Before the specialty boarding, CMEs seemed to be adequate in keeping physicians current. How did hospitals get on the bandwagon requiring boarding in order to have privileges?
The practice improvement requirements are especially ridiculous and time consuming and completely redundant. Many docs make things up just to satisfy the requirement while in real life working to improve things day to day in their own offices and whatever system they may be in in less formal ways that are not really “data gatherable”.
Thank you so much for this and for your work on this topic! I have let my medicine boards lapse but continued to recertify in my subspecialty. I have now taken that exam three times and am due for the fourth in a few years. I will not do it again in my 60’s, so I will either figure out a way to work without or retire. I do not feel the need to prove myself yet again after 30+ years of practice. I don’t need to waste more money or time in studying and I don’t need the stress associated with it, either. This system is a complete travesty. It will definitely exacerbate the physician shortage when we all exit the profession earlier. Most of my classmates are retiring now. Enough is enough!
Keep up the good fight, Westby - I’m looking forward to Part 2, and I’m more than willing to participate in anything that gets rid of this onerous scam.
Not a doctor but am not surprised at yet another AMA sponsored rip off of the system. I wonder who heads up these boards? Who make the rules? Anybody with a mind, heart and soul? Or just thugs wanting control and money?
I have no doubt that these ridiculous fees are passed on to the customer which is customary in any business. More and more, the curtain parts and behind it is massive conflicts of interest and big pharma skulduggery.
Thank you, Westby. I am a retired pediatric pulmonologist and am so glad that I will never need to recertify again. It clearly has become a racket. The major organizations have conspired to support MOC and its bureaucracy. The fees are ridiculous. The idea of keeping up with one's field makes sense but the magnitude of the conflict of interest in this area is massive. The AMA, the American Academy of Pediatrics and the ABIM have all benefited and have failed their members. I got a bill from the AAP for continued membership with no mention of a lower fee for retired members. I am going to write them a hot letter with no regrets. Their role in supporting the transgender craze has been unconscionable. Absolutely, these organizations need to be sued. Big time.
I became board certified in Internal Medicine a long time. I gave the MOC my middle finger and haven’t had any negative consequences. I’d retire from medicine before being held hostage by MOC. I haven’t sent a dollar to any medical association in 30 years. There’s no way woke associations will ever get a penny from me. They can all go to hell.
We definitely pay for our own indoctrination. There is not one NOT ONE physician who agrees with this racket but we are so cowed and pushed into submission by these agencies. I am working on my “MOC” making fake charts and fake office improvement in an effort to get the practice improvement module done although I don’t own a practice
"As these younger doctors gain experience and awaken to the realities of their new health care arena that is increasingly dominated by unaccountable organizations led by non-clinical members of our own profession.....As a result, the brittle credibility and hard-earned trust with our patients is squandered..." sure sounds like situation going on in all our 3 letter agencies which has really been unmasked by past 3 years.
Thank you for your courage in speaking out and pursuing solutions to this corruption. Hoping many more doctors wake up and join forces with you to combat this. I am wonder if deeper dive into the money trail would lead to big pharma.
The money trail would lead to Government agencies (3 letter agencies) who are creating incentives for the institutions (in this case AMA, ABMS, AAMC, AHA, and yes pharma too etc.) that can then enrich themselves and then donate a part of their profits to political parties who then make the rules that help the Government agencies create incentives for the institutions that can then enrich themselves and donate to political parties who then make the rules that help the Government agencies create incentives for the institutions that can enrich themselves and......so on and so on and so on.... As physicians, we need to fight and expose this cycle for our patients who are caught in the unhappy condition of paying more (>20% of GDP!) for poorer care, leaking money and value out to these institutions (who are at best middlemen) within a pie that cannot grow.
In Texas, we passed legislation (led by TMA physician leaders) which attempted to break this monopoly. The big hospital systems in coordination with these self-enriching, working-physician-fleecing organizations simply turned it into a shell game in response. They moved the marble to a different shell so the one we were holding held nothing. However, the response of ABMS to the uproar was a marketing campaign and change to a “kinder gentler” approach. They apologized for enriching themselves and for their dishonesty about their conflicts of interest. The AMA was not on board with its physicians, but this is hardly surprising since membership is a small fraction of its revenue. With all the bells and whistles, it is still a time consuming, pocketbook-emptying experience. The MOC’s now include social experimental and nebulous subjects like DEI and gender-affirming care. The practice management modules give me the distinct feeling that I am paying for my own indoctrination, LOL! Seriously though, there is nothing funny about this. ChatGPT will be completing these for me, but I will still have to pay. Our patients, as always are the biggest losers in this schema. I can’t wait to hear in part 2 what we can do.
Aren't large language models (AI) going make certification and recertification irrelevant?
Do they give a math test module or do they presume you have a calculator (for those under 35, there used to be a dedicated device instead of the app on your phone; for those over 60 - yeah the slide rule we got in high school will still work if you can find it in that box of stuff your parents sent to you when they downsized - look under the track and field ribbons)?
If an AI can complete the module what is the point?
AI will quickly replace pathologists and radiologists. It already reads sleep studies very well. Machines learn patterns. The MD just has to quickly review and cosign. If anything happens, he just has to say "sue the corporation and the hospital as its product was the guide"
AMA will not care. Its money is made from ICD-10 royalties.
MDs are at fault for this as they tend to be lone wolves. A lone wolf can only hunt small prey. It is the pack strength that allows it to hunt large prey.
ChatGPT or its equivalent will never issue "MOC points." Therefore, the monopoly stranglehold on physicians for hospital privileges and insurance panel participation will continue unless the courts understand the ruse.
Before the specialty boarding, CMEs seemed to be adequate in keeping physicians current. How did hospitals get on the bandwagon requiring boarding in order to have privileges?
The practice improvement requirements are especially ridiculous and time consuming and completely redundant. Many docs make things up just to satisfy the requirement while in real life working to improve things day to day in their own offices and whatever system they may be in in less formal ways that are not really “data gatherable”.
Seems like the very definition of extortion…
Thank you so much for this and for your work on this topic! I have let my medicine boards lapse but continued to recertify in my subspecialty. I have now taken that exam three times and am due for the fourth in a few years. I will not do it again in my 60’s, so I will either figure out a way to work without or retire. I do not feel the need to prove myself yet again after 30+ years of practice. I don’t need to waste more money or time in studying and I don’t need the stress associated with it, either. This system is a complete travesty. It will definitely exacerbate the physician shortage when we all exit the profession earlier. Most of my classmates are retiring now. Enough is enough!
Keep up the good fight, Westby - I’m looking forward to Part 2, and I’m more than willing to participate in anything that gets rid of this onerous scam.
Wow, I knew MOC was shady but this article does good job of articulating the problem. Thank you.
Not a doctor but am not surprised at yet another AMA sponsored rip off of the system. I wonder who heads up these boards? Who make the rules? Anybody with a mind, heart and soul? Or just thugs wanting control and money?
I have no doubt that these ridiculous fees are passed on to the customer which is customary in any business. More and more, the curtain parts and behind it is massive conflicts of interest and big pharma skulduggery.
Thank you, Westby. I am a retired pediatric pulmonologist and am so glad that I will never need to recertify again. It clearly has become a racket. The major organizations have conspired to support MOC and its bureaucracy. The fees are ridiculous. The idea of keeping up with one's field makes sense but the magnitude of the conflict of interest in this area is massive. The AMA, the American Academy of Pediatrics and the ABIM have all benefited and have failed their members. I got a bill from the AAP for continued membership with no mention of a lower fee for retired members. I am going to write them a hot letter with no regrets. Their role in supporting the transgender craze has been unconscionable. Absolutely, these organizations need to be sued. Big time.
I’m needing a shower now to wash off the stink and slime of this scam. Thank you for your work in exposing this.
I became board certified in Internal Medicine a long time. I gave the MOC my middle finger and haven’t had any negative consequences. I’d retire from medicine before being held hostage by MOC. I haven’t sent a dollar to any medical association in 30 years. There’s no way woke associations will ever get a penny from me. They can all go to hell.
As one famous person said If you want to really see what is happening, follow the money. Appears clearly to be the case here.
We definitely pay for our own indoctrination. There is not one NOT ONE physician who agrees with this racket but we are so cowed and pushed into submission by these agencies. I am working on my “MOC” making fake charts and fake office improvement in an effort to get the practice improvement module done although I don’t own a practice
It's amazing how every corner of healthcare in the US has somehow been compromised by money. Thank you for shedding some light on this issue.
From authors 2014 paper he cited - http://drwes.blogspot.com/2014/12/the-abim-foundation-choosing-wisely-and.html?utm_source=substack&utm_medium=email&m=1
"As these younger doctors gain experience and awaken to the realities of their new health care arena that is increasingly dominated by unaccountable organizations led by non-clinical members of our own profession.....As a result, the brittle credibility and hard-earned trust with our patients is squandered..." sure sounds like situation going on in all our 3 letter agencies which has really been unmasked by past 3 years.
Thank you for your courage in speaking out and pursuing solutions to this corruption. Hoping many more doctors wake up and join forces with you to combat this. I am wonder if deeper dive into the money trail would lead to big pharma.
The money trail would lead to Government agencies (3 letter agencies) who are creating incentives for the institutions (in this case AMA, ABMS, AAMC, AHA, and yes pharma too etc.) that can then enrich themselves and then donate a part of their profits to political parties who then make the rules that help the Government agencies create incentives for the institutions that can then enrich themselves and donate to political parties who then make the rules that help the Government agencies create incentives for the institutions that can enrich themselves and......so on and so on and so on.... As physicians, we need to fight and expose this cycle for our patients who are caught in the unhappy condition of paying more (>20% of GDP!) for poorer care, leaking money and value out to these institutions (who are at best middlemen) within a pie that cannot grow.
In Texas, we passed legislation (led by TMA physician leaders) which attempted to break this monopoly. The big hospital systems in coordination with these self-enriching, working-physician-fleecing organizations simply turned it into a shell game in response. They moved the marble to a different shell so the one we were holding held nothing. However, the response of ABMS to the uproar was a marketing campaign and change to a “kinder gentler” approach. They apologized for enriching themselves and for their dishonesty about their conflicts of interest. The AMA was not on board with its physicians, but this is hardly surprising since membership is a small fraction of its revenue. With all the bells and whistles, it is still a time consuming, pocketbook-emptying experience. The MOC’s now include social experimental and nebulous subjects like DEI and gender-affirming care. The practice management modules give me the distinct feeling that I am paying for my own indoctrination, LOL! Seriously though, there is nothing funny about this. ChatGPT will be completing these for me, but I will still have to pay. Our patients, as always are the biggest losers in this schema. I can’t wait to hear in part 2 what we can do.
Aren't large language models (AI) going make certification and recertification irrelevant?
Do they give a math test module or do they presume you have a calculator (for those under 35, there used to be a dedicated device instead of the app on your phone; for those over 60 - yeah the slide rule we got in high school will still work if you can find it in that box of stuff your parents sent to you when they downsized - look under the track and field ribbons)?
If an AI can complete the module what is the point?
AI will quickly replace pathologists and radiologists. It already reads sleep studies very well. Machines learn patterns. The MD just has to quickly review and cosign. If anything happens, he just has to say "sue the corporation and the hospital as its product was the guide"
AMA will not care. Its money is made from ICD-10 royalties.
MDs are at fault for this as they tend to be lone wolves. A lone wolf can only hunt small prey. It is the pack strength that allows it to hunt large prey.
Physicians are healers. They do not need to be hunting anything.
ChatGPT or its equivalent will never issue "MOC points." Therefore, the monopoly stranglehold on physicians for hospital privileges and insurance panel participation will continue unless the courts understand the ruse.
A veterinarian as author--just like A. Bourla