Internal Medicine Gets Exploited

You’ll pay your fees if you enjoy having kneecaps

[@rubiconsrundry7765]

sure am glad that we as a society decided that if people want to become a doctor and help people, its its entirely okay to just abuse them endlessly for no reason

[@ChartreuseDan]

It's not for no reason: it's for having the audacity to become highly trained and useful specialists instead of becoming hedge fund managers

[@msplendor]

And by society I'm guessing you mean Big Business. I doubt they were treated this way during home visit days. Corpohealth abuses doctors and patients like Corpoagriculture abuses farmers and animals and Corpofood abuses workers and consumers.

[@Ikajo]

In the USA... not elsewhere

[@t-spark]

@@ChartreuseDan ​ Ha! Imagine telling the world that you're motivated by something other than seeing your net worth go up.

[@infin1ty850]

​@@IkajoI love dunking on our healthcare system here in the US, but this is absolutely not just a US issue.

[@jenleigh4212]

The more the healthcare system is explained, the worse and worse it looks.

[@asmerX100]

lmao true, the larger the dr glauc's universe expanded...the more it reveals the dark side of medicine

[@HyperLuigi37]

the worse we realize it actually is*

[@Rockribbedman]

Don't forget that the doctors involved in the organization Don't have to take the exam. And they go on paid trips to conferences all the time.

[@ar2851]

That's how radiology works too

[@1014p]

Its a money extortion scheme on practitioners and patients.

[@steingrenadier5511]

I like how often "Research purposes" is used as an excuse every time someone asks "why" in the US health care system.

[@sethreign8103]

Or mostly any other organization that "accepts" your "fees/payments" they force on you 😅

[@thewhitewolf58]

Researching the best luxury cars to buy.

[@Iflie]

`Yeah remember how many countries made a Covid vaccine, sounds like the U.S isn't the only place doing research and medication development but it's the only one where they charge that much for medications, including very old ones.

[@Ciborium]

ABIM does "research" into the next Lambo they gonna buy.

[@voodoobunny13]

And every medical researcher actually conducting medical research will assure you that they sure as fuck aren't getting any of that money.

[@khco7913]

I like how the ABIM guy starts to just threaten Internal Medicine with his increasing evil tone when he realizes that the system's math ain't mathin' 😂

[@Oswin2642]

ABIM internal thoughts: "Oh, shit! He's right! Um, what do we do?" "Put on a calm face. Remember, confidence is key. Stall, and you can figure this out." "Hey, he's getting aggressive! What do we do here!?" "You get aggressive back, obviously! How dare he challenge us!" "Great, he's back to being confused and disoriented. What now?" "Keep it up! Double down!" "I don't know... that never works for us at the poker table. Remember when we had to sleep in that hotel using his money last month when our wife kicked us out?" "Don't think about our gambling issues right now, and just do what I tell you to do!" "Okay... Okay, he's looking really uncomfortable. I think we should just come clean and admit it doesn't make any sense!" "No... light 'em up." "What?" "The box of certificates is right under our desk. If he received his bill the other day then his certificate should be close to the top. Grab it." "Okay... got it. Why does we need it though?" "Do you remember what Grace said to us last year when we lost $12,000 over the weekend?" "Other than all of the comments about our masculinity and intelligence? She threatened to burn the house down. Again, I have to ask why you're bringing this up." "Burn it all down."

[@LyonPercival]

"Threaten"? Technically it's extortion.

[@TFT-bp8zk]

It's mathin' just fine for him.

[@dorkydoctorsongs]

Medical colleges and exorbitant fees go together like an ophthalmologist and their loyal scribe 😢

[@EastonJackson-GMC]

Except that ophthalmologists and their loyal scribes contribute something of positive value to society.

[@dorkydoctorsongs]

@@EastonJackson-GMC no arguments there!!

[@EvilPaladin11]

Evil Jonathan: *excited nod*

[@closest2he4ven]

I want to borrow Johnathan.

[@doctechno2241]

As a doctor, I can confirm that this video is 100% accurate and applies to A LOT more specializations than just internal medicine. In fact, I'm actually curious to know if ANY specialties don't have extortionate ongoing "certification" fees at this point. Incidentally, in my branch of medicine, $500/year is way cheap. I have to pay MUCH more.

[@anncondon2689]

Yes!!!!! In pediatrics, we have to pay separate fees for $$MOC 2, $$$MOC 3 (which consists of taking board questions every 12 weeks for 5 years.... But if we fail that we can pay $2,000 and sit and take an old fashioned exam).. AND $$$$MOC 4! Don't forget MOC 1.... Which is the easy one...$$$pay for your state license every year....... That's all you have to do for MOC 1....😢

[@jeremiahbaker6396]

Wth

[@fish_whiskers]

you have to adjust for the deflation of the im docs perceived value 😭😭

[@ondrejadamek5455]

Just - WHY? Is this some kind of american joke? Greetings from Europe

[@nadiaterzaghi3859]

It’s insane. I left the US to work overseas, contacted the board to see if I could just go inactive and then reactivate if I ever decide to move back. Yep, provided I still pay a slightly (very, very slightly) reduced fee every year.

[@juliatrejo865]

I was going to send this to my Aunt (a radiologist), but decided not to depress her at 9am on a Monday morning…😂

[@floricel_112]

Do it on wednesday

[@haggielady]

No, no, wait til Thursday at 4:30.

[@juliatrejo865]

Friday, while she’s completing her CME’s…

[@JH-lz4dh]

It's funny cuz it's true. 😢

[@bamidele4383]

​@juliatrejo865 No, not Friday. You'll wreck her weekend. Thursday's the sweet spot. She'll be depressed until Friday afternoon, and then she'll remember that her weekend off is coming. She'll lighten up, then.

[@SeliahK]

And then they wonder why more people are NOT pursuing careers in healthcare.

[@sirenia1241]

yep and as the older healthcare workers begin to retire in droves, chaos will ensue. even then, nothing will change, unless a miracle happens.

[@EakEmk]

The past 3 years have had record high MCAT examinees and applicants to medical school so I'm not sure about that.

[@ShuRugal]

@@EakEmk guess what else we have? a continuously increasing population. we can have more doctors, while simultaneously the % of people who choose to pursue careers as doctors is decreasing. those are not mutually exclusive conditions.

[@literalantifaterrorist4673]

@@EakEmkand residency numbers are in the toilet, what’s your point?

[@kennyc002]

@@EakEmk Oh yes, so we'll have even more people with MDs and not be doctors. Fantastic!

[@camillahannelibatalden1790]

I’m a licenced psychologist working in Norway. Here renewal is every five years and is covered by union fees and the hospital. What is described here sounds outrageous!

[@LNVACVAC]

Union fees are also outrageous. Same shit, different name.

[@alelom]

​@@LNVACVACbullshit. Union fees are incomparably lower, accountable and well explained, plus you get all of the other benefits of being protected by an union. The kind of thing Americans will never understand

[@LNVACVAC]

@@alelom In latin america union fees are pretty high. Have no transparency and are used to finance political parties.

[@andrewbloom7694]

​@@LNVACVACOk, but in western Europe they ARENT like that

[@wallycheladyn1190]

​@@andrewbloom7694interesting that you can speak for every union in western Europe. Unions in Europe routinely use membership fees to influence political outcomes.

[@felixmichael2904]

In germany we have the Landesärtekammer (state medical association), you have to pay those guys yearly Based on your income and you cant practice medicine in germany without beeing a member....and they Charge you for every test you take along the way....funny that certain things are always the same no matter where you live

[@amidola]

However, you actually get a weekly paper (that goes straight into the trash), a monthly paper and a lot of training (if you’d ever take advantage of it) and absurd German bureaucracy taken care of for that money. The US takes the money „just because“.

[@AhmedFathy-lt6wl]

I'm in the process of applying to Germany as a dentist, and I thought the worst thing I have to deal with were those Ausländerbehörde guys.. turns out I have to worry about much more 😵

[@SinisterMD]

As a physician I can assure you that this is incredibly accurate.

[@MyFiddlePlayer]

I hope no one from my board views this video, they will realize that they are undercharging at only $400 per year and next year's fee will be higher.

[@1anastudent]

Who in the USA can consider themselves proud of such an exploitative system? Honestly, the predators have taken over at every level

[@cbpd89]

We aren't proud, we all hate it. Except the Uber wealthy, apparently, because they can afford any care or procedure they want and they're used to exploiting people so it doesn't bother them.

[@Laecy]

Propaganda is a terrifying beast. My parents have been screwed by insurance over and over and over again to the tune of hundreds of thousands of dollars and chronic pain, yet they still parrot the party line of AT LEAST ITS NOT THE NHS. The particularly crazymaking thing is they spend a lot of time in Germany and have seen firsthand a better system, but …

[@slantdwave]

No one

[@slantdwave]

​@@Laecywhat's funny is we have so many specialists the wait times would not be increased a whit.

[@davidkent8769]

It happens in the UK too

[@danielthompson6207]

I'm not threatening you, I'm simply informing you of the gravity of your unfortunate situation.

[@lambentlamprey]

I'm not threatening you, I'm educating you.

[@Michael_Azrael]

It's honestly amazing how many cartels a single industry can manage to fit into itself with minimal overlap when you really think about it

[@falconerd343]

You have a point, there's so many different oligopolies abusing their power across healthcare. No wonder our system is the most expensive in the world.

[@MattMorency]

It's mafia all the way down.

[@Vishnu-B]

1. Pharma 2. Insurance 3. Certification People please feel free to add on.

[@dianagibbs3550]

I pay $1000+ per year for my license as a vet and I honestly don't know what the CVO does with it. They don't even issue cards anymore, and when they did they were paper. Not thick paper, just... Paper. Even the techs get a plastic card. Thankfully we also have the ovma. They actually help vets...

[@sourirenoire8]

1900 per year here in Alberta :(

[@dianagibbs3550]

@@sourirenoire8 Yuck :(

[@victorgabr]

The American Board of Radiology, you pay MOC fees, and they even send you random clinical questions every Monday morning, that you have limited time to answer, to "maintain" your certificate. Dare you answering a couple of them wrong if you are not in a mood of just had a hangover from a Sunday party? They can revoque the certification. Just being tortured while taking a day long exam after studying the entire residency is never enough. It's now weekly remainders that you can even lose your certificate, having weekly exam questions being sent to your inbox.

[@Roxy-Mara]

that is ridiculous!!! wth!

[@GoldenPantaloons]

Having had some insight into the internal machinations of professional boards, I'll bet weekly review questions sounded like a good straightforward idea to increase member engagement... when it was first brought up in committee. After bouncing around for months, accumulating amendments and exceptions, the seemingly simplest of processes can wind up implemented as an onerous convoluted mess. If my experience can at all be generalized, I think Hanlon's Razor applies - never attribute to malice what can be adequately explained by incompetence.

[@MsSgent]

Is that better or worse than sitting for ABR board exams every 7-10 years which is what was done prior? I don't know...

[@phaseencode4911]

The ABR will send you two questions every Monday, but you can wait up to a month to answer them before they mysteriously "expire". That should be long enough to sober up. Also, if you get one wrong they will ask you the same question again in 2-3 weeks. So at least you feel smarter the second time you see it. You only have to answer ~50 questions a year, so you can ignore all the questions for half the year, ignore half the questions for an entire year, or something in between. I recently finished 50 this year, so they will leave me alone until January. Yes it's annoying, but it's way better than sitting for an MOC exam every 10 years like the poor ABIM doc in the video.

[@AlexBesogonov]

Somebody will probably make a ChatGPT-based bot to answer them.

[@valfranmay2022]

I can't believe how accurate and sad this is. And it's not just in the U.S. I'm an Internal Medicine specialist and I'm from Argentina. We pay to the board every month a fee for our doctor licence and for a specialist licence, a monthly fee for insurance and we also pay every five years an extra fee for the "renovation" of the specialists certificate. All in exchange for...nothing. They do dictate several courses but SPOILER! that comes with a different fee!! We pretty much feel robbed

[@mt.n5427]

He forgot to mention the fact that you are not allowed to register to take your 10 year recertification exam without paying for all the MÓC fees first. Essentially, pay so that you can pay to get tested. The ABIM needs to get audited by the federal government or we as physicians should boycott it completely

[@Julia-lk8jn]

Where are they even getting their authority from? And is that a government organization or a private one? Because practices like that scream "well we have a responsibility to our share holders to squeeze money out of health care providers" .

[@rcslyman8929]

@@Julia-lk8jn Well, they were already squeezing as much money as they could out of the patients. When you've bled one stone dry, gotta find a new stone.

[@Julia-lk8jn]

@@rcslyman8929 still, if anybody/ any government entity gave them authority, shouldn't they also check against abuse?

[@wandanorris5388]

This made me feel so sad…and horrified! But what makes me happy is that this channel’s content is raising awareness of our medical system’s flaws. Please keep the humor rolling out Sir!

[@carmenjholmesmd4226]

Thank you, and thanks to all who have sued and protested this extortion since it began in 2014. Shot out to the NBPAS, which provides an increasingly viable alternative to the ABMS.

[@Flynn-dy5zv]

Exactly the same in France with our mandatory annual fee of 400€ to the National Medicine Order, just to maintain the right to exerce our profession, but without any positive action from their part to the Doctors and the Healthcare, and without knowing where the money is going appart in their pocket and in a villa with swimming pool... No Fee, no Medecine... It seems we have the same kind of racket everywhere...

[@Roxy-Mara]

Yeah same here in the UK... and they use our money to sue us and invest in stocks of fast food and soft drink companies....😔

[@Mrinsecure]

In theory, there are very good reasons to ensure continuing compliance with professional requirements to ensure a high level of care for patients. In practice, however, some of the things doctors need to go through to maintain that compliance are arbitrary, redundant, or just plain rent-seeking. Remember: it's not a racket if it's legally mandated.

[@jacobthelioneater]

Of course if it were about standards, they'd ask for demonstration of competence - not money. This system only weeds out those who can't afford it.

[@KiithnarasAshaa]

@@jacobthelioneater "Oh, don't worry, we'll still require that you demonstrate your competence, otherwise our expensive certification process will lack the appearance of legitimacy. That will be five hundred dollars. Or Else."

[@aduboo29]

I'm required to maintain various training certificates in my own job, taking fresh tests every year, and I've never had to pay a penny for them.

[@Mrinsecure]

@@aduboo29 Good for you? Not everyone is so fortunate as to have an employer that'll cover the costs of certification/continuing education requirements.

[@MrScrofulous]

Yeah, but the Mickey Mouse shit in place does little to catch or remediate delinquent practitioners. The systems are too easy to game and conscientious people don't need a brownie point system.

[@WolfiePH]

"It seems that the knowledge you've acquired through college is expiring soon. Feel free to pay to renew this neural pathway."

[@carmenbirb1687]

Once again it takes a comedian (or someone stepping into the role of one) to expose the truth to the public. You're doing the right thing with your platform. Thank you 🤜🤛

[@BlueNEXUSGaming]

Never anger the Jester nor the Fool, for they are the ones who can expose the real tool, the real jewel, and the real wrongdoer.

[@T123456788]

Makes American Board of Pathology's $150 annual fee for MOC questions and no exam every 10 years seem like a steal

[@blueblood20102]

My oral boards were in a VERY nice headquarters building. What I would have preferred would be to take them on Zoom and save the facility fee, and proctor fee, and hotel bill, and plane ticket, and...

[@muhsalihu]

I feel your pain. In Anglophone West Africa, one must travel to Accra or Ibadan for some of the exams.

[@willow6049]

I am a speech language pathologist. I do not make anything near what a doctor does. I also have to maintain a certificate. I spend close to $400+ every year taking continuing education courses, dues for my Certificate or clinical competency, AND I have to pay for a license to practice in what ever state I live in. It is ridiculous. The only benefit I get is to be able to keep my job. There are no protections or guidelines. I do not even get liability insurance. I also do not get any free continuing education courses and I have to pay extra for the organization to keep a record of the continuing education courses that they require I take. It is a racket.

[@mikealphagolf]

Literally paid ABIM yesterday and was fuming over the uselessness of the fee. This made me laugh, then cry. But laugh.

[@lisa2000geese]

Same thing happens with clinical social work, another healthcare field. The fees for mandatory continuing education training and maintaining the license were so expensive it's one reason I quit. And yes, they charge these costs right after we pay for grad school and pay for the licensing exam. You can access so much of the training content for free but they still make you pay for the certificates, sometimes hundreds for just one training. All this while social workers earn such low income.

[@falconerd343]

Social work is such an undeserved field too! This is a big factor in why society is falling apart.

[@evajaz16]

Wonderful video! I was upset this was happening to nurses as well. We should protest!! I was like don’t they need more nurses why is my license renewal ever increasing in cost! I’m so annoyed

[@classicambo9781]

Can't you claim it as a deductible on your tax, though? We do in Australia as it is required for work.

[@kerriadereth]

You all need a general medical work-to-rule across the entire USA. I know you can't strike outright, but yeah.

[@slantdwave]

​@@kerriaderethwhat is that? And where from?

[@Weatherman4Eva]

I feel like no matter what evil shit happens, it always ties back again with the insurance companies. Sure am glad that by law I have to keep these companies in business no matter how bad a service they provide

[@MyFiddlePlayer]

Want to know why US health care is so expensive? Because insurance companies get about 30% of every dollar spent.

[@beanmeupscotty]

If you're looking for another reason to hate the insurance companies- they are the reason hospital labs are now considered a large source of financial loss in spite of being involved with 70%+ of patient diagnoses. Medicare set arbitrary reimbursement prices that often don't even cover the full cost of materials, let alone cost of lab maintenance & staff salary, and most private insurances followed suite because they can. However, to the private individual (ESPECIALLY the uninsured ones), any costs from insurance refusing the true bill & the hospital doesn't just absorb are passed onto them! I'm sure there will be no adverse byproducts from disincentivizing investing money into the lab personnel that influence patient diagnosis & the expensive equipment that help make it happen. :)

[@GammerGurten]

The way his eyes dart to the side when he says “research” is a classic and very subtle signal of a lie. Genius.

[@harrynazarian3184]

Oh. My. God. I am sending this to my uncle. He's going to be playing this over and over again, after his complaints about ABIM. This short is a lot cleaner than what he would say about ABIM.

[@Crymeariver227]

Gee, sounds a lot like insurance deductibles, OOP expenses, and copays!!👍

[@AP-nj1mr]

Same scam going on here in UK with the General Medical Council.

[@hollywalker7235]

I discovered you when recovering from a tibial fx with a long rehab/PT. You helped me laugh when I was actually afraid of the health system in general. I'm a nurse with extensive ICU experience, and oh yes, I was afraid. Maybe Jonathan or your wife can be the patient who knows too much. As a farmer's daughter, ,( stop sniggering.), I love the rural medicine bits. What's his pain level? I'm here ain't I?! You and your wife are beautiful people, and thank you for sharing your stories. They almost give me chest pain. Bless you both, and thanks for your important work, couched in humor.

[@ElSeif666]

Is there a part of US Healthcare which is not a Scam? 😅

[@XSniper74184]

... I mean maybe the surgery itself? Like you go in to get your appendix out and I think they'll get the whole thing out... Right?

[@Siseja]

Ironically: Vaccines

[@_Ekaros]

@@XSniper74184 And sometimes they don't even leave any extra inside you!

[@Sceusell]

When they do a kidney transplant, sometimes they don't even bother taking the old one out. They just leave a dead kidney inside you and close you back up

[@XSniper74184]

@@Sceusell sweet, bonus kidney!

[@1986lazarus]

My college fees this year came up on my bank statement as an "entertainment expense". Paying that thousand dollars to keep my job sure was entertaining!

[@hm8489]

As a PA, I have to pay for DEA license, which is $888 every 3 years even though I don’t prescribe narcotics in my work. I also have to pay for national license and state license. If you are full time, your employer may reimburse you, if not, it is coming out of your pocket. There is also fees for recertification exam.

[@ej1847]

Hell no lol

[@yaboicolleen]

damn, ANOTHER reason to hate the DEA. the list just keeps growing

[@22Too]

Wow! Keep on telling us the terrible truth, Dr. G!

[@CattyT1]

So true, even in the U.K. it’s expensive to be a doctor. Exams, meeting attendance fees, college and association annual fees, Defence union fees, other societies. All annual payments that can add up hugely. 😢

[@Roxy-Mara]

especially on the pay we're on 😭

[@Roxy-Mara]

Pf, this hit me hard. In the UK we pay over 400 pounds per year just to be registered as a doctor. And this goes up significantly when you're a board certified specialist. And that's just one of the many fees...😩

[@nothingleft08]

I'm not even medicine and I felt every bit threatened as well. What is happening 😢

[@sandroairj]

“Are you threatening me right now?” “No, technically it’s extorsion” killed me 😂

[@Mo-tn1gm]

My guess is every discipline is subject to this extortion. For CRNAs, they raised the requirements to PhD for new graduates and similar fees and recertification is required. No increase in pay either and higher student loans...Quite the racket.

[@patrickclark9430]

Cue the classical music and Internal medicine waking up with the head of a Foley catheter.

[@JonathanMichael]

It would've been better if the IM attending threw Harrison's Internal Medicine book into the director's face for being greedy

[@doctorgears9358]

I feel like situations like this are widespread throughout multiple industries and we just don’t hear about it because there isn’t a funny youtube person who happens to be a professional in that industry to tell us about it. Really makes you think.

[@NYKevin100]

Most kinds of engineering probably have something like this... except for software engineering, which bizarrely hasn't gotten around to inventing a "real" certification yet. There are pieces of paper that say "certification" on them... but most engineers don't even have one, and literally nobody cares.

[@christinabratcher2625]

Welcome to my world. Hope the ABIM exec Dr Baron watches your channel. Will be one of the best things about retiring, not paying the extortion!

[@pimpnorris2097]

It quite literally is legal extortion

[@Murnan79]

Thank you for exposing all the dark corners of the medical world! Spreading awareness of a problem is the first step in changing, but no one likes to be lectured. To spread awareness through humor is wildly effective!

[@m0nkEz]

They are simply researching new ways to make the quarterly report look good for shareholders.

[@CardioDoc-gw8pf]

This is so true and apt. I have to pay more than a 1000$ every year to maintain not just my IM but also all of my subspecialty certification despite passing the exam for the MOC! And no one knows where the money goes!!

[@margaretbear]

Gah, nursing is moving in the same direction 😩

[@BigArmBoss]

What a racket. Wish I'd thought of it! The American Board of Anesthesiology sure does have a nice fancy building, though. Of course, they start training you for this in medical school. That Step II Clinical Skills test? Designed to make sure foreign graduates could adequately communicate and such. But you're not going to fund all those testing centers and staff unless you compel the U.S. students to take it, too!

[@PhoenixRoseYT]

We don’t do clinical skills anymore.

[@kennyc002]

@@PhoenixRoseYT Ya, was out of the loop, kinda surprised they stopped doing step 2 CS, since that was basically yet another easy way to scam you out of a bunch of cash. Unless...they just raise the price of CK....

[@pimpnorris2097]

@@PhoenixRoseYT Best f***ing believe they will be bring that back as soon as is possible

[@euaggelion03]

Dude, love it. I'm an internist...this is 100% accurate. I think you are about to see a mass exodus from ABIM for this reason.

[@liberalsockpuppet4772]

Thank you for bringing these issues to light.

[@rebekahshoop2949]

This is so true - I pay fees to three different medical “regulatory” organizations every year and I have NO IDEA what they’re doing for me. Nothing, I suspect. The fourth organization is for malpractice insurance - that’s the only one I have any respect for. The rest are leeches.

[@rainsonata4724]

I'm not internal medicine, but as a speech language pathologist, we have the same problem with the American Speech-Language-Hearing Association (ASHA) :^)

[@mommachupacabra]

It's not just your certs. My younger kiddo was getting SLP therapy; her SLP let us rip a copy of her outdated PECS disk (hers was 2 generations old, the latest version was about $300+) so we could print and laminate our own cards, and when she showed me how much the tools and games cost in her catalog, I pulled out my Oriental Trading Company catalog which had THE EXACT SAME TOYS (sold as, well, TOYS) for about 1/10 to 1/50th the cost (but without the instructions.) Southeastern PA had a OTC outlet store, and not only could she buy the stuff, she could buy the supplies for her child patients for LITERAL PENNIES.

[@rainsonata4724]

​@mommachupacabra Do you happen to have a link to cheaper places to buy toys and material for this SLP? I usually go to dollar tree or Target's $5 section, but would love to have more options.

[@suziemyers9855]

ABFP -- same thing, of course. The annual maintenance of certification tests just got printed off and exchanged among us for years and years because THEY NEVER CHANGED THE TESTS! So much for keeping us up to date. I quit paying the extortion money about 6 years into my last cycle. I'll work in a prison before I pay them another dime. One year, I had the 10-year test, my license, DEA, and the required 30 hours of CME (plus travel) all hit. I was working PT, and it took me four months of working to pay that off. None of it deductible. It'd be more honest if they'd just kneecap me.

[@catdad626]

If there's money to be made, there are parasites waiting to exploit the host

[@GamerX13X]

Another great vid by the good doctor. Another funny and pointed critique of the american healthcare system

[@emperor8716]

poor internal medicine, everyone hates him 😢

[@muhsalihu]

He is just an example for the skit, all the colleges do it.

[@SubtleBanshee]

Unfortunately, this goes for administrative parts of Healthcare, too. As a Certified Medical Coder, I paid $500 a year. $480 of it was the certification itself, and $120 was for the webinar subscription because I didn't have the time to go to the monthly meetings for our chapter. And here's the kicker: I never once worked as a medical coding specialist because I "didn't have enough experience" and couldn't pass the aptitude tests they gave in lieu of experience (I was one of the top of my class and I passed the CPC exam on the first try; An exam that, statistically, takes people anywhere between 5-15 attempts to pass. $390 an exam, mind you).

[@deep-seeker]

And this people is one of the reasons why we have expensive doctors.

[@wibufisika9606]

It's also prevalent in academics, where the need for English language certification cost so much money, up to 200 dollars and the certificate is only available for 2 years. I can't help but to draw a comparison with Japanese certification, which cost barely 20 dollars and it is eligible for life.

[@sallymoen7932]

Beyond the absolute crapshow that is the certification game, I really loved the "I really need you to stop asking questions."

[@vuedoc]

Don't forget about losing hospital privileges should one's certification lapse. Thank you so much for making this video! This is exactly the situation in which we have found ourselves themselves: Mob-level extortion from the ABIM. And this is all in addition to sub-specialty MOC. There will come a time when physicians will need to pay more than they earn for the privilege of practicing medicine.

[@paulperryman9989]

For the record, the annual fee is $220 but you video captures the essence of how many internist feel about the ABIM yearly maintainence fee. Thank you for bringing attention to this issue.

[@socalsp3]

its not so much the money but the time wasted away from actual patient care for these shenanigans

[@bordenfleetwood5773]

I really hate how accurate this is. Couch it however you like, this is what's happening throughout the medical community.

[@Yachirobi]

Our constant desire for profit is killing us at every level. We are turning into Ferengi.

[@carriejordan8573]

ABIM: You know what? It would be great if you would just stop asking questions? That says it all right there!! 🤣🤣 Thank you Dr G for your comic relief….laughter IS the best medicine As usual, your videos are 100% on point 👍🏾👍🏾

[@AnOriginalYouTuber]

If people knew how many industries operate, there'd be a change in management within the week.

[@annelynn8708]

I wish.

[@rayzerot]

The Status Quo is practically undefeated. Test him at your own peril.

[@adamspark9259]

If that were true, that change would have happened years ago.

[@Mysticth]

Thank you as always for the humor and the content. Burn this system to the ground.

[@Just1Nora]

My mom is a retired RN. She went to school in the 80s. She spent most of my childhood my adulthood working as a school nurse. Now I can understand retesting every ten years if you haven't been working under a physician because new information and techniques are discovered or developed all the time, but the fees are ridiculous. She volunteers a couple days a week at the local free clinic just to keep herself busy, and she still needs to keep her certification renewed. I can see both sides. I've had doctors who were still practicing using their 1980s school knowledge, and while they were good doctors they were missing a lot of current changes, especially one of my neurologist. Good diagnostitian, but not so great as a clinician. At least not for migraines anyway. My dad sees him for Parkinsons and he handles that really well. And yes, he was listed as a migraine specialist. After a number of years without success he did refer me to a colleague who was better equipped to handle my case. I respect a doctor who knows their limitations and will send you elsewhere if they aren't able to help you anymore. I think of the medical licensing a bit like a driver's license. In my state you have to pass an eye test and get a new picture taken every 10 yrs, with proof of residency and birth certificate. You don't have to take a road test or knowledge test, though you probably should. It only costs like $20-$30 too. One year I saw an old man REALLY struggling with the eye test and I just kept thinking about how they shouldn't have kept trying to help him pass if his eyesight was that poor. That's dangerous.

[@jeanjaz]

I'm not a doctor, only a long term and well informed patient due to the childhood one of a chronic disease and the side effects of the meds I take. I haven't noticed that this recert process makes much difference in the quality of doctor. I've had a few doctors tell me I was more complex than they were comfortable dealing with, but I have had a greater number just bluffing their way through my problems. I've had several make totally STUPID recommendations - like amputation to deal with the pain in my feet for instance. I had one ridicule me for avoiding using my hands to push myself up out of a chair so that I didn't cause deterioration in my knuckles and other things. He said he did karate and purposely hit walls to strengthen his knuckles my forming scar tissue. He didn't have a deteriorating disease, and he hadn't been taking Prednisone for 20 years. He was just an ignorant doctor, regardless of recertification programs.

[@abbieund]

When I started as a nurse in 2016, the renewal fee was $99 for WA state. This year, it’s $135. What do they do with that money? No clue. I’ve never seen a dime of it benefit myself or any other nurses. Oh, and on the reminder they mailed about my license renewal, it states: “Application and renewal fees were raised by…$15 for RN’s…to cover the cost of a new licensing database and increased staffing to address workload.” Such a joke.

[@MinhTran-qs3rr]

I don't know if I should laugh or cry. Regardless, I really enjoy your work. Thanks!

[@katm1379]

1:00 correction required here... the purpose of American Healthcare association is to make 1 billion dollars in profit every year so that their CEO can buy another yatch

[@StrangeTimesIndeed]

Like everything else in our system, it's a racket. 😐

[@BoneDoctor_YouTube]

Appreciate you sharing that perspective, excellent job as always

[@docgammycat]

Regardless whether the original intent of boarding or certifying was to ensure safe, skilled practitioners, in reality, the trustworthiness and excellence of a doctor emanates from internal motivation and dedication to the craft. Annual exams and society membership cannot inspire good work. As the saying goes, "It's an inside job."

[@Quickturealeyes]

Grifters gotta grift.

[@-beee-]

I'm still utterly shocked that we have a hard cap on the number of people we allow to train to be doctors. Like what??

[@whoshotashleybabbitt4924]

What is every medical governing body, EVER, Alex?

[@jeanjaz]

I'm not a doctor, only a well informed patient due to the childhood onset of a chronic disease and the side effects of the meds I take. I haven't noticed that this recert process makes much difference in the quality of doctor. I've had a few doctors tell me I was more complex than they were comfortable dealing with, but I have had a greater number just bluffing their way through my problems. I've had several make totally STUPID recommendations - like amputation to deal with the pain in my feet for instance. (Amputated limbs STILL hurt, and are very hard on other limbs and joints that are used to make up the difference. ) I had one ridicule me for avoiding using my hands to push myself up out of a chair so that I didn't cause deterioration in my knuckles and other things. He said he did karate and purposely hit walls to strengthen his knuckles by forming scar tissue. He didn't have a deteriorating disease, and he hadn't been taking Prednisone for 20 years. He was just an ignorant doctor, regardless of recertification programs. Good doctors keep up on their reading, and read up on the conditions and meds their own patients deal with. The BEST thing is for a patient to be informed - keeping up on the research, understanding the systems their own conditions(s) affect, and checking on the meds they take -- their interactions, side affects, and contraindications (have ONE pharmacist and have a good relationship with them!) Being a well- informed patient helps your doctor, and may save your life. Especially if you end up with a hospital doctor who knows nothing about you or your meds. When they have a load of patients, they don't have time to look up conditions or meds they are unfamiliar with - that's just unrealistic. There have been times I've had to explain my own meds to a hospital doctor. What if I had been unconscious? I have two summary sheets I give to family members and any new medical facility or doctor. One gives a short outline summary of my medical history and explains all my diagnoses, the other gives a summary of my meds (name, dose, why I take it, how it works, containdications, interactions, side-effects), this includes supplements. I have another page that lists all my doctors, their specialty, and phone number. (For possible consults) I keep a copy of these with me in my hospital room because you get new doctors and nurses at shift change. You can't guarantee the new staff has seen/ heard more than the comments of the outgoing shift. A copy of these papers are in my records, but most doctors I ask haven't seen them and have to drill down into my records to even find them. Most of my medical staff are grateful for them - it saves them having to research all that (IF they were even so inclined in the first place). If you have a complex medical history like me, understanding your conditions, your meds, the normal and imperfect human beings who are (hopefully) trying to care for you, and the medical system you are stuck in are vitally important!

[@bobbyfeet2240]

A likely part of the reason a lot of fees like this are high is because many employers cover them so the doctors don't really see them. I suspect hospitals/clinics/medical systems see it as a small outlay relatively speaking (or just silently mentally deduct it from what they pay doctors), so they don't push back. If you're employer doesn't pay it... ouch.

[@snafons]

Sorry, while there are occasional fees covered for the most part that is not the case at all.

[@hazeltulip]

No, the fees aren’t covered.

[@uglytv3417]

Maintenance of Certification (MOC) fees are not covered by the largest Healthcare employer in the US. Source: I am a physician employed by them, and am required to pay the fees myself. Also worth noting: this ain't just internal medicine. Most American medical boards now have MOC.

[@Gilvala]

Doc from Australia here - we have similar annual fees - I’ve never come across an employer that helped to cover them before :( Best we can do is chuck them on as business expenses on the tax return

[@IndigobluBeauty]

My group covers them but I am reimbursed so I definitely see them

[@emilytransue5953]

omg I love every single video but, as an internist, this one just feels like a very special gift... every year I write my check to ABIM and die a little bit more inside.... thank you!!!

[@echassin]

Fantastic video and I hope it has a positive impact. I accept the need for regulatory oversight and I confess I don't know a better way, but one of the niggly annoyances that led me to retire young is that orthopedic surgery suffers the same phenomenon. The expense is exacerbated by the time expenditure and even worse, I didn't learn much of anything useful from MOC or CME. The useful learning took place through day-to-day immersion in the field. IMO the question remains how to encourage that behavior and measure it unobtrusively.

[@ShuRugal]

"and I confess I don't know a better way" pick any country in the European Union. Literally every single one of them has longer life expectancies, fewer emergency visits, more positive-outcome results from those emergency visits, and less cost per citizen to provide medical services. Like, just make a dartboard out of all countries in Europe west of the former Iron Curtain, and we'll do whatever the country the dart lands on is doing.

[@cbpd89]

But, as noted by other commenters, the issues in this video of doctors paying large fees to maintain certification happens in the EU too.

[@ShuRugal]

@@cbpd89 Doesn't mean there's nothing we can take from those models to improve our own.

[@trellises]

How is this legal? 😕

[@abd-animation-22]

I have no idea

[@emperor8716]

loopholes

[@rawaz940]

MURICA BABY!!

[@cosmocosmos]

you know... USA. land of the free... Can't have the government controll something, no matter how stupid it is

[@SamlSchulze1104]

Did you not hear? "No, please, stop. I'll pay you whatever you want!". People being exploited are not doing anything about it. They've given up.

[@chriscourtois9103]

This is so true. As a Massage Therapist our fees are $1000 annually plus insurance 😢

[@maryroberts9315]

"It would be great if you stopped asking questions.". The answer to most questions.

[@nithilanamudhan6260]

How is any of this legal lmaooo? Isnt an organisation like this supposed to help doctors from getting exploited and not this way?

[@ShuRugal]

go ask your neighbors who keep voting for Republicans how it's legal.

[@PhoenixRoseYT]

Capitalism

[@Emilio1985]

And this is why unions and worker solidarity are so important. As long as any worker is being exploited by the system, it justified exploitation of every worker.

[@PhoenixRoseYT]

We need a major healthcare strike.

[@stephenmcginnis5789]

Except when they are exploited by the union.

[@BlueNEXUSGaming]

Oh yeah, now I remember why I don't want to become a Psychologist. It wasn't the Psychological Trauma I would experience from treating my patients, it's the extortion to maintain my certification!

[@diasmemorylane5827]

1:31 "Are you threatening me right now?" "No. Technically, it's extortion." I LOL'd at that one.

[@PhoenixRoseYT]

I have the same questions about the $1500 i spent on boards and the $600 I’m about to pay for residency applications 😐

[@angelagunn7986]

Reporting in all the way from infosec to confirm -- recurring cert fees are a stickup. Sorry to see internal medicine getting the shakedown today.

[@leelu9236]

Same for lab scientists. Pay hundreds to take the exam and then pay every three years for the rest of your career for them to say you're current. And usually pay for the CE too.

[@uglytv3417]

And pathologists, while we're on the lab. =)

[@privacyvalued4134]

"Internal Medicine Gets Blackmailed" is a more fitting title for this video. Exploitation is treating someone unfairly and usually overworking them. Extortion is coercion through money and threats. Blackmail is extortion but includes the added bonus of entrapment or even losing your livelihood for not paying up. This goes way beyond simple extortion and is squarely in the territory of blackmail. This isn't the first time the insurance industry has been involved in actual blackmail. I've been blackmailed by them before. In my case, they required me to "go get a physical or they would raise my rates." Going and getting a physical cost me the exact amount they were going to raise my rates by. And I couldn't drop them because they were through a group policy. "Do this or else" resulted in loss of income. In short, I was blackmailed by my company's insurance provider, paid their blackmail amount, called them out on it, and they stopped that practice at least with me.

[@CliffSturgeon]

The change in the characters eyes is great. Good job expressing the dead corporate look vs the hopeful eyes.of the physician staff (except radiology. Pretty aure those qre just cameras under there).

[@stefanlinton9782]

In England, we have to pay the royal college for….reasons