC and time delimited certification are unreasonably burdensome in a physician’s time and money that is threatens their rightful practice of Osteopathic family medicine. This violates the Osteopathic oath of Andrew Taylor Still, DO that we all pledged to uphold, that even the AOA, “never by word or by act cast imputations upon them (DOs) or their rightful practices.”

Best wishes for good health,

Craig M. Wax, DO

Residency trained, Osteopathic Family Physician

Host of Your Health Matters on Rowan Radio 89.7 WGLS FM

Medical Economics Editorial Board Member

Sample MOC OCC board letter

Short board MOC OCC letter

Dear (insert specialty) certifying board

Please discontinue your maintenance of certification(MOC) program. I, and many other colleagues, will not participate. MOC is unnecessarily burdensome, costly in time and money to participate. Certification boards stand to make millions of dollars on MOC procedures, causing a conflict of interest with their membership. They spend hundreds of thousands on
lobbying efforts to help perpetuate their testing monopoly and also
what they pay their executives.

MOC is not statistically proven to improve patient care or outcomes. Actually, it takes countless hours away from patient care, our own health maintenance time and family time. MOC may be used by insurance industry to discriminate against participation or reimbursement. It may be used by hospitals and health systems to further discriminate against our staff privileges. MOC is leading to MOL – maintenance
of licensure trials in states. Physicians in Ohio refused MOL and the proposed trial was discontinued. I will not participate in the regulatory capture of the entire practice of medicine.

Do not mock(MOC) me or my hardworking fellow physicians.

Board certification was developed as a training outcome validation and nothing more. Certification should indicate the completion of residency and should be lifelong. No further testing should be required after residency, but only flexible CME as currently instituted in each state.

Sincerely

I. Do Care, DO, MD

MOC OCC MOL board certification and medical license regulations

Dear physician colleague,

You’ve probably heard about the additional time and expense to pursue maintenance of certification (MOC) / osteopathic continuous certification (OCC) beginning January 1, 2013. If you were lifetime certified prior to 1997, read on because eventually it will effect you for certification and your state medical license. MOC/OCC will take countless hours from your patient care, personal health and family time, as well as, more than $3000 direct cost for each certification period plus extra thousands more in indirect costs. Physicians and patients already suffering at the hands of insurance industry and government regulations, but now our own AMA or AOA and specialty board are adding to our burdens in response to government and industry pressure and profit.

In Ohio during 2012, the state licensure board attempted to enforce a MOC/OCC program for medical licensure, MOL. The Ohio state medical board tried to implement this time and money intensive program just to maintain physician’s medical licenses to practice in the state. This is why ALL physicians must be active in rejecting MOC/OCC as it has led to MOL. It was the active practicing physicians in Ohio that rejected participation in the program and caused the state of Ohio to cease the MOL program.

The time is now to send a letter to the AMA or AOA, and Appropriate specialty board to refuse participation in the MOC/OCC program. This goes for ALL physicians no matter what your board certification circumstance.

Please DO it now.