www.Changeboardrecert.com www.aapsonline.org www.docs4patientcare.

org

NO MOC Petition
ABIM should recall the recent changes to Maintenance of Certification (MOC) Started March 10, 2014 2,708 signatures as of NOON 3/23/14
http://www.petitionbuzz.com/petitions/recallmoc

License and certification: Limiting competition

Milton Friedman, (1962) the pressure on the legislature to license an occupation rarely comes from the members of the public . . . On the contrary, the pressure invariably comes from the occupation itself. Harold Demsetz, (1968) regulation has often been sought because of the inconvenience of competition.

25% FMGs in GME and General Physician Workforce

10.1056/NEJMhpr1107519-September 7, 2011

The Certification industry Millions for nothing but a promise!

CME PRA R AMA recognition Award

Licensure and credentialing confer, in the eyes of the public a Good Housekeeping Seal of Approval (To Err is Human 1999 page 3)

Voluntary recertification failed

progressively fewer diplomates opted to participate in each recertification cycle:
3355 in 1974 2240 in 1977 1947 in 1980 1403 in 1986

Only 8945 diplomates, less than 10% of those eligible, elected to undertake voluntary recertification.

Regulatory Capture
Regulatory capture occurs when special interests co-opt policymakers or political bodies regulatory agencies, in particular to further their own ends. ABMS and FSMB have declared themselves as Sole official agents of verification of physician abilities-yet provide NO educational materialsthis is left to the national specialty societies who are coerced for the $$$$$$$$$$

NO one regulates the FSMB or ABMS!

The FSMB, INC: The FSMB leads by promoting excellence in medical practice, licensure, and regulation as the national resource and voice on behalf of state medical and osteopathic boards in their protection of the public. ABMS, INC recognized as the gold standard in physician certification, believes higher standards for physicians means better care for patients

Nurses Colleagues Patients & families Private interest groups Also: Hospital boards, other physicians, nurses, Better business bureau, etc

Disciplinary actions in Ohio:

Of the 42,102 allopathic and osteopathic physicians with active medical licenses issued by the Medical Board, 75% (31,550) practice in Ohio. The percentage of in-state licensees with active licenses has remained constant over the past five years. The Medical Board regulates over 62,000 licensees including:
MDs, DOs, DPMs, Physician Assistants, Radiologist Assistant, Anesthesiologist Assistants, Acupuncturists, Cosmetic Therapists and Massage Therapists.

During calendar year 2010, the Medical Board issued 208 formal disciplinary actions (all groups) with 155 physician actions (0.37% rate). Competency issues in 2011 possibly 1/42,102= 0.002% incidence!

I Hold Certification That Is Valid Indefinitely. Why Are You Reporting That I Am Not Meeting MOC Requirements When I Don't Have Any Requirements To Meet?
However, for all ABIM Board Certified physicians, regardless of when they were initially certified, ABIM and ABMS will begin reporting whether or not they are "Meeting MOC Requirements.
http://moc2014.abim.org/q-and-a.aspx

 In addition to the "Meeting MOC Requirements" requirement, diplomates with a certification that is valid indefinitely will need to pass the MOC exam in their certification area by 12/31/23 in order to be reported as "Meeting MOC Requirements." This is in addition to continuing to meet the point requirements of the MOC program. Grandfathers who do not meet the MOC program requirements will be reported as "Certified, Not Meeting MOC Requirements." They will NOT be reported as Not Certified for failing to meet MOC requirements.
http://moc2014.abim.org/q-and-a.aspx

Medicare Physician Quality Reporting System PQRS-MOC Incentives and Penalties

2013

0.5% if no MOC, 1% if MOC (performance year for 2015 penalty)

0.5% -1.5% -2%

2014 2015 2016

Licensing, Certification MOC and MOL

ABMS: FACT: ABMS recognizes that regardless of the profession whether it is health care, law enforcement, education or accounting - there is no certification that guarantees performance or positive outcomes

 Meta-analytic statistics were not feasible due to variability in outcome measures across studies.

STATEMENT

2010

_____________ ________________________________________
_______________________________________________________________________ _________ With CMS: any "carrot" will quickly become a "stick" of penalty

2. Based on its understanding of the current CMS requirements, the ABA does not believe that the additional requirements for the MOC bonus will have a sufficient impact on patient care, nor will the reimbursement bonus justify the additional time and resource burden on its diplomates. Accordingly, the ABA does not intend to submit an application for CMS approval of an ABA MOC-PQRS program in 2011.

Ex-President of the ABIM was a member of the same 2000 ABIM Task Force on Recertification and originally certified in medicine in 1979, (re-) certification in geriatrics occurred only in 1998 and 2005, without the recommended primary recertification in internal medicine.

Dr. Christine Karen Cassel

Certification Area
Certification Status

Certification History

Comments

Internal Medicine

Certified

Certified 09/12/1979, Certificate valid indefinitely

Certificates awarded in Internal Medicine prior to 1990 do not require renewal. However, ABIM encourages all diplomates voluntarily to renew certificates relevant to their practice.

Geriatric Medicine

Certified

Certified 01/01/1998, Certificate valid through 12/31/2004 Certified 02/17/2005, Certificate valid through 12/31/2015

Humayun J. Chaudhry, DO, MS, MACP, FACOI Secretary FSMB President/CEO

Dr. Humayun Javaid Chaudhry Certification Area

Certification Status

Certification History

Comments

Internal Medicine

Certified 08/21/1996, Not Certificate valid Certified through 12/31/2006

Lois Margaret Nora, MD, JD, MBA President and Chief Executive Officer

Specialty or Subspecialty Neurology Certificate No. 29063

Certification History Certified on

01/30/1987
certificate valid indefinitely

Status as of 1/13/2013 Certification Status: Certified MOC Status: Not Meeting MOC Requirements and Is Not Required To Do So Clinical Status: Unknown

Five Things Physicians and Patients Should Question Participating Internists From The ABIM!

By Eliminating unnecessary testing we will be able to pay for Obmacare---C Cassel, MD, ABIM
All specialties sure to follow! just say no To what? Patient satisfaction? Lawsuits?

Bayes theorem
All testing is good -WRONG! Testing where indicated will yield information that may be helpful. Sensitivity (true positive rate) vs specificity (false negative rate (1-Specificity) But we have always done it that way! MOC failure rates of FP=33% and IM=25% -experienced practicing physicians! Competency NOT an issue at Med Boards!
Competency issues rate 1/42,102= 0.002% incidence!

Ohio State Medical Association resolution in April 2012

"Resolved, the OSMA actively oppose any efforts by the State Medical Board of Ohio to implement DIFFERENT maintenance of licensure requirements OTHER THAN THOSE CURRENTLY IN PLACE FOR physicians in Ohio, and, be it further,

Ohio State Medical Association resolution in April 2012 Resolved, that the OSMA form a task force to explore alternate methods, other than maintenance of certification, for physicians to demonstrate ongoing competency in anticipation of new requirements for maintenance of licensure by the state medical board."

Medical Society of the State of New York: resolutions 2013

RESOLVED, That the Medical Society of the State of New York acknowledges that the certification requirements within the Maintenance of Certification process are costly, time intensive and result in significant disruptions to the availability of physicians for patient care; and be it further RESOLVED, That MSSNY acknowledges and affirms the professionalism of individual physicians to self-determine the best means and methods for maintenance of their knowledge and skills; and be it further RESOLVED, That MSSNY communicate to the American Medical Association (AMA) and American Board of Medical Specialties (ABMS) examples of disproportional fees, onerous time requirements and unnecessary fragmentation of commonly recognized specialties; and be it further RESOLVED, That MSSNY oppose mandating Maintenance of and be it further RESOLVED, That a copy of this resolution be transmitted to the AMA House of Delegates for its consideration.

Certification until such time as evidence-based research demonstrates MOC is linked to improved patient outcomes;

How to organize
States have rights to legislate licenses-the battle will be drawn here-PASS LEGISLATION & RESOLUTIONS! Organization of State opposition among physiciansDATABASES/EMAIL! Proactive measures to meet real needs Define the truth-expose the lies with States own data! Require only Certification and NOT recertification for:
Hospital privileges Group membership Insurance payment and participation

'I'll make him an offer he can't refuse'

Certification improves nothing:
Physicians are and remain competent for many reasons-NOT because of MOC By creating legally mandated MOL, MOC becomes an offer you cannot refuse Protection racketeering = EXTORTION You dont really need the protection Until after the need is created by the offering entity!

NCQA invites you to become a Patient-Centered Medical Home Certified Content Expert
Demonstrate your expertise of NCQA's PCMH Recognition Program. Strengthen your professional portfolio. Obtain a credential that will boost the confidence of your client base. Differentiate and distinguish your knowledge base of NCQAs PCMH Recognition program from others.

Certified content experts are required to complete two NCQA educational seminars, pass a comprehensive exam and commit to continuous learning and recertification to maintain the credential.

Payments to CEO Raise New Conflicts at Top Health Quality Group

Denhams NQF chlorhexadine endorsement started multimillion fraud issue

Dr. Christine Cassel, President and CEO of the National Quality Forum, speaking before the Senate Committee. Dr. Cassel was paid hundreds of thousands of dollars in additional outside compensation after she was hired in December 2012.
http://www.propublica.org/article/payments-to-ceo-raise-new-conflicts-at-top-health-quality-group

Citing Distraction, Quality Forum CEO Resigns Board Seats

Dr. Christine Cassel said she is voluntarily stepping down from directorships at two health care companies that have an interest in the National Quality Forums [gets the bulk of its money from Centers for Medicare & Medicaid Services (CMS).] resigning from the boards of two health care companies amid questions about the ethics of the relationships: paid $235,000 as a director for
Premier, Inc., $203,500 in 2012, Kaiser Inc.

Corruption in medicine
Cassel and National Quality Forum Journal articles/supplements as free advertisement J Contin Educ Health Prof, 2013;33(S1):S1-60 Failure to disclose conflicts in articles Specialty societies as majors in Certification Industrial Complex
Existing LIFELONG LEARING VALIDATION mechanisms: State Board Licensure AMA PRA-CME Canadian/British systems emulate US CME

24390882 PMID: 24390882 PMID: 24390882

Failure to comply with Journal ethics (ICJME)

PMID: 24390882

Certification is merely "BRANDING= advertisement.

Such activity has long been despised by medicine and physicians (and for a time even lawyers) were prevented from running ads for themselves As such it is as unwanted as selling sham surgery, ineffective therapy or any other unethical behavior, like dating your patients! Simply exposing the practice: NOT an indicator of quality is the most practical means of defeating the beast.

These Boards developed similar but separate standards and processes that enabled organizations to submit individual quality improvement MOC Part IV credit for their own physicians
Q: What is the fee to participate in the Portfolio Program? A: There is a non-refundable $1,000 application fee due upon submission of the Portfolio Program Application through the MOC Activity Manager. If the applying organization is approved for participation in the Portfolio Program, a $5,000 participation fee is due. The renewal fee is $5,000. Fees are subject to change. Q: What is the approval term? A: Portfolio Sponsors are approved or renewed for a two year term.

ACCME ersatz

http://mocportfolioprogram.org/

CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES > PART 482--CONDITIONS OF PARTICIPATION FOR HOSPITALS

(7) Ensure that under no circumstances is the accordance of staff membership or professional privileges in the hospital dependent solely upon certification, fellowship, or membership in a specialty body or society.
http://law.justia.com/cfr/title42/42-3.0.1.5.21.2.199.2.html

just say NO and stop paying extortion to Bait and $witch Ponzi schemes

www.Changeboardrecert.com

Physician vs Administrator growth in Healthcare

Parallels The increasing need to document in healthcare

ACA in PRINT

http://www.medibid.com/blog/2013/04/medi crats-increase-healthcare-costs/