MOC is a cash cow for the American Board of Medical Specialties (ABMS) and its 24 specialty boards, which administer the exams. According to its most recent tax filings, ABMS president Lois Margaret Nora made nearly $700,000 in compensation from the organization in 2016. Thirteen other executives made over $150,000 from the nonprofit in the same year. In total, ABMS spent over $10 million on compensation, more than half its annual revenues, which largely come from inflated testing fees.
Many families have brought their children, grandchildren, and great-grandchildren to us for more than 40 years. We have seen them through the darkest moments of their lives, at their most vulnerable, and brought them into the light. Now, our patients must guide me through unimaginable heartache and grief.
Physicians must stand up and be counted. Our time is now. Practicing physicians can deliver valuable insight and novel perspective on how to enact change. We must give the power to make healthcare decisions back to the patient and their doctor, rather than to the insurance and pharmaceutical industries.
Recently I wrote about empowerment and the importance of letting patients make their own health care decisions. Our job is to make sure patients are given information and then allowed to choose (continue reading →)
I Wish My Doctor Knew… I am scared of being deported. A few weeks ago, a child said they were worried about who was going to be elected, because they were afraid of being sent back to El Salvador. I asked if he was born in the US and he replied he was but his parents were not and he was afraid they would be sent away. He is just seven years old. I honestly did not know what to say.
“To say the things he truly feels; and not the words of one who kneels. The record shows I took the blows – and did it my way.” My way would involve fewer bureaucrats making significant healthcare decisions that impact the entire country and its population at large. Both patients and physicians are taking blows from those in charge of the system who know nothing about the world of primary care.
The No Child Left Behind (NCLB) Act is to the education system what MACRA is to healthcare. Why must we keep repeating history?
As the reality of MACRA (Medicare Access and CHIP Reauthorization Act of 2015) looms, the pressure is on small practices to survive. CMS plans to penalize 87% of solo physicians and reward bonuses to 81% of practices with more than 100 physicians. It is time for passive resistance, defined as protesting against a law using peaceful methods such as refusing to obey or refusing to leave a building. I vehemently refuse to leave the building.
We should pay physicians for time spent engaging patients in conversation, instead of rewarding them for checking boxes on a computer screen. Physicians were trained to care and comfort people, not chase blood pressure numbers and pain scale scores. Changes masquerading as meaningful have only increased physician workload. We are widgets in the ever expanding assembly line. Do you think the MIPS will give us more time to practice medicine? If you believe it will, then I have a bridge to sell you.
In my humble opinion, that type of communication provides tremendous value. Paying more to a physician who provides services that benefit patients directly is a metric worth tracking. If physician and patient can work together by rowing in sync on the same boat, maybe we could get those in control of the healthcare system on board with us after all. Medicine is not a one-way road. You are spot on about that.