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    ABIM: Time to heal thyself

    Since 1936, the American Board of Internal Medicine (ABIM) has been a respectable and credible organization; one that I believed in and supported. I am proud to be board certified in Internal Medicine. Certification was a milestone in my career as I felt I had reached a level of excellence that set me apart from other physicians. It means something to my patients, as well as my colleagues, and it gives them some assurance that I am board certified by an independent organization.

    2015 EHR Report Card results

    Dr. EllisABIM certification is supposed to be the highest standard in internal medicine and its subspecialties. It means that internists have demonstrated—to their peers and to the public—that they have the clinical judgment, skills, and attitudes essential for the delivery of excellent patient care.

    My credentials are important to me and although I don’t plan to retire any time soon, I refuse to sit for another ABIM recertification exam. Since January 2014, when the ABIM changed the maintenance of certification (MOC) requirements, it has wreaked havoc on a system that worked well for decades; and if I were to believe the articles that have appeared in Newsweek, the organization made the changes for its own financial gain, not for the advancement of medicine or patient care.

    ABIM betrayed the trust of its constituents, ruined its stellar reputation, and turned its back on the values of the physicians that it serves. Over the last few months, ABIM has attacked Newsweek, sent out a letter of apology to physicians, backpedaled on its MOC requirements, and more-or-less tried to justify its actions.

    Instead of doing the right thing by physicians, the board has intensified the sense of anger and frustration among its constituents by focusing time and attention on its own public relations debacle. It has failed to work on solving the deep-rooted issues created among physicians regarding certification. As a result, there are now calls to abolish ABIM and MOC.

    Next: 'ABIM needs to get out of crisis management mode'

    17 Comments

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    • RICHARDHESHAM
      Dear Dr. Ellis, You are totally on target about ABIM’s betrayal of its constituents. I am now totally retired so I can be reflective. Like you, I was extremely proud of my achievement of ABIM certification at first sitting (including the arcane oral exams). I had mixed feelings when ABIM moved to recertification although I was grandfathered to life-time status. The first sign of trouble came when, despite assurances to the contrary, we grandfathered certificate holders received an asterisk signifying we were not enrolled in Maintenance of Certification signifying we were somehow less accomplished. Further I had achieved Added Qualifications in Geriatrics but chose not to recertify after 10 years since, as it turned out, there was no added value or benefit to being geriatrics certified, but I still felt denuded. I share your hope that ABIM can be remediated however they may be beyond resuscitation. If certification is important, a new more nimble and in touch entity may be needed. Like the ACP they may have outlived their relevance to the practicing community of Internal Medicine. Dick Richard H. Esham, MD (formerly FACP, if that’s important)
    • Dr. G. T. A. Morris
      For a start , pass everyone who takes and completes the periodic MOC exam . Give each one tested a report on how she/he did on each question and how each question was answered by everyone examined at that time. Recognize that MOC is only a test and not surrogate for anything else. Give CME credit for study done in prepping for the test and for the test itself. Require MD ABIM to take the test too.
    • Dr. G. T. A. Morris
      For a start , pass everyone who takes and completes the periodic MOC exam . Give each one tested a report on how she/he did on each question and how each question was answered by everyone examined at that time. Recognize that MOC is only a test and not surrogate for anything else. Give CME credit for study done in prepping for the test and for the test itself. Require MD ABIM to take the test too.
    • Dr. G. T. A. Morris
      For a start , pass everyone who takes and completes the periodic MOC exam . Give each one tested a report on how she/he did on each question and how each question was answered by everyone examined at that time. Recognize that MOC is only a test and not surrogate for anything else. Give CME credit for study done in prepping for the test and for the test itself. Require MD ABIM to take the test too.
    • Dr. G. T. A. Morris
      For a start , pass everyone who takes and completes the periodic MOC exam . Give each one tested a report on how she/he did on each question and how each question was answered by everyone examined at that time. Recognize that MOC is only a test and not surrogate for anything else. Give CME credit for study done in prepping for the test and for the test itself. Require MD ABIM to take the test too.
    • Dr. G. T. A. Morris
      For a start , pass everyone who takes and completes the periodic MOC exam . Give each one tested a report on how she/he did on each question and how each question was answered by everyone examined at that time. Recognize that MOC is only a test and not surrogate for anything else. Give CME credit for study done in prepping for the test and for the test itself. Require MD ABIM to take the test too.
    • Excellent article, Dr. Ellis. I agree with everything you said. Initial certification is enough, then the board should leave us alone to do our job taking care of patients. As long as a diplomate keeps a clean record, the board has no business regulating or interfering with that diplomate's practice. Currently, the board assumes its diplomates are all mentally deficient, dangerous providers with questionable ethics who must be constantly reevaluated and monitored to protect the public. They base this assumption on the flawed and disingenuous 1999 IOM "To Err is Human" Article and a bunch of pseudoscientific mumbo jumbo about physicians being poor at self evaluation. Their logic is laughable! Like Dr. Ellis, I forfeited my American Board of Urology certificate over MOC and I am now proudly board-certified by NBPAS. Let's break the ABMS Monopoly and get them off our backs! Go to NBPAS.org and join the fight. It's not to late... Dr. Stephen G. Weiss II MD, FACS, NBPAS Board-Certified
    • Excellent article, Dr. Ellis. I agree with everything you said. Initial certification is enough, then the board should leave us alone to do our job taking care of patients. As long as a diplomate keeps a clean record, the board has no business regulating or interfering with that diplomate's practice. Currently, the board assumes its diplomates are all mentally deficient, dangerous providers with questionable ethics who must be constantly reevaluated and monitored to protect the public. They base this assumption on the flawed and disingenuous 1999 IOM "To Err is Human" Article and a bunch of pseudoscientific mumbo jumbo about physicians being poor at self evaluation. Their logic is laughable! Like Dr. Ellis, I forfeited my American Board of Urology certificate over MOC and I am now proudly board-certified by NBPAS. Let's break the ABMS Monopoly and get them off our backs! Go to NBPAS.org and join the fight. It's not to late... Dr. Stephen G. Weiss II MD, FACS, NBPAS Board-Certified
    • Excellent article, Dr. Ellis. I agree with everything you said. Initial certification is enough, then the board should leave us alone to do our job taking care of patients. As long as a diplomate keeps a clean record, the board has no business regulating or interfering with that diplomate's practice. Currently, the board assumes its diplomates are all mentally deficient, dangerous providers with questionable ethics who must be constantly reevaluated and monitored to protect the public. They base this assumption on the flawed and disingenuous 1999 IOM "To Err is Human" Article and a bunch of pseudoscientific mumbo jumbo about physicians being poor at self evaluation. Their logic is laughable! Like Dr. Ellis, I forfeited my American Board of Urology certificate over MOC and I am now proudly board-certified by NBPAS. Let's break the ABMS Monopoly and get them off our backs! Go to NBPAS.org and join the fight. It's not to late... Dr. Stephen G. Weiss II MD, FACS, NBPAS Board-Certified
    • Excellent article, Dr. Ellis. I agree with everything you said. Initial certification is enough, then the board should leave us alone to do our job taking care of patients. As long as a diplomate keeps a clean record, the board has no business regulating or interfering with that diplomate's practice. Currently, the board assumes its diplomates are all mentally deficient, dangerous providers with questionable ethics who must be constantly reevaluated and monitored to protect the public. They base this assumption on the flawed and disingenuous 1999 IOM "To Err is Human" Article and a bunch of pseudoscientific mumbo jumbo about physicians being poor at self evaluation. Their logic is laughable! Like Dr. Ellis, I forfeited my American Board of Urology certificate over MOC and I am now proudly board-certified by NBPAS. Let's break the ABMS Monopoly and get them off our backs! Go to NBPAS.org and join the fight. It's not to late... Dr. Stephen G. Weiss II MD, FACS, NBPAS Board-Certified
    • Excellent article, Dr. Ellis. I agree with everything you said. Initial certification is enough, then the board should leave us alone to do our job taking care of patients. As long as a diplomate keeps a clean record, the board has no business regulating or interfering with that diplomate's practice. Currently, the board assumes its diplomates are all mentally deficient, dangerous providers with questionable ethics who must be constantly reevaluated and monitored to protect the public. They base this assumption on the flawed and disingenuous 1999 IOM "To Err is Human" Article and a bunch of pseudoscientific mumbo jumbo about physicians being poor at self evaluation. Their logic is laughable! Like Dr. Ellis, I forfeited my American Board of Urology certificate over MOC and I am now proudly board-certified by NBPAS. Let's break the ABMS Monopoly and get them off our backs! Go to NBPAS.org and join the fight. It's not to late... Dr. Stephen G. Weiss II MD, FACS, NBPAS Board-Certified
    • Excellent article, Dr. Ellis. I agree with everything you said. Initial certification is enough, then the board should leave us alone to do our job taking care of patients. As long as a diplomate keeps a clean record, the board has no business regulating or interfering with that diplomate's practice. Currently, the board assumes its diplomates are all mentally deficient, dangerous providers with questionable ethics who must be constantly reevaluated and monitored to protect the public. They base this assumption on the flawed and disingenuous 1999 IOM "To Err is Human" Article and a bunch of pseudoscientific mumbo jumbo about physicians being poor at self evaluation. Their logic is laughable! Like Dr. Ellis, I forfeited my American Board of Urology certificate over MOC and I am now proudly board-certified by NBPAS. Let's break the ABMS Monopoly and get them off our backs! Go to NBPAS.org and join the fight. It's not to late... Dr. Stephen G. Weiss II MD, FACS, NBPAS Board-Certified
    • Anonymous
      The ABIM is a self appointed agent that administers a voluntary certification process. They are self regulating and self governing. If they say board certification is for life, it is. If they change their minds, then it is something different. There is no oversight and no recourse. Docs need to make up their minds -- either the ABIM is important or it is not. If it is, quietly do what they tell you to do, and pay up. If it is not important, then turn away and focus on caring for your patients. To say it is important to be certified but then deny the board's authority about keeping that certification seems oxymoronic. Personally I've not taken the boards after 30 years of practice and do not plan to. I cannot be the chairman of the department of medicine at the hospital I attend but neither do I care to. Any insurance company that insists on board certification needs to look elsewhere for a provider. To date every single company has come back to me and offered a contract. I am still waiting for the compelling study that shows that residency trained physicians who are not board certified are deficient compared to those who pass the test. There is a recent study that shows that docs who participate in MOC are not delivering better care than those who do not. The ABIM has never done such a study because they are afraid that the result would challenge their existence. So if board certification is really important, docs need to do what the boards tell them to do. Do your MOC, take your tests, and send your payments and do so quietly. Watching people demanding to have it both ways is really hard to take. TT Wilson MD proudly not certified by the ABIM
    • DONALDLBLACKMON
      Fully agree with Dr. Ellis and am glad to see a few PRACTICING physicians beginning to question the edicts of our non-practicing, non-patient caregiving "leaders" who have abandoned patient care in favor of becoming our "regulators." These syncophants are complicit in AHA's focus on giving patients an insurance card rather than a doctor visit, complicit in mandating EHR's which have demonstrated increased danger to patient care and health -- NOT improved patient care and health -- and are complicit with CMS's continued emphasis on regulations to handcuff our delivery of care. Best options to improve care in this country? 1) Repeal AHA, 2) Repeal HITECH (EMR mandate), 3) Overhaul ABIM, ACP, AMA, AAFP, etc. with PRACTICING physicians, not bureaucrats, 4) Fire spokespeople who apparently are moles for governmental regulations (Bob Dougherty with ACP being the most egregious), 5) Outlaw the new payment models (ACO's, PCMH's) which tout quality reimbursement models but are being proven now to divert payments to bean counters from caregivers (which, in my opinion, was the prime reason they came into being), and finally 6) Pass no laws without prior approval by those most invested in patient care -- PRACITICING physicians!
    • CHRISTOPHERJUNREIN
      What a wonderful article! Struck just the right tone and approach that needs to move the internal medicine profession (and all of the medical profession for that matter) looking forward. We need to return to a health care system that is focused on patients and physicians, not process (EMRs, MOC, PQRS, etc). Thanks Dr. Ellis
    • Anonymous
      Excellent article. I am "lifetime" board certified in neurology and internal medicine. I am in active practice. The idea that board certification should "expire" when a physician has an active license (keeping up with CME, etc.) is absurd. This is a "make work" and possibly "make money" requirement whose benefits (if any) are clearly outweighed by the effort (and money) required to recertify every 10 years. Thank you for writing this.
    • Dr. G. T. A. Morris
      I agree as a lifer who took one voluntary recertification after 10 years and passed I realize the value in making one aware that some of the current questions can indicate areas of ignorance for the one examined. How competence in the practice that the individual is engaged in is not assessed by these exams.

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