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Did American Board of Internal Medicine Overreach?

Joe Cantlupe, for HealthLeaders Media, January 13, 2011

Months ago, the American Board of Internal Medicine proposed sanctioning 139 physicians for passing along and receiving test questions from a test preparation company.

While many physicians feared the sanctions would cost them their jobs, it now appears dozens of the physicians cited won't be held for sanctions the ABIM initially sought.

As the process began, I was wondering if the ABIM officials were over-reaching in their inquiry, and it certainly seems they did. Initially, it reached back more than 20 years to find alleged violators. The board talked tough.

That tough talk is ebbing and now there appears to be reconciliation. In some cases, recommended sanctions have been rescinded, in the words of the ABIM president Christine Cassel, the ABIM president and CEO, acknowledged in a statement to me.

Meanwhile, Drew Wachler, an attorney representing 40 physicians, says the ABIM has allowed his clients to resume their careers, by shifting course, in part. Still, he says, he hopes ABIM will revise its procedures, and that remains to be seen.

The controversy over the testing began when the ABIM cited the 139 physicians in June for improper conduct over the testing. The board took steps to strip board certification of many physicians for periods ranging from one to 5 years. The ABIM also sent what some have dubbed "shame on you" letters to about 2,700 physicians who took the test. These doctors were not accused of wrongdoing, but the ABIM said the doctors should have known what was going on.

Aside from the test takers, the major target of the investigation was Arora Board Review, a New Jersey test-preparation course. The principal of Arora Board Review, being sued by ABIM has surrendered his certificate to perform the tests. Arora Board Review shared information garnered from physicians who took the ABIM test with other would be test takers for years, according to ABIM.

Wachler, one of the many attorneys representing physicians caught up in the ABIM probe, says that in many cases ABIM has shifted from its original position of outright sanctions "in a way that will allow these doctors to continue their careers."

Wachler, based in Royal Oak, MI declined to discuss the specific allegations involving his clients, nor the ABIM's exact determination of their cases. Throughout the legal process, Wachler says that it's been his goal to reach an "alternative resolution" with the ABIM following the initial charges against his clients. Besides preserving each physician's career, he sought to "minimize consequences of licensure, maintenance of staff privilege employment and participation with third party payers."

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