Editor's Note: As I prepare for my THIRD board exam in 20 years, I…
The Man Behind the MOC
If you ever want to lose weight via vomiting then I recommend you read this pitiful article in Medical Economics. Richard Baron MD is the President and CEO of the American Board of Internal Medicine and ABIM Foundation and he offered to be interviewed in order the defend the program. You can read the whole thing here but here are just some of the highlights:
- “Putting out a credential that speaks to whether doctors are staying current in knowledge and practice, I think overwhelming numbers of doctors want to have a way to reassure themselves that they’re doing that.”
- “The second thing is everyone agrees CME varies enormously in quality and effectiveness. Everyone knows about courses you can go to on the cruise or at the ski resort and may or may not be getting any knowledge. And it’s important not just that your seat was in the seat, but that you actually know what you need to know to do what we do. And what we do is pretty important and it changes pretty rapidly and people are not good at assessing what they don’t know.”
- It used to be that lifetime certification was a great way to do that. But with knowledge changing as fast as it does, it becomes pretty important to know who’s staying current.
- ME: Is there any evidence that certification, or lack of certification matters to patients?RB: “Absolutely. I think patients are desperate for high-quality information about doctors and who they’re seeing. Lots of doctors say to me, ‘no patient has ever asked me whether I’m board-certified.’ Well first of all, lots of patients I talk to say ‘I go on the internet or I look at the directory, and if that doctor’s not board-certified I don’t go.’ Lots of people tell me that. They’re not asking the doctor because they already know before they came. So yeah, I think patients do care about it. I think patients don’t look too deeply the way doctors do at what’s behind the credential. But I think they respect it a lot more deeply than they do Yelp reviews.”
- ME: So you’re not concerned that what NBPAS does may make what ABIM does irrelevant?RB: “I’m not concerned at all, I think if anything they make it more relevant, because they highlight the fact that we actually have a performance standard in the middle of our program.”
- ME: Another big concern we hear is how ABIM spends its money. And today’s announcement didn’t really touch on finances at all. Are you concerned about the anger that’s out there about ABIM’s finances?RB: “A lot of people have raised issues about that. We are fully transparent about that. Go to our website, abim.org/finances and you’ll see a graphic that shows you where we spend our money and how we spend our money. You’ll see an audited financial statement posted on our website, which very few nonprofits do.People have raised questions about compensation practices. We have a compensation committee that follows best practice standards, gets comparable figures on what people in senior executive positions get paid, which is how nonprofits set salaries.
To put it more bluntly, if I were trying to hire a cardiologist, and I said I’m going to pay you a general internist’s salary, I couldn’t hire a cardiologist on a general internist’s salary. And you can’t hire a chief operating officer of a $56 million-a-year company on the salary that you hire somebody to manage a one-doctor medical practice.
So we’re in a competitive market for talent. Our salaries are competitive, they are reviewed by an executive compensation committee, there’s an independent consultant that provides competitive data in the marketplace. So we have nothing to apologize for in our finances, That’s why we put it all out there.
We understand that every dollar we get we need to spend carefully. And we understand that doctors are concerned about the fees. And as we think about re-creating the program we will be looking at ways to restructure fees. But what I pay in fees to ABIM is less than what I pay the Commonwealth of Pennsylvania for being licensed, less than what I’m paying the federal government for having privileges to prescribe narcotics.”
So as you can see, the ABIM and their leaders are overall good guys. They are there for you. Without their seal of approval you are NOT current in your knowledge. They have deemed that your CME, without them, sucks. They feel that certification is critical to patients because they can look it up on the internet but, interestingly enough, Baron never discusses recertification. Isn’t that what the whole controversy is about? And the crack team at Medical Economics doesn’t even ask about it or the fact that they can remove all evidence that you ever certified in the past if you don’t pay up. Overall, Dr. Baron isn’t worried at all about the alternative board NBPAS because not enough docs have joined them yet. He then finishes off with some complete bulls&t about the absurd amount of money they are being paid.
As we physicians continue to try and take back healthcare it sure would be nice if we could also shut these jokers down. Dr. Wes, how about it? Your thoughts on this?