Monday, January 19, 2015

Boarded to Death — Why Maintenance of Certification Is Bad for Doctors and Patients — NEJM

Boarded to Death — Why Maintenance of Certification Is Bad for Doctors and Patients — NEJM

Regardless of how the MOC issue is resolved, the recent focus on the ABIM has shed a bright light on how medicine is regulated in the United States. The ABIM is a private, self-appointed certifying organization. Although it has made important contributions to patient care, it has also grown into a $55-million-per-year business, unfettered by competition, selling proprietary, copyrighted products. I believe we would all benefit if other organizations stepped up to compete with the ABIM, offering alternative certification options.

More broadly, many physicians are waking up to the fact that our profession is increasingly controlled by people not directly involved in patient care who have lost contact with the realities of day-to-day clinical practice. Perhaps it's time for practicing physicians to take back the leadership of medicine.

A good start to regaining that leadership might be backing off support for the  Affordable Care Act.  Government's do-gooder effort giving us less care at greater expense.

Beyond a Traditional Payer — CMS's Role in Improving Population Health — NEJM

Beyond a Traditional Payer — CMS's Role in Improving Population Health — NEJM

There are limits to CMS's statutory authority to fund services provided to people other than Medicare or Medicaid beneficiaries, but the agency can leverage its influence beyond the payment of claims. Whereas our approaches for providers focus on enrolled or attributed populations, SIM seeks to affect broader populations


I suppose CMS can leverage but I wonder if those funding limits suggest it shouldn't extend into something its unfunded and therefore ill equipped to influence for the good.