Latest news with #AmericanBoardofInternalMedicine
Forbes
26-06-2025
- Health
- Forbes
Patient Survival Jumps If In-Hospital MD Aced Assessment Test: Study
Patients are significantly likelier to survive a hospital stay if their hospitalist scored in the ... More top quartile on a knowledge test linked to board certification. The odds that a patient survives a hospital stay sharply increase if the physician overseeing in-hospital care aced a special test designed to assess doctor knowledge and judgment, according to a new study. The study found that patients of hospitalists who placed in the top quartile of a professional exam from the American Board of Internal Medicine were nearly 8% less likely to die within a week than the patients of doctors with lower scores. In an interview, Furman McDonald, a hospital medicine specialist who's president and chief executive officer of ABIM, emphasized that the actual number of patient lives affected by the relative difference among physicians was 'massively significant.' 'The absolute difference in mortality is about four people per thousand hospital admissions,' said McDonald. 'By way of comparison, the mortality from cardiovascular disease, the number one killer in this country, is about two patients per thousand. So this is a massively significant result.' Assessing Knowledge The professional exam, known as the Longitudinal Knowledge Assessment, is given quarterly and is designed to both assess physician clinical knowledge and encourage learning. Every five years, ABIM determines whether the physician maintains board certification – a prestigious designation that also has concrete economic value. The study examined the medical records of more than 260,000 Medicare patients and the test scores of more than 4,000 physicians specializing in hospital medicine. If all hospitalized patients had fared as well as those cared for by physicians who achieved the top quartile in knowledge and judgment, 1,069 lives would have been saved yearly just considering the first week of care, the study's lead author, ABIM health economist Bradley Gray, said in an interview. Top scorers also had fewer readmissions, suggesting fewer complications. 'The patient has a better prognosis if the doctor knows more,' said McDonald. The expertise of the doctor really matters." The predictive value of tests of doctor knowledge has known for decades and has been repeatedly reaffirmed in focused studies involving hundreds of thousands of patients and many different specialties, McDonald said. This study, published as a research letter in JAMA Internal Medicine, was designed to assess whether the results of this newer exam correlated with better patient outcomes. The connection between ABIM board certification and patient outcomes, if substantiated for all the subspecialties the ABIM certifies, could easily affect many millions of Americans. The group oversees some 270,000 physicians practicing in 22 different subspecialties. A previous study sponsored by the ABIM found that the score on its exam for internal medicine trainees applying for certification for the first time was also associated with improved patient outcomes and reduced readmissions. McDonald says the group plans to continue its test assessment effort. One notable feature of this study was a methodology that allowed researchers to compare different doctors as if they were working in the same hospital so as to minimize any influence the facility might have on outcomes. In addition, various adjustments to reduce the risk of misleading conclusions meant the researchers were 'underestimating the extent to which the higher scores are flags of quality,' said Gray. 'We really wanted to have a believable research design.' Open Book Beats Closed Room Before the Longitudinal Knowledge Assessment exam was instituted as an option in 2022, all physicians seeking to be recertified by the ABIM took a detailed, all-day test in a controlled environment every ten years. The LKA, in contrast, is a 30-question, open-book exam given every quarter, with a dashboard telling the doctor the correct answer to each question and, in detail, how they fared in comparison to the ABIM certification standard and their peers. That continual feedback is meant to prompt focused improvement before the recertification test, which is given every five years. McDonald acknowledged he was 'stunned' when a clinical trial the group ran to evaluate alternative approaches to administering the new test showed that the open-book approach most produced results most likely to accurately discriminate among different clinicians. 'It was better able to tell the doctors who knew less from the doctors who knew more,' said McDonald. 'It was amazing.' The approach worked, McDonald suggested, because of the way the questions are designed. ABIM spends a substantial amount of time and money developing and validating realistic clinical vignettes. The goal is for the answers to reflect reliable judgment, not rote knowledge. 'It turns out the doctors who know more are even able to know what to look up and how to look it up,' McDonald said. Thus far, use of artificial intelligence chatbots has not been a problem, but the group is closely monitoring the potential for abuse. Physicians seeking board certification are highly motivated to learn how to be better doctors, Gray and McDonald both noted. Over time, looking at how doctors' scores change and evolve, 'we'll be able to see whether learning results in improvement in patient care,' Gray said.
Yahoo
05-06-2025
- Entertainment
- Yahoo
‘She's sold out': Meghan McCain accused of going ‘full grift' after promoting COVID vaccine ‘detox'
Meghan McCain, who once chastised rap superstar Nikki Minaj for spreading 'vaccine hesitancy' during the covid-19 pandemic, is now partnering with a fringe 'wellness' company to promote a 'detox' supplement for those who 'regret taking the shot.' The former host of The View hawking $90 bottles of the 'Ultimate Spike Detox' prompted critics to call out the daughter of John McCain for going 'full grift' and accuse her of selling out 'to the crazies' after championing herself as a 'voice of reason on the right' for years. McCain, who now hosts a twice-weekly podcast, took to X Wednesday to announce that she was 'thrilled to partner' with The Wellness Company, a business run by Canadian entrepreneur Foster Coulson that is 'rooted in conspiracy theories' and employs 'several doctors who have been accused of spreading medical misinformation.' Coulson, who has paid accused rapist and mysogynistic influencer Andrew Tate to sell his products, says he is creating a 'parallel economy' for 'consumers who believe their freedom is under threat by censorious elites and corrupt scientists.' Other ventures he has backed include a dating site for unvaccinated singles and an 'anti-woke' coffee brand. One of the doctors Coulson has employed is Dr. Peter McCullough, who is listed as The Wellness Company's 'chief scientific officer' and developed the 'Ultimate Spike Detox' supplement line. McCullough, who was an early proponent of the debunked hydroxychloroquine covid-19 treatment, co-authored a retracted paper that claimed 74 percent of autopsies of people who 'suddenly died' showed they were vaccinated, suggesting that was the cause. According to the company's site, the 'extra-strength formula' designed by the 'world's leading pandemic expert' includes 'a key enzyme that may help break down spike protein and disrupt its function.' It also claims it will provide the user's 'body with unparalleled support for cellular defense and detoxification.' Despite McCullough having his board certifications for cardiovascular disease and internal medicine revoked by the American Board of Internal Medicine earlier this year for promoting misinformation about covid-19 vaccinations, McCain urged her followers to buy the supplements – and even gave her name as a promotional discount code. 'Concerning data continues to emerge regarding mRNA vaccines and their unforeseen health impacts,' she tweeted on Wednesday. 'They did not deliver what was promised by government + health officials. I have friends who suffered – heart and menstruation issues & more. It's time to pull them off the market NOW.' McCain added: 'Thrilled to partner with The Wellness Company! If you regret taking the shot, there's hope. Dr. Peter McCullough's all-natural Ultimate Spike Detox is helping people worldwide. Use code MCCAIN for 10% off + FREE shipping on all orders.' It was just a few short years ago, however, that McCain was criticizing others as being 'deeply irresponsible' for pushing skepticism over the vaccines. Additionally, when the Biden administration was first rolling out vaccinations to the public, she expressed 'vaccine envy' because she wasn't sure when she was personally going to get the shot. Along those lines, she complained during a July 2021 broadcast of The View that the Biden White House turned down her offer to help the president reach out to 'vaccine-hesitant' Republicans and convince them to get the jab. McCain promoting a disgraced doctor's supplements while partnering with a company that is pandering to anti-vax conspiracists prompted several media figures and observers to call her out as a right-wing grifter. 'Meghan Goes Full Grift: Is Meghan McCain that desperate for some extra cash?' Status News founder Oliver Darcy pointed out in his newsletter, adding: 'For someone who spent years portraying herself as the voice of reason on the right, this is quite the grift.' Gizmodo reporter Matt Novak shared a screenshot of McCain's tweet and noted that 'the entire conservative movement must be funded by health grifts at this point,' while author Stephen Elliott claimed that 'they all sell snake oil eventually' because the 'incentives are too great not to.' Cybersecurity expert Rob Graham, meanwhile, said that while McCain 'would speak out against the crazies' and defend actual science five years ago, she has since 'been captured by her audience' now that she is a conservative podcaster. 'Her audience is drifting further to the fringe, so is she,' he stated. 'So she's now become the thing she [fought] against 5 years ago. From being the champion on the Right-wing against the crazies, she's sold out to the crazies.' Ironically, it was just a few months ago that McCain herself appeared to take issue with those she saw as hustling and camming their audience. 'Grifters can only keep up a grift for so long,' she tweeted in December. Representatives for McCain did not respond to a request for comment. This isn't the first time McCain has been accused of hypocrisy. Earlier this year, she announced that she was 'excited' to be joining a media startup run by political journalist Mark Halperin, whom McCain had publicly trashed years prior over allegations that he sexually assaulted and harassed multiple women. 'With age comes wisdom and different perspectives on people. I am now a 40 year old mother of two. I have grown and evolved like everyone else, particularly in the past five years — Mark has also grown and evolved,' she said when asked at the time by The Independent what had changed regarding her views on Halperin. 'Like Mark, at this point in my life I believe in giving people the presumption of grace and forgiveness as I would like it in return.' Just three months after joining Halperin's 2way network, low viewership continued to plague the show, prompting her to merge her existing Citizen McCain podcast with the YouTube program in hopes of sparking interest.
