Time to Hammer the the ABMS and MOC!

I was alerted to take some survey about board certification and this is interesting. It came via the AAFP website: If you’d like to offer your insight on the current state of continuing board certification and how it can best evolve to truly serve the needs of physicians and their patients, here’s your chance. You…

The Urgent Care Center Charade

This recent article in the NY Times, about urgent care centers, is really interesting.  It’s called The Disappearing Doctor: How Mega-Mergers Are Changing the Business of Medical Care and it is full of irritating stuff.  Let me explain. I did a transition year in an urgent care center before I did my DPC practice.  It was in a massive…

The Highlander is Dead by Pat Conrad MD

We wonder at the ongoing loss of respect accorded doctors by a whiny, furtive public, and then this:  “Leading Scots doctor in call to ban ‘killer’ kitchen knives.”  That’s right girls and boys and undecided, Dr. John Crichton, the new chairman of the Royal College of Psychiatrists in Scotland, did a study.  He looked at…

Ridiculous Study of the Week: Irritability

Did you know that there was “qualitative study comparing the way family medicine and pediatric vs specialty care providers evaluate and treat school-aged children who present with irritability”?  Yes, it’s true.  Money was spent on this. The study sample included 17 family medicine, pediatric, and psychiatry care providers from a single facility who participated in in-depth interviews…

Can You Please Spare a Listen?

The first two episodes of the Authentic Medicine Podcast are up.  The first is just an introduction and the second is with my friend Vance Lassey MD.  The goal is to NOT be DPC centric.  Landon’s DPC podcast is for that. Vance and I talked about our Placebo Journal days and other really fun stuff.…

Get Your ABFM Button Eyes Here

I received this message recently from a reader of this blog:

“Just got the latest ABFM mailer. The creepy ‘get with the program’ cheerleading reminded me of the following (Coraline movie clip above)”.

I was surprised that such juicy material had skipped by me without my notice. Then I saw it.  Oh, it’s a good one. Here is the PDF from the idiots at the ABFM.  I am going to copy their first article here in full:

The ABFM PRIME Support and Alignment Network News: Supporting and aligning your professional activities with practice transformation to help bring joy back to practice!

What was Good for Farms may be Good for Practices by Robert L. Phillips, Jr., MD MSPH

For more than 100 years, the Cooperative Extension System (CES) has led the way in innovation discovery in American agriculture and farming. It is heralded as one of the most successful technology catalyst programs of all time, ensuring food production at critical times in our recent history. Thanks to its connection to land-grant universities, there are now CES agents in nearly every U.S. county who continue a legacy in rural and farming communities, but who are also enabling a new generation of farmers and the locally-sourced food movement that supplies many of your favorite restaurants. The CES also has a National Framework for Health and Wellness that aims to help create healthy and safe communities, support clinical and community preventative services, and contribute to the elimination of health disparities. The well-tested and well-developed CES recognized an important opportunity to help improve health beyond food production. More than a decade ago, Dr. Don Berwick and others recognized the potential for the Cooperative Extension model to be a boon for discovering healthcare innovations and speeding up the testing and dissemination of those innovations across physician practices. Family medicine innovators, like Dr. Art Kaufman in New Mexico, and Dr. Jim Mold in Oklahoma, built co-op-like models of practice support and change-facilitation that have operated successfully for nearly two decades. In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act was launched as a component of the American Recovery and Reinvestment Act. This act created 62 Regional Extension Centers that worked with individual practices to speed up adoption of electronic health records (EHRs). Congressional staffers who drafted the HITECH Act borrowed the extension model for EHR adoption. That toe-hold for healthcare extension became the nidus for the Primary Care Extension Program (PCEP) authorization in 2010, which was written, in part, by a small group of family medicine leaders. In 2011, the Agency for Healthcare Research and Quality piloted the PCEP concept with Infrastructure for Maintaining Primary Care Transformation (IMPaCT), and then in 2015 launched the much larger EvidenceNOW, which is providing quality improvement services to 250 small- and medium-sized primary care practices across 12 states. IMPaCT influenced the Centers for Medicare and Medicaid Services to launch two related demonstrations in 2015: The Comprehensive Primary Care Initiative (now in its second generation as CPC+) and the Transforming Clinical Practice Initiative (TCPi).TCPi aims to reach 140,000 clinicians across all states, providing practice assessment, transformation, and improvement services through 29 Practice Transformation Networks. CPC+ provides multi-payer payment reform and transformation support to nearly 3,000 practices in 18 regions. These three projects will put nearly $1 billion into testing the value of local practice transformation services. The ABFM believes that extension-like services are important to helping family medicine practices survive and thrive. For that reason, we are directly participating in TCPi with the ABFM PRIME Support and Alignment Network and supporting both EvidenceNOW and CPC+. It is also one of the reasons the ABFM created the PRIME Registry and is offering three years of free registry enrollment for thousands of family physicians.

Right off the bat the title of their whole publication makes me ill:

Supporting and aligning your professional activities with practice transformation to help bring joy back to practice!

You are a damn testing organization who gouging us for money and whose biggest income producer (MOC) is a scam. You are almost obsolete.  Everyone hates you. We do not want you to transform us.  Removing the MOC would be the only thing you could do to bring us joy.

Now to the article itself.  Uhh…….WTF is that?  I couldn’t understand anything this guy said.  I lost interest by sentence two.  It’s all about confusion and persuasion to make us follow them with their stupid initiatives.  Like the reader who sent me this says, “None of which makes any sense…. EHR’s are the buttons we all must sew on….like in Coraline.  Yup. 

What are your thoughts?

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ACOs That Lose Money

A few years back I highlighted how ACOs were failing but when does that stop bureaucracy?  At that time (2015) they had tons of excuses.  Here is one I highlighted back then: Their experiences reflect that ACOs are still a new structure, and building a new payment and care model as complex as an ACO…

Don’t Spill My Beans by Pat Conrad MD

On the rare morning when I stumble into work and am immediately peppered with coding questions from the day before, or patient’s families’ complaints that they couldn’t videotape me suturing a drunk relative, I will give an acid, acrylamide-free stare at whichever offending staff member, and quietly growl, “You are asking me questions before I’ve…