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G2Voice Broadcast 121 – Why the “board certified doctor” is a triple negative for your health!

Sunday, Jan. 6th , 2018

10 AM EST

www.g2voice.is

 

Last week’s G2Voice Broadcast

178 Testimonies from New Zealand!

 https://youtu.be/WOIUW3Jssl0

 

Two weeks ago

G2Church Health Hacks!

https://www.youtube.com/watch?v=lV6SSbyxZ4c

 

Next week’s G2Voice Broadcast

Acidity vs. Alkalinity

Life or Death? and The pH Fallacies

 

G2Church Seminars for 2019!

We are looking at two areas in the U.S. to hold our NEW designed G2Church Seminars.

April: Seattle, Washington

June: Buffalo, N.Y.

NOTE: Don’t have the EXACT dates yet but please contact Bishop Jonathan at: This email address is being protected from spambots. You need JavaScript enabled to view it. if you are interested. This helps us to plan, ok?

 

You want to help us get this message around the world?

PLEASE, PLEASE, take 10 minutes and send ALL you friends and relatives these two links and this will help tremendously!

To bring in the New Year with the information you need in 2019 to stay healthy ALL year we are continuing our “two week” sale for another 30 days!

 

Two-week end of year sale is being extended to Jan.31st!

 

 “Imagine, A World Without DIS-EASE” by

Mark S. Grenon

imagine a world without disease image

 

Book Details

We at the Genesis II Church of Health and Healing have been involved in one of the most comprehensive, worldwide, cross cultural, broad spectrum, voluntary, human health studies of this world for the past 7 years.

Volume One This book is about my personal research and experience with thousands of people worldwide about why we have “dis-ease” and how to “restore health” in the body by practicing “self-care” with the Genesis II Church of Health and Healing Sacraments.

This book covers the following topics:

What is the dis-ease of the body?

Why is the body dis-eased?
How to stop the body from being dis-eased.
History of “western medicine” that will open your eyes and hopefully motivate MANY start to do something about it!
Who were the key players in developing vaccines and pharmaceuticals?
Real written and video testimonies of REAL people with restored health from illnesses
How to “restore health” by practicing selfcare NOT healthcare
What toxins are doing to the body’s systems
How the body was designed to work from “the pie hole to the butt hole”.
Why NOT to trust your doctor
Should we be afraid of cancer?
How important is a clean liver?
G2Voice Broadcasts covering 40+ illnesses that cause the body to be DIS-EASED!
Genesis II Church 10 sacramental commandments for “restoring health”.
ALL the information about the G2Church you will need in ONE book!

 

We will also be offering the eBook for a $15.00 Donation for the Two-Week End of Year Sale!

For a limited time you can get the printed and ebook editions for $40.00!

Go to www.g2churchbooks.org to donate for the book!

Available in Spanish

Disponible en español

NOTE: For international orders please contact This email address is being protected from spambots. You need JavaScript enabled to view it.

Also, the book is on Amazon but Amazon gets 50% and the G2Church 50% BUT they can get it places we can’t so it is another option!

English: https://amzn.to/2EScRBg

Spanish: https://amzn.to/2s2QWix

 

100% of the proceeds from this book will be donated to the Genesis II Church of Health and Healing to support its workers and support official G2 Projects around the world to help create, “a world without dis-ease.”

We have a new G2Church Membership Site!

Check it out and become a G2Church Member.

 

https://officialg2churchmembership.org/

 

 

NOTE: Genesis II Church Online Course (Being stopped selling this course) Why do you think that is happening? “They” are trying to stop us from getting this science to the world!!!! For information about the Online course please contact us at: E-MAIL Contact: This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Video course tutorial. Click below for follow along guide.

course clip

Publisher Contact
Bishop Jordan Grenon
This email address is being protected from spambots. You need JavaScript enabled to view it.

 

New G2 Sacramental Video Course includes!!!

We are now offering a downloadable Genesis II Church Sacramental video course. It will be much cheaper because we have eliminated the shipping and can be viewed immediate on-line or downloaded to your personal PC! English will be the first language available. Spanish, Portuguese.

If you take this course, you will be able to protect  yourself and your loved ones from the threat of 95% of the world's diseases. We want this information in the homes of everyone in the world as quick as possible. Help us see that a reality.

1. 50 New Instructional Videos

2. All up to date G2 Sacramental and Protocol videos.

3. Imagine a World Without Disease - Is It Possible? Archbishop Mark Grenon eBook

4. NEW Revised 2016 Sacramental Workbook (Health Sacraments Workbook)

5. Course exam.

6. Upon Completion of the Home Video Course, One free year membership in the Genesis II Church of Health and Healing with membership I.D. Card, (sent to your address).

7. Certificate of Completion of G2Church Seminar, (Emailed to You)

8. Minister of Health Certificate with Reverend I.D. card  - (sent to your address).

9. Certificate of Authorization to start a Genesis II Church chapter, (Emailed to You).

10. Special Health Minister newsletters from Genesis II Church.

11.Constant updates, news and much more!

Get this course and study the information as quickly as you can!! Study hard because this could save your life and the lives of your loved ones!

After you finish the course, take the exam and graduate as a Health Minister. If you have any questions please email This email address is being protected from spambots. You need JavaScript enabled to view it.

Note: If you have not received the log in information for the download this course, contact us at: This email address is being protected from spambots. You need JavaScript enabled to view it. with your receipt and we will get it to you quickly.

By studying to become a Health Minister, we know each person knows the G2 Church Sacramental Protocols enough to guide others. There is an exam to test the basic knowledge of each student before they are awarded a Health Minister Certificate. Once a person has become a “H.M.” then the practicing and experience comes as more people are guided to “restored health”.

Below are the steps in establishing a Genesis II Church of Health and Healing Chapter in your area!

To start a Genesis II Church chapter, you will need to meet the following requirements:

1. Become a Health Minister by attending a G2 Seminar or completing a Genesis II Church Video course

2. Request and approved for a Genesis II Church chapter

3. Make a Public announcement in the local newspaper for two weeks. Copy and post also.

4. Post the following documents in your place of abode, preferable on the wall in the entrance of your house.

At least post the Church Logo at the entrance of your home and the rest in your Church office.

Note: After you have treated and documented giving Health Guidance to 10 people you can request to become a Bishop.

 

Weekly Testimonies

  • Chief BARIMA!

Many thanks Jonathan,

This donation is going help immensely in purchasing materials like roofing sheets, 10 bags of cement, iron rods, wood and nails for the center at Bimma. 

Best Regards

Bishop Dr. Barima Asamoah Kofi IV
Genesis 2 Church of Health & Healing CHP. 314

We are helping him If you want to donate, please contact him directly at: This email address is being protected from spambots. You need JavaScript enabled to view it.

 1st

https://www.youtube.com/watch?v=pO2Era-hQN8&feature=youtu.be

 

  • Charles Poulnot click the Genesis II Church link and go from there. MMS works. I've used it for 15 yrs with remarkable results
  • MMS IS CURING MY PROSTATE CANCER - I'm 2 months into the Protocol and happiness has returned to my life Thank you so much for your superb information all the best to you both ashdavenport23
  • Natalie STa The first thing I did. Took pure DMSO and applied it in her whole arm, this morning she came jumping - no more swelling!! 👍
  • Here is my dog. She developed two hot spots.  Within a couple days healed completely with MMS by spraying or cotton ball application off 50 activated drops down to 20 drops the last few days!
  • Good morning Mark. I was going to give you all the testimonials all together but here is the first one.  This is my granddaughter.  She had her ears pierced and lost one earring and a day or so later they put a "temporary" earring in and had to push it through a little.  After several days my daughter accidentally hit the ear and the earring went through her ear hole.  The earring was covering the festering that was going on behind it.  I advised her to mix a 20 drop MMS and spray on her ear as often as possible before and after school.  Within 6 days it was completely healed. Regards Angela

2nd3rd

4th

 

  • Here is my son. He came to me with what seemed to be an auto ammunition reaction like lupus.  I have never had any experience with this however I felt it could be related to his long time battle with kidney stones and shingles outbreaks he's had since he was 15 years old.  He is 24 in this photo.  Started him on the starting protocol of MMS1 along side of CBD oil topically infused with frankincense oils for pain and swelling relief on his feet and hands.  Within a couple days the issue has resolved enough to ease his way back to work.  He was weak for a few weeks but as of today he is still doing well.  He didn't continue the protocol as I recommended however.

5th6th

7th8th

 

 

  • MMS and AS - I am only on day 7 of protocol one and my AS seems to be in remission completely. I even consumed a starchy meal last night.. and I am in zero pain today. Will be ordering more for family!
    Thank you for this wonderful sacrament. from Laura T.:"
  • Leslie Breitsprecher Thank God for mms
    It is our only weapon against the assault

I do not have any health issues other than a mild rosacea on my forehead, however, I tried the 3 week protocol (3 drops 8 times per day; during third week I added 3 drops DMSO) just to see what would happen. The rosacea redness is less than 50% plus no more flair-ups.

  • HACK - If you're landlord and want to get rid of the odor from the previous tenant simply put 50 active drops of MMS with enough water to run a essential oil diffuser for 8 hours on each floor. When you come back the next day the odor is gone. Cheaper than buying an ozone air purifier.  Hayes
  • I used MMS for back pain relief of inflammation/arthritis. it was great. Kept on maintenance and then went off for a month.

 

 

Why the “board certified doctor” is a triple negative for your health!

 

This title is passed around like it should be revered when in reality it is a description of a doctor that is completely controlled by the Big Pharma/Medical Industry. I hear and see on TV doctors being introduced as being a “board certified doctor” and people don’t even know what that really means! To find out what that title really means one has to ask a few questions and research for the answers to find the truth.

Questions:

  • What board certified them?
  • Who started this board?
  • Who controls this board?
  • What is ‘peer reviewed’ mean?
  • What does the certification mean?
  • Who trained the doctor?
  • Are the doctors pressured to be “board certified”?
  • Is their job and salary based on that certification?
  • Does being a “board certified doctor” make the doctor a better healer?

There are many other questions one could ask but the answers to these few questions should give us an idea if being a “board certified doctor” is really an important title to have to heal and cure people of the DIS-EASE of the body!

Let’s first look at the board that certifies these doctors and see who they are and what they do for the Medical Industry and the Big Pharma, ok? Please follow my train of thought here.

 

Excerpt from

Source: “Imagine, A World Without DIS-EASE” www.g2churchbooks.org

 

Chapter 7 – Don’t ask your doctor about anything in regard to health or Nutrition

 

But ye are forgers of lies, ye are all physicians of no value.” Job 13:4

9th

You could probably ask your doctor about golf or fishing. He would probably have a lot of knowledge about that, right? Then walk out the door and never go back! In fact, when you are done with this book you’ll know more about health and nutrition than he does after 12 years of study! You don’t need him like he wants, you to believe and the media pushes you to believe. The fact is doctors can’t know what they haven’t been taught!

Let’s just look at what Hippocrates said and did 2,000+ years ago. He is called the “Father of Western Medicine” and he didn’t believe what doctors believe today!

Look at two things he said it the Hippocratic Oath:

1. Do NO harm!

2. NEVER give a poison!

That is ALL modern doctors do today is, harm and give poisons - pharmaceuticals!

The facts are that Hippocrates cured people with raw milk and apple cider vinegar and he knew that the body can heal itself. He even said that when you are sick, fast. He believed that eating during sickness is feeding the problem. Isn’t that what animals do? When you see an animal sick they don’t eat. The doctors of today need to look at animals instead of their professors! I am NOT saying doctors are stupid, just trained wrong!

Just about everywhere you hear or read if you have any physical problem you need to ASK YOUR DOCTOR, and he or she can tell you what to do. That might not be the best way to seek a cure for your physical problem because of what has come out about ‘iatrogenic.’ Iatrogenic is the number 3 killer in the US now! Some studies say #1 if you add all the deaths by diseases caused by the pharmaceutical drugs and recommended procedures such as chemotherapy, radiation, surgery and vaccines to name a few. What is “iatrogenic?”

  • Iatrogenic: Due to the activity of a physician or therapy. For example, an iatrogenic illness is an illness that is caused by a medication or physician.
  • • iat·ro·gen·ic/ (i-ă´tro-jen´ik) resulting from the activity of physicians; said of any adverse condition in a patient resulting from treatment by a physician or surgeon.
  • Etymology of “iatrogenic”: Gk, iatros, physician, genein, to produce caused by treatment or diagnostic procedures. An iatrogenic disorder is a condition that is caused by medical personnel or procedures or that develops through exposure to the environment of a health care induced unintentionally in a patient by a physician. Used especially of an infection or other complication of treatment.

    NOTE: These definitions are from various medical dictionaries I found on Google.

 

The Hippocratic Oath

This is the “ethical” oath doctors make; the Hippocratic Oath:

“I swear by Apollo the physician, and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation—to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this Art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. (Emphasis mine.) With purity and with holiness I will pass my life and practice my Art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; (emphasis mine) and, further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot”! (Emphasis mine.) 

Source: https://www.britannica.com/topic/Hippocratic-oath

NOTE: They should call their oath the Hypocritical Oath!

Arnold Seymour Relman, the former editor-in-chief of the New England Medical Journal, and professor of medicine at Harvard University, once stated:

The medical profession is being bought by the pharmaceutical industry, not only in terms of practice of medicine, but also in terms of teaching and research. The academic institutions of this country are allowing themselves to be the paid agents of the pharmaceutical industry. I think it’s disgraceful.”

Source: http://www.medicine.news/2016-09-23-doctor-tells-all-claims-prescription-drugs-are-killing-us.html

Again, ‘Iatrogenic’.

Dr. Peter Gotzsche, co-founder of the Cochrane Collaboration (the world’s most foremost body in assessing medical evidence), hopes to make clear this very problem. He is currently working to inform the world about the dangers associated with several pharmaceutical grade drugs. Based on his research, he estimates that 100,000 people in the United States alone die each year from the side-effects of correctly used prescription drugs, noting that “it’s remarkable that nobody raises an eyebrow when we kill so many of our own citizens with drugs.” He published a paper last year in the Lancet arguing that our use of antidepressants is causing more harm than good and taking into consideration the recent leaks regarding antidepressant drugs, it seems he is correct.

Many of our most commonly used drugs, from painkillers to antidepressants, are dangerous and are killing us off in large numbers, says a leading researcher visiting Australia.

Source: http://www.collective-evolution.com/2016/02/17/meet-the-doctor-who-says-prescription-drugs-are-killing-us-and-hes-not-the-only-one/

How Prepared are You to Not Become a National Statistic?

If a Jumbo Jet crashed and killed 280 people every day... 365 days a year... year after year... would you be concerned about flying?
Would you question the Federal Aviation Administration? Would you demand answers?

Think about it!
Close to 100,000 people die every year from plane crashes? Sounds Ridiculous??!!

Well, think again. What if you were told that over 100,000 people are killed and over two million people maimed and disabled every year...year after year from modern medicine...would you believe it?

Well, these may be my words...but read the following articles from the most respected medical journals and institutions (Journal of the American Medical Association, Harvard University, Centers for Disease Control, British medical journal The Lancet, New England Journal of Medicine and national news (New York Times, Washington Post, CNN, US World Report) and you be the judge.

Writing in the Journal of the American Medical Association (JAMA), Dr. Starfield has documented the tragedy of the traditional medical paradigm in the following statistics: If the higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000. Even at the lower estimate of 225,000 deaths per year, this constitutes the third leading cause of death in the U.S.

Source: http://www.yourmedicaldetective.com/public/335.cfm

NOTE: I put a lot of articles from doctors about the whole “board certified” doctor program so read them, and we will talk about these articles this Sunday Dec. 6th 10 AM EST on G2Voice Broadcast www.g2voice.is

 

The “board”, what is it and who is on it?

Let’s look at how and why the “board” was even created and see if it is following what it was originally founded to do.

Why the History of the Specialty Boards Is Important?

 

According the American Board of Medical Specialties' website, the creation of the first medical specialty board was widely attributed to the ophthalmologist Derrick M. Vail, Sr., MD  because of remarks he made in his presidential address to the American Academy of Ophthalmology and Otolaryngology (AAOO) in 1908.  In 2012 while researching the origins of modern-day specialty boards, Denis O'Day and Mary Ladden from Vanderbilt in Nashville, TN performed a historical literary criticism of the ABMS's assertion that the ophthalmologist Derrick M. Vail, Sr., MD conceived of the specialty board system. By O'Day and Ladden's careful research, the true origin of specialty boards was likely created over a 12-year period by much of the work of ophthalmologist Edward M. Jackson, MD whose "Education for Ophthalmologic Practice" presidential address four years earlier at the AAOO meeting in 1904 sowed the seeds for board certification education system as we know it.

In their paper, O'Day and Ladden published the sentinel characteristics and principles embodied in the American Board of Ophthalmology (the "first" specialty board), the American Board of Medical Specialties, and its Member Boards:

10th

 

Today, many of these founding characteristics and principles have been cast aside long ago, specifically, (1) the "Board does not determine the ability to practice" and (2) "Board directors serve without compensation", and (3) "Certification is voluntary."

For instance, with Maintenance of Certification (MOC), a trademarked product created by the ABMS, the program goes much further and is increasingly tied to hospital credentials and is now thoroughly incorporated into the new Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ensconcing the program with the US government and will impact how physicians are paid after the law takes effect in 2019.  So much for the ABMS principle of "not determining the (physician's) ability to practice" or keeping the ABMS "a non-governmental entity."

Also, the entire 24-member specialty board system of the ABMS is mired in large conflicts of interest created by their physician officers earning millions of dollars in compensation on the backs of working physicians.  Only the National Board of Physicians and Surgeons (NBPAS.org) has unpaid board members for its recertification program created to compete with the AMBS MOC program, yet is still at its infancy of being accepted by hospitals in the United States.

Clearly, the original creators of specialty boards recognized the potential for conflicts of interest to arise when non-clinical physicians earned handsome incomes regulating their peers and worked to limit such conflicts.  This is clearly not the case with the ABMS today.

As history reminds us, board certification was once performed to assure the proper education of specialty physicians, not to assure a money stream to the boards. "Re-certification," it seems, is little more than a means to subsidize the overpaid leadership of the ABMS and its member boards.

-Wes

P.S. Be sure to listen to Paul Tierstein, MD's NPR interview that aired yesterday for more on the origins of the NBPAS.

References:

History of the ABMS. ABMS.org website. Archived Jan 31, 1998. Available at: https://web.archive.org/web/19980131095657/http://www.abms.org/history.html 

O’Day DM and Ladden MR. The Influence of Derrick T Vail Sr, MD, and Edward M. Jackson, MD, on the Creation of the American Board of Ophthalmology and the Specialist Board System in the United States. JAMA Ophthalmology Feb 2012 130(2): 224-232.

Source: http://drwes.blogspot.com/2015/09/why-history-of-specialty-boards-is.html

Note: I have to say that ALL the doctors are trained with the same curriculum which is a Big Pharma Curriculum focusing on sustaining a constant self-dosing of medications i.e. $$$$$$$$ and NOT healing! So, whether ‘they’ say they are specializing and expanding their education or not it all goes back to what are they ‘practicing’, medicine or healing?

Here is what is going on today with this “board” stated from a doctor himself!

Board certification of physicians has grown into a big business. What was once a one-time exam has slowly expanded to an ongoing and time-consuming process that includes recertification exams every decade and a near continuous stream of online learning modules.

It’s also gradually become a multi-million dollar industry that includes fees, study materials and prep courses. Many doctors claim it’s an expensive waste of time, and now some of them are challenging the business of board certification.

Paul Teirstein, chief of cardiology at Scripps Clinic in San Diego, he sat down at his computer a little over a year ago and attempted to complete the online modules required to maintain his certification with the American Board of Internal Medicine, or ABIM. He figured it’d be no big deal.

“And I was shocked at how complicated it was and how much time it took, and how unrelated to important patient care it was,” Teirstein says. Source: https://www.nashvillepublicradio.org/post/upstart-certification-doctors#stream/0

 

“Certified” - Who certifies the doctors?

 

Established in 1933, the American Board of Medical Specialties (ABMS) is a non-profit organization which represent 24 broad areas of specialty medicine. ABMS is the largest physician-

led specialty certification organization in the United States.

Board certification demonstrates a physician's exceptional expertise in a particular specialty and/or subspecialty of medical practice. Certification by an ABMS Member Board involves a rigorous process of testing and peer evaluation that is designed and administered by specialists in the specific area of medicine.

What is the difference between board certified and not board certified?

While medical licensure sets the minimum competency requirements to diagnose and treat patients, it is not specialty specific. Board certification demonstrates a physician's exceptional expertise in a particular specialty and/or subspecialty of medical practice.

Source: https://www.theabfm.org/diplomate/certified.aspx

 

Exceptional expertise to whom?

  • Other ‘certified doctors’? They are patting each other of the back!
  • Big Pharma? They are excited that the ‘certified’ doctor is staying certified to do the BIG PHARMA’s Plan to medicate everyone which in turn toxifies everyone!
  • Patients? They are proud that the “certified doctor” is studying! Studying what? Not their health that is for sure!

 

What is their ‘exceptional expertise in?

NOTE: Not talking about surgeons learning to operate correctly!

  • What did they learn in Medical School? How to prescribe MEDS!

 

Here is an excerpt from the Vaccine/toxicity timeline in the book, “Imagine, A World Without DIS-EASE” by Mark Grenon page 28 www.g2churchbooks.org

NOTE: I had to add this part from the whole-time line because it is the plan that the U.S. educational system is based on, i.e. programming! Pay attention to this! Even our T.V. shows are called “programs”!

1819 Prussian (German) law makes education compulsory. The Humboldt brothers, Stein and others divide German society into three distinct groups: (1) those who will be policy makers who are taught to think (.5%), (2) those who will be engineers, lawyers, doctors who are taught to partially think (5.5%) and (3) the children of the masses (94%), who were to learn obedience and how to follow orders. The school of the masses (volkschulen) divided whole ideas into subjects which did not exist previously. The result was that people would (1) think what someone else told them to think about, (2) when to think it, (3) how long to think about it, (4) when to stop thinking about it, and (5) when to think of something else. This way, no one in the masses would know anything that's really going on. (Although brilliant, the system is inherently negative in nature - it would lead eventually to German mind control paradigms in the late 19th and 20th century. The system also weakens or breaks the link between the child and the capacity to read (cross-assimilation creating whole ideas) by replacing the alphabet system of teaching reading with a system of teaching sounds, (breaking into smaller units). The same paradigm relative to reading is currently injected into U.S. Society by the Peabody Foundation, who imposed a northern system of schooling on the U.S. South between 1865 and 1918. The system in the northern U.S. is the Prussian system. Over 48% of the soldiers in the American Revolution against the British, on both the American and British sides, were Prussian (German) mercenaries.

1910 AMA requests Carnegie Foundation to survey all U.S. medical schools. Simon Flexner (later to be a director of the Rockefeller Foundation) produces the report.

NOTE: So what Flexner did was to attempt to align medical education under a set of norms that emphasized laboratory research and the patenting of medicine — both of which would serve to further enrich the estates of the entrepreneurs who funded Flexner’s 1910 report: John Rockefeller, Andrew Carnegie, and others. SEE: https://www.cancertutor.com/flexner-report/

 

Here is the “American Board of Family Medicine” website

11th

Source: https://www.theabfm.org/diplomate/certified.aspx

 

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

Source:https://www.nejm.org/doi/full/10.1056/nejmp1407422?sort=featured&page=-1121

Physicians are under increasing pressure to subscribe to Maintenance of Certification (MOC) programs, the proprietary product of the American Board of Medical Specialties, Inc., (ABMS) and its 24 affiliates. This is promoted as a necessary means to assure physician competence. The publications cited

to support MOC are generally authored by corporate employees

and hired subcontractors, without consistent disclosure of conflicts of interest.

 

Ethical Guidelines Violated

In December 2013, the International Committee of Medical Journal Editors (ICMJE) revised, renamed, and published online its new Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals.

These guidelines outline requirements for disclosure of conflicts of interest, including appropriate declaration by authors and responsibilities of editors. ICMJE’s guideline states: “Financial relationships (such as employment, consultancies..., and paid expert testimony) are the most easily identifiable conflicts of interest and the most likely to undermine the credibility of the

journal, the authors, and of science itself.” Individual journals

may have higher ethical requirements, while many have none,

fail to impose them or are inadequately informed by the authors.

Numerous articles are authored by executives of the American Board of Medical Specialties, Inc., (ABMS) and its 24 affiliates in medical journals concerning proprietary products of Board Certification (BC) and Maintenance of Certification (MOC).

These ABMS corporate executives frequently do not disclose their significant employment income from this commercial enterprise, and may even state: “Competing Interests: The authors are not supported by, nor maintain any financial interest in, any commercial activity that may be associated

with the topic of this article.”

Yet ABMS and its affiliates are corporations with clear business prerogatives, despite their tax-exempt status.

Review of publications by several ABMS executives reveals that these authors may disclose or fail to disclose employment as a conflict of interest in an almost random fashion. Some will state “no conflicts to declare”in one publication, while elsewhere disclosing employment. They may provide disclosure that omits mention of conflicts that suggest service to a company,provide no conflict-of-interest disclosure,or isolate disclosure to internet sites, which must be actively

sought, without publication in the PDF files typically read or distributed.

Authors were asked to disclose employment in the journal that published original research and editorials, yet failed to do so in the same journal’s supplement, which ABMS sponsored. This suggests that both authors and journals may be responsible.

Authors may state “nothing to disclose” while ignoring employment, sponsorship in supplement publication, and direct funding of the symposium involved.

This inconsistency suggests author awareness of employment and other significant matters as real conflicts of interest, with selective failure to comply.

For example, in two back-to-back articles in the Journal of the American Board of Family Medicine (JABFM) one author who contributed to both papers failed to consistently declare conflicts, while another, James C. Puffer, is also executive editor of the journal. Despite the statement, “Conflicts of interest: none declared,” Puffer earns more than $600,000 per year as

chief editor of JABFP and president and chief executive officer

of the ABFM, according to IRS documents. ABMS funds journal supplements promoting its proprietary products, BC and MOC programs, spending as much as

$50,000 per issue. See, for example, the 66-page Fall 2013

supplement to the Journal of Continuing Education in the

Health Professions. Recently, the National Quality Forum (NQF),

with a long history of American Board of Internal Medicine (ABIM) leadership interactions and personnel exchanges, has been involved in questionable conflicts of interest, leading to congressional investigation and strong allegations of

misconduct by an NQF official and inadequate policy to prevent conflicts.

British and Canadian programs emulate the current individual physician’s self-directed Continuing Medical Education (CME) and lifelong learning documentation programs founded in the U.S.

under the American Medical Association’s Physician Recognition Award program (AMA-PRA) in the 1960s-1970s.

Harrison and Olson write: “Researchers, practitioners, and policymakers in continuing education in the health professions need to be aware of the history, current status, and future directions for MOC in these 3 countries.”

This is particularly important for American physicians, because the historical process and purpose of certification was not designed to serve the financial interests of the contemporary political and corporate entities involved in MOC.

ABMS publications actively prescribe an urgent need to test, control, and validate lifelong learning of physicians, the most trusted and educated of professionals, through its proprietary programs. ABMS implies an international support

of its particular certification, falsely asserting that its program is voluntary, despite the significant consequences of expiration of certification. ABMS holds a virtual monopoly on medical specialty certification in the U.S., without any appreciable.

Source: Boarded to Death — Why Maintenance of Certification Is Bad for Doctors and Patients https://www.nejm.org/doi/full/10.1056/nejmp1407422?sort=featured&page=-1121

 

Maintenance of Certification:

Ethics and Conflicts of Interest

 

Paul Martin Kempen, M.D., Ph.D.

Source: http://www.jpands.org/vol19no3/kempen.pdf

 

AMA Journal of Ethics

Mar 2015

Disagreements between Medical Specialty Boards and their Diplomates

David B. Waisel, MD

After physicians complete residency or fellowship, they apply to medical specialty boards for board certification. For example, anesthesiologists will apply to the American Board of Anesthesiology (ABA) for specialty board certification in anesthesiology. Diplomates, which is what board-certified physicians are called, may undergo further training to receive subspecialty board certification from the ABA in critical care medicine, hospice and palliative medicine, pain medicine, pediatric anesthesiology, or sleep medicine. Twenty-four medical specialty boards offer certification in more than 140 specialties and subspecialties. The American Board of Medical Specialties (ABMS) comprises representatives from these 24-member boards, and its purpose is to improve the quality and safety of health care by “supporting the continuous professional development of physician specialists” [1].

Board certification is an expectation in the United States. More than 75 percent of physicians in the United States are diplomates. The other 25 percent are mainly special cases: 9 percent are physicians over the age of 60, who trained at a time when board certification was less important, and another 7 percent are physicians under 40, some of whom are probably still undergoing the board certification process [2].

The concept of specialization and creating medical specialty boards to monitor specialists most likely came about in 1908, when Derrick T. Vail, Sr., gave his presidential address to the American Academy of Ophthalmology and Otolaryngology [3]. He proposed that specialties should have defined sets of knowledge and that physicians should only be licensed as specialists after demonstrating the required knowledge “before an examining board” [2]. This imprimatur would permit patients to choose physicians wisely and would most likely lead to specialists’ garnering all the relevant cases in their towns; specialists would then develop greater clinical expertise and provide improved patient care. By limiting the number of specialists and creating a specialist system as described, specialists would be able to support themselves by practicing only their specialties.

Further events contributed to greater “quality control” in physicians’ provision of medical care. In 1910, Abraham Flexner’s report to the Carnegie Foundation for the Advancement of Teaching declared that higher standards were required for the people, the education, and the institutions in medical education [4]. In 1915, the National Board of Medical Examiners was founded to serve the public by providing meaningful assessments of medical students seeking to receive their medical degrees [5].

Implementing processes to safeguard the quality of physicians continued in 1917 with the establishment of the first medical specialty board, now known as the American Board of Ophthalmology. Between 1917 and 1935, the number of medical specialty boards grew to nine [6]. In 1936, the American Medical Association (AMA) set the trend for future boards by establishing the American Board of Internal Medicine (ABIM) as an autonomous body, allowing it to prioritize patient care while being protected from the vicissitudes of politics and practice [7]. The ABIM certifies nearly 25 percent of all physicians.

Medical specialty boards are beholden to the patient. As Vail explained more than 100 years ago, board certification allows diplomates to distinguish themselves and patients to know more about their physicians [3]. The actions of medical specialty boards also improve the health of the public by decreasing the burden of disease, increasing individual productivity, and providing and more cost-effective care.

No system is perfect. Sometimes boards take steps that they later withdraw, such as in 1950, when for a period the ABA reserved the right to revoke board certification for failure to limit clinical practice to anesthesiology [8]. Sometimes boards need to take legitimate actions to which diplomates object. Two current disputes center on requirements for maintaining certification and limitations on practice.

Maintenance of Certification

In the past, physicians were board certified for life unless they violated a specific board policy, typically by committing a felony or having a medical license limited or revoked.

An important change in the last 20 or 30 years has been the development of the maintenance of certification (MOC) system, which “promotes lifelong learning and the enhancement of the clinical judgment and skills essential for high quality patient care” [9]. Time-limited certification and the need to recertify has developed over the years; for example, the American Board of Family Practice began time-limited certification in 1972, the ABIM in 1990, and the ABA in 2000 [7, 10]. When time-limited certification started, most boards required little more than obtaining continuing medical education credits and a test [7]. But with the development of MOC, requirements became more standardized across boards and continued to grow to include practice assessment (e.g., through patient or peer surveys), simulation, and activities related to patient safety and quality improvement.

The latest ABIM MOC iteration has spawned some pushback. ABIM will now report a physician is meeting MOC requirements if he or she is continuously engaged in MOC activities. Diplomates are required to complete a MOC activity every two years, acquire a certain number of points (given for activities) every five years, complete patient safety and patient voice modules every five years, and pass the MOC exam every 10 years [11]. The ABIM changed its MOC requirements because of the concern that merely “engaging in MOC” every 10 years was insufficient to keep up to date with clinical changes.

There are two main approaches that diplomates have taken in addressing concerns about changing MOC requirements: petitions and lawsuits.

Petitions. Since March 2014, more than 19,000 physicians have signed a petition requesting that the only requirement for recertification of ABIM diplomates be the decennial exam [12]. Others have suggested that some of the ABIM’s tactics, such as asking patients to consider encouraging their physicians to become board certified, constitute bullying. The petition also declared that MOC “adds significant time and expense to board certification” and that “scientific data indicating MOC provides benefit is lacking” [12].

In its response to this petition, the ABIM noted that the yearly cost for MOC was $200-$400, a fee that included access to the ABIM self-evaluation products for which physicians can earn continuing medical education credits. The annual fee also includes the cost of the first ten-year exam, which can be upwards of $1,500 in some specialties. The ABIM response estimated that its MOC requirements should take 5 to 20 hours annually to fulfill in nonexamination years and pointed out that “diplomates who complete them [MOC activities] report they are valuable” [13].

It seems that, while the ABIM is doing its best to maintain the commitment to ensure its member physicians are professional and skilled, the 19,000-plus physicians who signed the petition are tired of being subject to requirements they do not feel benefit patients. Both views have validity. The ABIM may underestimate the time and economic costs of fulfilling these requirements—remembering that the fees paid to the ABIM are only the beginning of the costs. The petitioning physicians may understate the value that ABIM’s nudges have in maintaining their knowledge and skill.

Medical knowledge and practice changes more often than once every ten years, so requiring education and practice improvements between the decennial exams hardly seems worth arguing about. But it is reasonable to expect that designated education and practice improvement activities have evidence supporting their effectiveness, to make sure that diplomates’ time is being used wisely, the goals are being achieved, and the costs of participation are not wasted [14]. In her recent New York Times op-ed article “Stop Wasting Doctors’ Time,” Danielle Ofri, MD, criticized the MOC requirements for ABIM diplomates, particularly the “practice assessments meant to improve care in your own practice that end up being just onerous” [15]. She points out that most of medical practice is like an open-book exam—and that it may make more sense to examine in a way similar to clinical practice.

Lawsuits. Another means of protest against boards’ actions is seen in the ongoing case of American Association of Physicians and Surgeons v. American Board of Medical Specialties [16]. The American Association of Physicians and Surgeons (AAPS) suit claims that fulfilling MOC standards is burdensome, expensive and time-consuming, does not benefit patients, and has ramifications for physicians who do not meet MOC requirements such as “being excluded from hospitals and insurance plans” and “being publicly disparaged by ABMS as someone who is not ‘Meeting MOC Requirements’” [16]. AAPS suggested that the ABMS is attempting to maximize revenue by requiring participation in MOC and by providing products that meet the requirements. AAPS also expressed concern that, because of MOC, patients will have less access to physicians due to both the aforementioned exclusion of some physicians from hospitals and the time spent completing MOC requirements. As of December 20, 2014, the parties are waiting on the court to rule on the ABMS motion to dismiss.

Putting aside the legitimacy of the argument, using litigation to challenge medical specialty boards’ policies typically poisons future relationships and should be used only after nonlegal negotiations have failed.

Limitations on Clinical Practice

Diplomates have also objected when boards threaten revocation of certification for diplomates who do not limit clinical practice in prescribed ways. For example, gynecologists often manage the care of men at high risk for anal cancer because of similarities between treating anal and cervical cancer. The American Board of Gynecology (ABOG), feeling that managing the care of these men was outside of its mission of treating women and that its diplomates did not have proper training for the care of men, declared that gynecologists were not permitted to provide this care for men, although there was no evidence that gynecologists providing this care were harming patients. The result could have had damaging effects on research and clinical practice [17]. A hullabaloo followed. Particularly agitated were the male patients who lost their physicians. The public and professional outcry caused the ABOG to change its stance, in part to preserve the focus on its primary mission [18].

Boards have also prohibited diplomates from performing some legal actions out of concern for the specialty’s reputation with patients. In 2010, the ABA determined that participation in lethal injection, as defined and prohibited by AMA policy, was grounds for revocation of board certification [19, 20]. The ABA explained that anesthesiologists in particular should not participate in lethal injection, because lethal injection superficially mimics anesthesia, leading to patients’ distrust of their anesthesiologists. If this were true, causing this distrust would violate physicians’ obligation to put patients’ interests first. This prohibition avoided the outcry over ABOG’s action, perhaps because the number of physicians affected was much smaller.

In its role of establishing professional standards and because of the similarities between lethal injection and anesthesia practice, it may be reasonable for the ABA to prohibit diplomates from performing this action. But that raises two questions: when is it legitimate for boards to prohibit diplomates from performing legal actions, and does prohibition of one legal action set the standard that a board can prohibit members from performing other legal medical actions merely out of concern for the specialty’s reputation (that is, the fact that some people oppose the particular action on moral grounds) [21]? In that regard, this action is a sea change from modern board practice, and one that requires discussion and the development of ground rules for the revocation of board certification for legal actions.

Conclusion

Medical specialty boards contribute significantly to a successful health care system. But boards are not perfect, and they, with the best of intentions, do overreach. Once they overreach, it often sets a pattern that is hard to reverse. In general, boards seek to be inclusive, so diplomates are obligated to participate in shaping them. For diplomates deliberating about boards’ actions, considerations of whether a board action makes sense should include asking whether the goals are valid and what supports that view. For example, ensuring physician competence, because it relates to ensuring high-quality patient care, is clearly a valid goal demanded by professional ethics and state medical practice laws, while limiting gynecologists’ activities may be a valid goal, depending on the level of qualitative and quantitative evidence of harms. Similarly, safeguarding a specialty’s reputation is valid, but public discussion and sufficient evidence of harm should precede the prohibition of a legal action. Another consideration is whether there is evidence to indicate that the intervention will achieve relevant goals. Continuing medical education in all competencies is likely to improve patient care, but, given the time and opportunity costs of fulfilling MOC requirements, better data need to be used to determine which activities are most relevant.

Despite these hiccups, boards do a vital function well. New physicians who enter the system and get disenchanted (and they will get disenchanted) must remember that the driving force behind medical specialty boards is to meet the needs of the public.

References

  1. American Board of Medical Specialties. Better patient care is built on higher standards. http://www.abms.org/about-abms/. Accessed January 20, 2015.
  2. Young A, Chaudhry HJ, Thomas JV, Dugan MA. A census of actively licensed physicians in the United States. J Med Ed.2013;99:11-24.
  3. Vail DT. The limitations of ophthalmic practice. Trans Am Acad Ophthalmol Otolaryngol. 1908;13:1-6.
  4. Flexner A. Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching. New York, NY: Carnegie Foundation for the Advancement of Teaching; 1910.
  5. National Board of Medical Examiners. About the NBME. http://www.nbme.org/about/. Accessed January 20, 2015.
  6. American Board of Medical Specialties. ABMS member boards. http://www.abms.org/about-abms/member-boards/. Accessed January 30, 2015.
  7. Cassel CK, Holmboe ES. Professionalism and accountability: the role of specialty board certification. Trans Am Clin Climatol Assoc. 2008;119:295-304.
  8. American Board of Anesthesiology. Booklet of Information. New York, NY: American Board of Anesthesiology; 1950:6-7.
  9. American Board of Internal Medicine. Maintenance of certification guide. http://www.abim.org/maintenance-of-certification/. Accessed December 20, 2014.
  10. American Board of Anesthesiology. Maintenance of certification in anesthesiology (MOCA). http://www.theaba.org/Home/anesthesiology_maintenance. Accessed January 30, 2015.
  11. American Board of Internal Medicine. What changed in 2014? http://www.abim.org/maintenance-of-certification/faq-2014-program-changes/what-changed-in-2014.aspx. Accessed December 20, 2014.
  12. ABIM should recall the recent changes to maintenance of certification (MOC). http://www.petitionbuzz.com/petitions/recallmoc. Opened March 10, 2014. Accessed December 20, 2014.
  13. Statement from Richard J. Baron, MD, MACP, president and CEO of the American Board of Internal Medicine regarding anti-MOC petition [news release]. Philadelphia, PA: American Board of Internal Medicine; April 28, 2014. http://www.abim.org/news/statement-from-richard-baron-regarding-anti-moc-petition.aspx. Accessed December 20, 2014.
  14. American Board of Internal Medicine. Requirements. http://www.abim.org/maintenance-of-certification/requirements.aspx. Accessed December 20, 2014.
  15. Ofri D. Stop wasting doctors’ time: board-certification has gone too far. New York Times. December 15, 2014. http://www.nytimes.com/2014/12/16/opinion/board-certification-has-gone-too-far.html?_r=0. Accessed January 20, 2015.
  16. Association of American Physicians and Surgeons, Inc. v American Board of Medical Specialties, 1:14-CV-2705 (NDIL).
  17. Grady D. Gynecologists run afoul of panel when patient is male. New York Times. November 22, 2013. http://www.nytimes.com/2013/11/23/health/gynecologists-run-afoul-of-panel-when-patient-is-male.html?pagewanted=all&_r=0. Accessed January 20, 2015.
  18. Johnson, EM. US board allows gynecologists to treat more men. Reuters. January 31, 2014. http://www.reuters.com/article/2014/01/31/us-usa-gynecology-idUSBREA0U0RW20140131. Accessed December 20, 2014.
  19. American Board of Anesthesiology. Anesthesiologists and capital punishment. ABA News. 2010; 23(1):9-10.
  20. American Medical Association. Opinion 2.06 Capital punishment. Code of Medical Ethicshttp://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion206.page. Accessed December 20, 2014.
  1. Waisel DB. Revocation of board certification for legally permitted activities. Mayo Clin Proc. 2014;89(7):869-872.

Source: https://journalofethics.ama-assn.org/article/disagreements-between-medical-specialty-boards-and-their-diplomates/2015-03

 

Five Things to Know About the Flexner Report

 

  1. Abraham Flexner was not a doctor, but a school teacher and educational theorist from Louisville, Kentucky. In 1910 he published the Medical Education in the United States and Canada, known as the Flexner Report, which elevated the importance of German educational methods in the teaching of medicine.
  2. There is a connection between the robber barons and medicine. John Rockefeller, Andrew Carnegie, and others saw this as a progression of peddling pharmaceuticals, which began as byproducts of oil refinement.
  3. There were no real effective governmental agencies in place monitoring the state of affairs within the medical community, so what Flexner did at the behest of the robber barons, he did so in favor of profits rather than the long-term care of patients. He effectively created a culture that enabled the monetization of medicine.
  4. Drugs are created to treat symptoms and only rarely treat the actual cause. Plus, drugs create their own symptoms, sometimes requiring additional drugs to offset their ill effects. We live in a quick-fix culture where we crave immediate gratification.
  5. For the most part, medicine has become tone deaf to the oath it claims to uphold — the Hippocratic oath. We believe Flexner paved the way for this overthrow of whole-body health by making scientific research and training alone the only desirable and credible approach to human wellness.

So what Flexner did was to attempt to align medical education under a set of norms that emphasized laboratory research and the patenting of medicine — both of which would serve to further enrich the estates of the entrepreneurs who funded Flexner’s 1910 report: John Rockefeller, Andrew Carnegie, and others.

Dr. Thomas P. Duffy in the Yale Journal of Biology and Medicine offered this analysis of Flexner’s approach:

“There was maldevelopment in the structure of medical education in America in the aftermath of the Flexner Report. The profession’s infatuation with the hyper-rational world of German medicine created an excellence in science that was not balanced by a comparable excellence in clinical caring. Flexner’s corpus was all nerves without the life blood of caring. Osler’s warning that the ideals of medicine would change as ‘teacher and student chased each other down the fascinating road of research, forgetful of those wider interests to which a hospital must minister' has proven prescient and wise.”

But isn’t this sort of what you’d expect when an evil genius — all intellect, no compassion — like Rockefeller determines the future of medical education and care?

 

Source: https://www.cancertutor.com/flexner-report/

 

  1. Abraham Flexner was not a doctor, but a school teacher and educational theorist from Louisville, Kentucky. In 1910 he published the Medical Education in the United States and Canada, known as the Flexner Report, which elevated the importance of German educational methods in the teaching of medicine.
  2. There is a connection between the robber barons and medicine. John Rockefeller, Andrew Carnegie, and others saw this as a progression of peddling pharmaceuticals, which began as byproducts of oil refinement.
  3. There were no real effective governmental agencies in place monitoring the state of affairs within the medical community, so what Flexner did at the behest of the robber barons, he did so in favor of profits rather than the long-term care of patients. He effectively created a culture that enabled the monetization of medicine.
  4. Drugs are created to treat symptoms and only rarely treat the actual cause. Plus, drugs create their own symptoms, sometimes requiring additional drugs to offset their ill effects. We live in a quick-fix culture where we crave immediate gratification.
  5. For the most part, medicine has become tone deaf to the oath it claims to uphold — the Hippocratic oath. We believe Flexner paved the way for this overthrow of whole-body health by making scientific research and training alone the only desirable and credible approach to human wellness.

So what Flexner did was to attempt to align medical education under a set of norms that emphasized laboratory research and the patenting of medicine — both of which would serve to further enrich the estates of the entrepreneurs who funded Flexner’s 1910 report: John Rockefeller, Andrew Carnegie, and others.

Dr. Thomas P. Duffy in the Yale Journal of Biology and Medicine offered this analysis of Flexner’s approach:

“There was maldevelopment in the structure of medical education in America in the aftermath of the Flexner Report. The profession’s infatuation with the hyper-rational world of German medicine created an excellence in science that was not balanced by a comparable excellence in clinical caring. Flexner’s corpus was all nerves without the life blood of caring. Osler’s warning that the ideals of medicine would change as ‘teacher and student chased each other down the fascinating road of research, forgetful of those wider interests to which a hospital must minister' has proven prescient and wise.”

But isn’t this sort of what you’d expect when an evil genius — all intellect, no compassion — like Rockefeller determines the future of medical education and care?

 

Source: https://www.cancertutor.com/flexner-report/

 

The history behind the MOC®kery

For those affected or scandalized by the way MOC® programs are being foisted on doctors, the following Wikipedia entry may provide an explanatory frame of reference:

A union security agreement is a contractual agreement, usually part of a union collective bargaining agreement, in which an employer and a trade or labor union agree on the extent to which the union may compel employees to join the union, and/or whether the employer will collect dues, fees, and assessments on behalf of the union.

Of course, the American Board of Medical Specialties (ABMS) is not a physician union in the strict sense of the term.  From the vantage point of ABMS executives, the situation is far better.  ABMS bosses can impose enrollment into MOC® without needing to grant doctors membership—and therefore voting rights—in the organization.

And of course, the Center for Medicare and Medicaid Services (CMS) is not an employer of physicians in the strict sense of the term.  Rather than being employees of CMS, doctors are subcontractors in the government’s “social contract” to provide health care to society.

Unless a doctor actively opts out of the Medicare program, he or she is automatically enlisted as a “health care provider,” subject to full weight and authority of the federal government.  Here again, from the vantage point of the government, using doctors as de facto subcontractors is much better than placing them on the federal payroll: no benefits to dole out and fewer headaches to deal with.

And now, as if subject to a union security agreement between CMA and ABMS, doctors may very well be required by law to enroll in MOC® after the recent passage of the “Doc Fix” legislation.

Physicians dismayed by the actions of ABMS are asking pertinent questions:

Who in the hell appointed them? How did they become our overlords?

— Vol. 4 (@C_R_Russo) May 25, 2015

The answer is that “they” appointed themselves our overlords and have been speaking on our behalf for more than 100 years.  Here is how it played out:

In the 1910’s, after decades of lobbying, the AMA convinced state governments nationwide of the wisdom of granting authority over medical school accreditation and medical license examination to a handful of private organizations associated with, issued from, or directly supervised by the AMA.  Having done so, the AMA established itself as a public cartel in full control of entry into the practice of medicine.

Later on, in the 1930’s, the AMA further established control over entry into specialty practice by creating the ABMS, which would administer board certification examinations to sanction those worthy to be called specialists.  

Since the specialist imprimatur confers a significant financial benefit to its recipient, it would not take long before everyone would vie for the stamp of approval.  General practice disappeared, giving way to the specialty of “family medicine,” and the ABMS found itself holding an excellent lever with which it could potentially exert control over the vast majority of American physicians.

Having such broad powers over critical aspects of a physician’s professional life, it is not too surprising that the AMA and the ABMS would go on to become natural partners for the federal government, helping it find “solutions” for the epic disaster otherwise known as the American healthcare system.  And MOC®, concoted under pretense of “professional self-regulation,” is the latest such solution devised by the overlords to regulate the unruly doctors.

With an employer as powerful as the federal government and union bosses as self-serving as the ABMS, what recourse do American physicians have?

Opting-out of this system, of course, should be the ultimate goal for anyone wishing to aspire to a modicum professional satisfaction.  For many doctors, however, this is not immediately practicable.  In the meantime, the National Board of Physicians and Surgeons (NABPS), led by Dr. Paul Teirstein and an impressive list of physician leaders, offers a viable means to counteract the corruption and extortion of the established order.  

I urge you to join forces with your colleagues and demand that the NBPAS certification be accepted by your hospital board as an alternative to the one forced upon you by the corrupt ABMS.  Read this latest message from Paul Teirstein and the proposed sample letter that you and your colleagues can submit to your hospital credentialing committee.

And think of this action as defense of your right to work.

Momentum building in our hospital to remove ABIM from credentialing.

— Edward J Schloss MD (@EJSMD) May 25, 2015

Source: http://alertandoriented.com/who-is-the-health-care-consumer/

 

 

The “doctor”. Who trained the doctor?

 

12th

 

Why do doctors prescribe so many drugs and offer so few natural treatments? One reason is the influence of Big Pharma. Get the inside scoop here.

·         How Medical School Funding From Big Pharma Impacts Your Health ...

https://www.onegreenplanet.org/.../how-medical-school-funding-from-big-pharma-im...

Did you know that, up until recently, U.S. pharmaceutical companies funded the majority of U.S. medical schools with very little regulation?

Apr 3, 2016 - The Pharmaceutical Industry's Role in U.S. Medical Education .... A revamping of medical school curricula to include these supplemental ...

Recent research has revealed widespread pharmaceutical influence and weak ... A July 4 study in PLoS One ranked the rigour of Canadian medical schools' 2011 ... or failing to make conflict-of-interest education a part of the curriculum.

Mar 6, 2009 - Harvard gets a failing grade in its potentially troubling links between Big Pharma and medical schools.

·         (PDF) Pharma's Marketing Influence on Medical Students and the https://www.researchgate.net/.../321873999_Pharma's_Marketing_Influence_on_Medica...

Oct 24, 2018 - Educational Curriculum in Medical Schools: A Comparative ... 2 Pharmaceutical and Healthcare Marketing Department, Saint Joseph's ...

Oct 17, 2014 - Western medicine relies on Big Pharma's petroleum drugs, which the body ... They systematically dismantled the curricula of these schools by ...

·         The Evils of Big Pharma Exposed - Global ResearchGlobal Research https://www.globalresearch.ca/the-evils-of-big-pharma-exposed/5425382

Jul 19, 2018 - Big Pharma with the help of their global army of doctors have purposely and ... the conventional dogma that's standard curriculum down to even the textbooks. ... Starting in the final year of med school, Big Pharma insidiously ...

Our medical schools must not become shills for big pharma - The https://www.theglobeandmail.com/...medical-schools...big-pharma/article13188578/

Jul 12, 2013 - These policies should address the medical curriculum and the ways in which relationships with pharmaceutical firms may affect the attitudes ...

The influence of big pharma | The BMJ

https://www.bmj.com/content/330/7496/855

Apr 8, 2005 - A report published last week on “the influence of the pharmaceutical industry” ... Over half of all postgraduate medical education in the UK, and much .... in UK medical schools: a core curriculum for tomorrow's doctors. Br J Clin ...

 

How Rockefeller founded modern medicine and killed natural cures

 

People these days look at you like a weirdo if you talk about the healing properties of plants or any other holistic practices. Much like anything else, there is a lot of politics and money behind our modern medical system.

It all starts with John D. Rockefeller (1839 – 1937) who was an oil magnate, a robber baron, America’s first billionaire, and a natural-born monopolist.

By the turn on the 20th century, he controlled 90% of all oil refineries in the U.S. through his oil company, Standard Oil, which was later on broken up to become Chevron, Exxon, Mobil etc.

At the same time, around 1900, scientists discovered “petrochemicals” and the ability to create all kinds of chemicals from oil. For example, the first plastic — called Bakelite — was made from oil in 1907. Scientists were discovering various vitamins and guessed that many pharmaceutical drugs could be made from oil.

This was a wonderful opportunity for Rockefeller who saw the ability to monopolize the oil, chemical and the medical industries at the same time!

The best thing about petrochemicals was that everything could be patented and sold for high profits.

But there was one problem with Rockefeller’s plan for the medical industry: natural/herbal medicines were very popular in America at that time. Almost half the doctors and medical colleges in the U.S. were practicing holistic medicine, using knowledge from Europe and Native Americans.

Rockefeller, the monopolist, had to figure out a way to get rid of his biggest competition. So he used the classic strategy of “problem-reaction-solution.” That is, create a problem and scare people, and then offer a (pre-planned) solution. (Similar to terrorism scare, followed by the “Patriot Act”).

He went to his buddy Andrew Carnegie – another plutocrat who made his money from monopolizing the steel industry – who devised a scheme. From the prestigious Carnegie Foundation, they sent a man named Abraham Flexner to travel around the country and report on the status of medical colleges and hospitals around the country.

This led to the Flexner Report, which gave birth to the modern medicine as we know it.

Needless to say, the report talked about the need for revamping and centralizing our medical institutions. Based on this report, more than half of all medical colleges were soon closed.

Homeopathy and natural medicines were mocked and demonized; and doctors were even jailed.

To help with the transition and change the minds of other doctors and scientists, Rockefeller gave more than $100 million to colleges, hospitals and founded a philanthropic front group called “General Education Board” (GEB). This is the classic carrot and stick approach.

In a very short time, medical colleges were all streamlined and homogenized. All the students were learning the same thing, and medicine was all about using patented drugs.

Scientists received huge grants to study how plants cured diseases, but their goal was to first identify which chemicals in the plant were effective, and then recreate a similar chemical – but not identical – in the lab that could be patented.

A pill for an ill became the mantra for modern medicine.

And you thought Koch brothers were evil?

So, now we are, 100 years later, churning out doctors who know nothing about the benefits of nutrition or herbs or any holistic practices. We have an entire society that is enslaved to corporations for its well-being.

America spends 15% of its GDP on healthcare, which should be really called “sick care.” It is focused not on cure, but only on symptoms, thus creating repeat customers. There is no cure for cancer, diabetes, autism, asthma, or even flu.

Why would there be real cures? This is a system founded by oligarchs and plutocrats, not by doctors.

As for cancer, oh yeah, the American Cancer Society was founded by none other than Rockefeller in 1913.

In this month of breast cancer awareness, it is sad to see people being brainwashed about chemotherapy, radiation and surgery.  That’s for another blog post … but here is a quote from John D. Rockefeller that summarizes his vision for America…

 

https://worldaffairs.blog/2015/10/20/how-rockefeller-founded-modern-medicine-and-killed-natural-cures/

 

What Big Pharma pays your doctor

 

July 4, 2018 7.04pm EDT

Research shows that money and meals from the pharmaceutical industry do increase the amount doctors prescribe the drugs being marketed. (Shutterstock)

Author 

13thJoel Lexchin

Professor Emeritus of Health Policy and Management, York University, Emergency Physician at University Health Network, Associate Professor of Family and Community Medicine, University of Toronto

Disclosure statement

In 2015-2018, Joel Lexchin was a paid consultant on three projects: one looking at indication-based prescribing (United States Agency for Healthcare Research and Quality), a second to develop principles for conservative diagnosis (Gordon and Betty Moore Foundation) and a third deciding what drugs should be provided free of charge by general practitioners (Government of Canada, Ontario Supporting Patient Oriented Research Support Unit and the St Michael’s Hospital Foundation). He also received payments for being on a panel that discussed a pharmacare plan for Canada (Canadian Institute, a for-profit organization), a panel at the American Diabetes Association and for a talk at the Toronto Reference Library. He is currently a member of research groups that are receiving money from the Canadian Institutes of Health Research and the Australian National Health and Medical Research Council. He is member of the Foundation Board of Health Action International and the Board of Canadian Doctors for Medicare.

 

Partners

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University of Toronto provides funding as a founding partner of The Conversation CA.

University of Toronto provides funding as a member of The Conversation CA-FR.

Members of Innovative Medicines Canada (IMC), the lobby group for the large pharmaceutical companies, recently released their voluntary reports of payments to health-care professionals and health-care organizations.

Altogether, the 10 reporting companies paid out more than $75 million in 2017.

This is the second year of these disclosures. When they started, Russell Williams, then the IMC president, said on CBC’s The Current: “We’re open to continually improving and monitoring” the disclosures. According to the new president, Pamela Fralick, the 2016 revelations were only a first step and she expected more companies to disclose payments in 2017.

Come the 2017 disclosures, and there are still the same 10 companies. Moreover, the disclosures are actually not on the IMC website, they are on the individual companies’ websites and are not easy to find. It takes at least a couple of mouse clicks to locate the material. Nor is there any more detail this year than last year about how the money is used.

IMC touts these disclosures as “part of our commitment to high ethical standards and enhancing trust.”

But all that the companies have disclosed are gross figures — with no information about what they paid for.

Paid to promote opioids?

Why did Purdue Pharma, makers of OxyContin and a host of other opioid products, give almost $1.9 million to health-care professionals in 2017?

All Purdue’s website says is that the money was for “services.” Were some of those services speeches made by doctors on behalf of Purdue? In the past Purdue has paid doctors $2,000 a talk.

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A report released in February 2018 by U.S. Sen. Claire McCaskill found that companies selling some of the most lucrative prescription painkillers funneled millions of dollars to advocacy groups that in turn promoted the medications’ use. Purdue Pharma, the maker of OxyContin, contributed the most money to the groups. (AP Photo/Toby Talbot, File)

Amgen Canada gave more than $6 million to health-care organizations, but we don’t know what these organizations did with that money.

Novartis spent $350,000 on travel expenses so that doctors and possibly other professionals could go to international congresses and/or global stand-alone meetings.

Who were these health-care professionals? What meetings did they go to? Where were the meetings?

Canada lags behind

Big Pharma here in Canada is far behind the curve when it comes to disclosing where the money is going. The federal government doesn’t seem to be in any hurry to force the companies to make more information public either.

Just over a year ago, then Health Minister Jane Philpott’s position was that forcing the disclosure of payments to individual doctors was, “in principle…an important concept” but should be left to the provinces.

In the United States, companies have had to disclose any payment of more than $10 to a doctor since 2013. The doctors are named.

In Australia, an analysis of information that companies must disclose found that, from October 2011 to September 2015, 42 companies sponsored 116,845 events for health professionals.

In nine European countries, disclosure is either mandatory or voluntary. Many of the European voluntary codes allow doctors to opt out of having their names disclosed.

IMC justified not linking doctors’ names to payments on the grounds of Canadian privacy laws but Ontario’s recently passed legislation will require disclosures to include the names of all health-care professionals who receive money or any other “transfer of value.”

Later this summer, British Columbia will hold public consultations about the same type of legislation.

Free meals increase prescriptions

Disclosure is only the first step. Payments made to doctors can be linked to how they prescribe.

In the U.S., this has been analyzed using the Medicare database. The links show an association between the amount of money doctors get and their prescription of brand-name statins (cholesterol-lowering drugs) rather than much less expensive generic versions.

Receipt of industry-sponsored meals with a value of less than $20 is associated with an increased rate of prescribing the brand-name medication that is being promoted.

Receiving money from opioid makers in one year is associated with prescribing more opioids the next year.

Perhaps this is why IMC doesn’t want to take disclosures any further. This lobby group is afraid that Canadians will realize the perverse effects of all the payments its member companies make.

Source: http://theconversation.com/what-big-pharma-pays-your-doctor-99431

 

Bad doctors earning good money from Big Pharma

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ProPublica is an independent, non-profit news agency that produces investigative journalism in the public interest – and this year, it became the first online newsroom to win the Pulitzer Prize for investigative reporting. When they start digging, they find something interesting. Lately, ProPublica has been investigating Big Pharma marketing,  particularly the growing practice of recruiting, training and paying doctors to give presentations to other docs about specific drugs.

They’re part of the pharmaceutical industry’s white-coat sales force, doctors paid to promote brand name prescription drugs to their peers — and if they’re convincing enough, to get more physicians to prescribe them.  

Drug companies say they hire the most-respected doctors in their fields for the critical task of teaching their peers about the benefits and risks of their drugs. It’s important to them – one effective speaker may not only teach dozens of physicians how to better recognize a condition, but also sell them on the drug to treat it. The success of one drug can mean hundreds of millions in profits for a company, in an industry that saw prescription drugs sales top $300 billion last year in North America alone.

Recruited and trained by the drug companies, these physicians — accompanied by their Big Pharma sales reps — give talks to doctors over small dinners, lecture during hospital teaching sessions, and chat over the Internet.

Typically, they must adhere to company presentation slides and talking points. This is especially important because, although it is illegal for drug companies to advertise any unapproved “off-label” uses for their drugs, doctors can legally share information about off-label prescribing with their peers.

The ProPublica investigation has uncovered hundreds of speakers on drug company payrolls who have been accused of professional misconduct, were disciplined by their professional medical boards, or lack credentials as researchers or specialists. For example:

  • The Ohio medical board concluded that physician William D. Leak had performed “unnecessary” nerve tests on 20 patients and subjected some to “an excessive number of invasive procedures,” including injections of agents that destroy nerve tissue. Yet the finding, posted on the board’s public website, didn’t prevent Eli Lilly and Co. from using him as a promotional speaker and advisor. The company has paid him at least $85,450.
  • In 2001, the U.S. Food and Drug Administration ordered Pennsylvania doctor James I. McMillen to stop “false or misleading” promotions of the painkiller Celebrex, saying he minimized risks and touted it for unapproved uses. Still, three other leading drug makers paid the rheumatologist $224,163 over 18 months to deliver talks to other physicians about their drugs.
  • In Georgia, a state appeals court in 2004 upheld a hospital’s decision to kick Dr. Donald Ray Taylor off its staff. The anesthesiologist had admitted giving young female patients rectal and vaginal exams without documenting why. He’d also been accused of exposing women’s breasts during medical procedures. When confronted by a hospital official, Taylor said: “Maybe I am a pervert, I honestly don’t know!” according to the appellate court ruling. But last year, Taylor was drugmaker Cephalon’s third-highest-paid speaker out of more than 900. He has received almost $200,000 through June of this year.
  • New York’s medical board put Dr. Tulio Ortega on two years’ probation in 2008 after he pleaded no contest to falsifying records to show he had treated patients when he had not. Louisiana’s medical board, acting on the New York discipline, also put him on probation this year.  But in 2009 and 2010, Ortega was paid $110,928 from drug companies Eli Lilly and AstraZeneca.

Investigators found 45 doctors who earned in excess of $100,000 a year as drug company Speakers Bureau presenters who did not have board certification in any specialty, suggesting they had not completed advanced training or passed a comprehensive exam. Most of those paid speakers also lacked published research, academic appointments or leadership roles in professional societies.

ProPublica’s review of physician licensing records found sanctions against more than 250 speakers, including some of the highest paid. Their misconduct included inappropriately prescribing drugs, providing substandard care, or having sex with patients.

Some of these doctors paid by drug companies to speak to other doctors had even lost their licenses to practice medicine.

More than 40 have received FDA warnings for research misconduct, lost hospital privileges or been convicted of crimes. And at least 20 more have had two or more malpractice judgments or settlements.

Meanwhile, the drug companies told ProPublica that they hire the most-respected doctors in their fields for the critical task of teaching about the benefits and risks of their drugs. They claim that their physician salesmen are thought leaders chosen for their “expertise“. GlaxoSmithKline, for example, said it selects only “highly qualified experts in their field, well-respected by their peers and, in the case of speakers, good presenters.”

But ProPublica reported that some top-earning speakers are experts mainly because the drug companies have deemed them such. Several doctors acknowledge that they are regularly called upon because they are willing to speak when, where and how the companies need them to.

Sociologist Dr. Susan Chimonas, who studies doctor-pharma relationships at the Institute on Medicine as a Profession in New York City, wrote:

“It’s sort of like American Idol. Nobody will have necessarily heard of you before — but after you’ve been around the country speaking 100 times a year, people will begin to know your name and think, ‘This guy is important.’ It creates an opinion leader who wasn’t necessarily even an expert before.”

Payments to doctors for promotional work are not illegal and can be beneficial to the drug companies. Strong relationships between pharmaceutical companies and physicians are critical to developing new and better treatments, says ProPublica.

“There is much debate, however, about whether paying doctors to market drugs can inappropriately influence what they prescribe. Studies have shown that even small gifts and payments affect physician attitudes.”

Read the rest of the ProPublica article, part of their Dollars To Docs report.

See also:

Source: https://ethicalnag.org/2010/11/16/bad-doctors-big-pharma/

 

Tune in Sunday as we discuss this topic in more detail

G2Voice Broadcast 121 – Why the“board certified doctor” is a triple negative for your health!

Sunday, Jan. 6th , 2018

10 AM EST

www.g2voice.is

Let’s change the world together!

Head Bishop Mark S. Grenon

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