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

$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

Concierge firms rattled by med mal award

MOC: the tide is turning

From Paul Kempen, MD, PhD

The tide is turning. Be sure to put this from NEJM on the table of your medical staff and demand all requirements for board certification be removed from privileges, insurance payment and licensing.

If you want a solid understanding of the history and extortion of the ABMS, see this lecture, especially around minute 40 when the obvious requirement for YEARLY payments through threats of losing your certification in spit of a 10 year issued certificate is clearly stated-valid only if MOC compliant printed right on the darn thing! Stop paying extortion and rise up against this ponzi style enrichment scheme. Continue reading

expose this corporate regulatory capture of medicine for the business it is

Dr. Paul Kempen replies to report that ABMS held if’s “first 2-day Forum on Organizational Quality Improvements, a poster session outlined 27 examples of successful quality improvement initiatives, such as a program to reduce adverse drug events and another to educate pregnant women with congenital heart disease.” 

As the ABMS has no oversight and the production of these “practice improvement modules occurs to facilitate and finance ABMS corporate programs, it is important to realize this unregulated industry is using patients (and physicians) as guinea pigs without their knowledge, informed consent or IRB approval. This referenced study illustrates the problem, turning a QI program into a MOC product, with retrospective IRB deferral to enable publication. The Medical Journals, being infiltrated by ABMS personnel will approve such studies facilitating their profits-studies in no way scientifically based or producing results.

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Pediatrics journal rejects ethical questions about MOC

Paul Kempen, MD, PhD shares a rejection letter from Pediatrics:

NOTE: No response regarding the costs to patients or the actual lack of science with only 1/3 cohorts reaching “statistical significance.”

Dr. Kempen,

The Executive Editorial Board has reviewed the e-letter that you submitted on June 18, 2014, and has decided not to publish it.

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ABA Leadership has seen the Light and it is $$$

Dear Tom:

I know you received my prior and recent email and have not heard from you since. This was evident in your concerns that your “secret” communication was disseminated. Please realize the open nature of the internet and ability to find data there!

As an ABA diplomate, currently listed as “moc compliant”-what a joke, and member of the ASA and licensed physician anesthesiologist in PA, I find it UN-collegial of you to fail to respond to my previous email. Think it is time to really sit down and discuss the problems facing the ABA as a member of the ABMS. Your non-response clearly indicates your inability to discuss openly the real issues of extortion propagated by the ABMS. NO wonder, with the imposing leadership and financial obligations your new position imposes. YOu could make THE difference,but we both know you never would have gotten the job if you had a moral backbone. We both also recognize that the ABA NEVER wanted to go down the road of MOC or time limited certification, but I guess you and the leadership Have seen the Light and it = $$$$$$$$.

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Reevaluating politically and bureaucratically based medical licensing

Guest post by Paul Kempen, MD, PhD
The natural history of any bureaucratic entity must include the generation of rules, procedures, restrictions, forms, fees, investigations, penalties, and educational material which shows how vital the respective entity is for the nation, civilization, etc. These productions are the lifeblood of the entity, since its first duty and task is to survive and expand its power. And its resistance to attrition and extinction can be as intense and extended as that of a biological organism fighting to survive. A very telling example is the Board of Tea Tasters: it took 20 years of bipartisan efforts spanning four administrations to finally close it down, after 99 years of existence and millions of tea brews, collections of samples, reports, stats, and permissions/restrictions of tea importation.
However, what we must observe with regard to our Medical Boards and Institutions is that our own profession has begot them. One hundred years ago, the Hippocratic “hypocracy” (leadership of hypocrites) of our allopathic forerunners decided to get the competition of homeopaths, naturopaths, and others out of business by resorting to the police powers of the governments. Medical Licensing was born, not as a private credentialing and certification agency, but as a general patent grant of exclusive economic rights, contrary to the US Constitution and to the British pro-market revolution initiated by the 1624 Statute of Monopolies, but very much in keeping with the burgeoning crony capitalism that swept the 20th century, introducing socialism through the back door of the progressivist movement and the figment of government-business cooperation, the American version of fascism.
The sea change that followed in medical ethics was not immediately apparent, as the medical hypocrisy alleged its continued commitment to the patient-centered Hippocratic values, even as behind the scenes it allowed vast inroads of the coercive-collectivistic values of a Platonic type of medical ethic. As you might recall, 24 centuries ago, in The Republic, Plato advanced the concept that the physician’s allegiance is to himself and the other holders of power, not to the patient: “The business of the physician, in the strict sense, is not to make a profit but to exercise his power over the patient’s body.” And Plato clearly explained, “This then is the kind of medical and judicial provision for which you will legislate in your state. It will provide treatment for those of your citizens whose physical and psychological constitution is good; as for the others, it will leave the unhealthy to die, and those whose psychological constitution is incurably corrupt it will put to death.”
It is of course high time for us to re-evaluate the sordid achievements of the politically and bureaucratically based Medical Licensing that we live and practice under today. Far from being crazy, its standards and procedures only reflect the natural course and propensities of this century old arrangement.
To put it more allegorically, no pact with the devil can portend the eternal life and perpetual happiness that the deceiver promised in order to get the agreement signed.

When Will ABIM Debate?

Paul Kempen, MD, PhD comments on Medical Economics article, “MOC changes aim to lessen burden on physicians, but debate continues” :

I continue to be astounded that the ABIM refuses to openly debate the topic in an open forum. The Benjamin Rush Society invited the ABIM and ABMS to debate MOC in their home town of Philadelphia last April-they failed to come ( The ABIM does NOT want to debate the issues openly in a neutral forum because the whole extortion process is unwanted by physicians in General, and it provides no index of quality. The ABIM and ABMS are trying to introduce these changes under the radar through the gradual program of lobby congress and hide from Open discussion. MOC is simply a money making extortion program self-serving to the certification industry. The ABIM itself concluded as early as 1986 and themselves published in 2000 the fact that voluntary MOC would not be possible (ANN INT MED 2000; 133:202-08 . THAT is why they imposed it with artificially restricting the certification to 10 then 8 and now to Continuous subscriptions to MOC to maintain a certificate that they themselves deem to be “VOLUNTARY”.

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