Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.

Monday, May 4, 2015


I really thought I was on an extended hiatus from being irked by the American Board of Psychiatry and Neurology. I was all set to wait until I get the bill for the annual fee to be pissed again, but they got to me sooner.

I haven't yet received my new board certificate. When I got my board scores, the package included a certificate shipping form that I could fax to them if I wanted to change my shipping address. It also had a box you could check if you were willing to waive the required signature. I wanted to do this in case no one was home when it was delivered, but the form was incomprehensible, because it wasn't clear if you had to change your address to check that box, or if you should include your current address or leave it blank because you don't have a change of address. I figured anything I did would only make it worse, so I didn't bother with it.

That was bad enough. Today, I get a letter from Jim Henry, Inc, informing me that my certificate is being prepared, and will be mailed to me on June 30, 2015. It also offered me, "A choice of quality frames as described in the enclosed brochure... Just indicate your choice of frame...and return it to us with your remittance no later than May 19, 2015. If no order is received from you by this date, your certificate only will be sent to you unframed at NO CHARGE." (boldface and caps are theirs, not mine).

I am so done with these people. The frames range in price from $70 to $600, with additional costs for special finishes. I already have a framed certificate. The ABPN sent it to me the first time around. It has a little rectangular piece in the lower left hand corner with the expiration date, and that's all that needs to be replaced. But they're sending an entirely new certificate with no expiration date which will need to be framed.

If I bother.

Do I have to speculate about whether the ABPN gets kickbacks on the frames? Honestly, the brochure looks like something from a company that does high school yearbooks. And if you checked out the link to their site, you may have noticed the "pharmaceutical" tab at the top. It links to this page, with the image:

Thousands of dollars in direct payment, board review, and lost patient hours already spent, and now they want me to pay for a crappy frame. Boy they must be broke. How fitting that medical associations and the pharmaceutical industry are grouped together.

In the words of someone very wise, "Sheesh!"


  1. Is the new certificate a different size than the old one, forcing you to buy a new frame?

    One of the few benefits of age: I'm grandfathered out of MOC. Not that exempting those trained and certified longest ago makes any sense at all.

    I've never framed or displayed any diploma or certificate. It's easy enough for anyone so inclined to confirm my credentials online.

    1. I don't know if it's a different size. I haven't received it yet. But I tweeted that I may frame it in construction paper with crayon flowers.

      I had a supervisor who told me not to put up any kind of diploma or certificate. I tried it for a while and then decided it didn't matter, and what else was I going to do with those things, so some of them are on my office wall.

  2. I understand what you're saying. Most credentialed professions have similar absurd processes.

    That said, it is really important that we acknowledge that there is currently no means for private practice psychiatrists to be evaluated or held liable for their practice -- this is not the case for any other profession. Case in point: I saw a psychiatrist who misdiagnosed me and put me on lithium - and once the level hit 9.0, never tested it again despite continuing to "treat" me for 3 more years with no results. Tests under a new psychiatrist found severe hypothyroidism and kidney damage. No wonder I wasn't getting any better. Who gave her a medical license? Why didn't she know to test to for thyroid and kidney function when on 900 mg of lithium for 3+ years? Or was she just lazy and a poor psychiatrist -- but there is no reason for her to be liable. She does not take insurance. She is completely in private practice. She could have killed me out of negligence -- but so what? She did a residency at a prestigious NYC hospital - there's no excuse. It is unrealistic for a patient to have the means, funds, and willingness to go public about mental illness in order to pursue a lawsuit. This kind of thing just doesn't exist in other professions. The MOC may not be functional, but at least there's a vague recognition that there should be some kind of monitoring and educational requirements for psychiatrists....The answer should be to make the MOC processes more meaningful, not to applaud even less oversight for psychiatry.

    1. It's unfortunate that you had that experience. But I don't see how MOC in its current form would have prevented it.

  3. Agreed. But the answer is not even less accountability. Psychiatrists, like most professions, should be mandated to have continuing ed that is meaningful and accountable. Psychiatrists should be able to demonstrate after practicing 5, 10, 15, 20 whatever years that they are still countable. There is currently no means to do that. Even less accountability is not going to achieve that.