Q&A: Retiring head of ABIM reflects on accomplishments, lessons learned during tenure

Key takeaways:

• The departing president and CEO highlighted the importance of listening to the internal medicine community.
• He also addressed how assessments might change in the future.

Richard J. Baron, MD, MACP, president and CEO of the ABIM, announced he would be retiring from his role in September 2024.

“It has been an incredible privilege to lead this storied organization at such an important and transformative time,” Baron, who has served as CEO since 2013, said in a statement.

He also highlighted his contentment with the work done over his tenure.

“By working in partnership with the community, we have evolved our program dramatically, offering multiple pathways for people to demonstrate that they have stayed current in their field — pathways that integrate more readily into the already too-full lives of internists and internal medicine subspecialists,” he said.

Speaking to Healio, Baron discussed some of ABIM’s biggest accomplishments over the last decade, what organizational changes he helped to make, and more.

Healio: What do you think is the biggest difference in ABIM’s organizational attitude, direction and efforts from the start of your tenure to now?

Baron: When we moved to a continuing certification program in 1990, we put ourselves in a lifetime relationship with physicians over the course of their career. However, we didn’t change very much about ourselves organizationally to create connections with physicians over the course of their career. I don't think we were thinking very deeply about how working with doctors over the course of their career was different than working with doctors at the beginning of their career.

I think the biggest changes are that we have many more channels of communication with the large internal medicine community but also ways to get input and feedback from from doctors who are in practice at various phases of their careers. I think the organization has become one that not just takes and hears that input but actually changes and evolves the program and develops new features on the program based on what we're hearing and learning.

Healio: What were some of ABIM’s biggest accomplishments during your time as CEO?

Baron: I think our biggest accomplishment was to get clearer about why our program makes a difference, why certifying doctors once for life is not a good way to go. But then we needed to offer a program that achieves the goals of a continuous certification program. We think all of us in the internal medicine community agree that it's important for doctors to stay current in their field over the course of their career.

I think we also have common ground with the community that self-declared expertise is not a reliable thing and that there's a role for an independent third-party verifying and assuring that doctors have expertise in a peer-defined way.

The biggest achievement is the evolution of the program, so that the program does what we wanted to be doing as an organization, which was demonstrating that doctors were staying current over the course of their career.

Healio: Was there anything you felt was left undone and still needs to be addressed?

Baron: I think anybody in any leadership position gets done what they get done and leaves things for somebody else to do. That’s an inevitable part of being in leadership. So, the program is never going to be a perfect program; it's always going to have ways it could be better.

Technology is going to evolve, so the way we can do assessments is going to change. Because doctors are practicing on electronic platforms, maybe there's a way to assess what they're running in the background, where you don't even have to have them show up ; it just is looking at what they're doing and making judgments based on that.

I’m not putting that out as an example of where we need to go but of how, as technology evolves, our opportunity for doing assessment evolves. I think my successor and future boards will need to think about how they can do assessments differently in ways that integrate more smoothly into the lives of the doctors who are going through the process.

Healio: When the ABIM’s maintenance of certification (MOC) program was initially criticized by physicians, you listened to them and made changes — including offering new pathways to earn credits. What was the lesson learned there?

Baron: I think the learning was that we needed to get closer to the community of doctors, and that was a matter of how we were structured as an organization. How did we have ways to hear what they were saying and how did we have ways to evolve the program based on what we were hearing?

I don't think we were very good at that before. It was kind of a challenge of ‘Wait, if you're a standard-setting organization and you know that there are right answers and wrong answers, how do you involve a broader community in doing that work?” And it took us a while to figure out that there are lots of ways we can do that in terms of how we deliver the assessments or how they experience the assessments. We also have come up with ways to involve many, many more doctors in writing the questions. Now we have hundreds and hundreds of doctors in practice around the country who we train to write questions.

We're certainly not perfect at it now, but I think we're getting a lot better in that area. So, I think one of the things we learned was if you are out of touch with the people who you need to fulfill your mission, you're going to have challenges engaging them and having them feel like they want to do that.

Healio: In the announcement about your retirement on the ABIM blog, you specifically mentioned “corporate consolidation and dramatic losses of professional autonomy” as examples of how the health care system is transforming. Do you see those as some of the biggest challenges to physicians trying to maintain their expertise? Why?

Baron: I think when you get consolidation and when you get corporatization, you lose a lot of that control. You're part of a larger entity and you don't get to decide everything about your environment. That has some upsides and some downsides.

I think what consolidation means is physicians and the systems that employ them are now negotiating different levels of control. I don't think we're at a steady state, and I think that health systems really need the buy-in commitment and leadership of their physicians.

I think there's plenty of room for doctors to help create and structure their own space. It's not quite as simple as it was when I was in my own practice.

On the other hand, as I say, there are other problems that the doctors don't have to worry about, and I think focusing on recognizing that the systems they’re in exist to serve the needs of patients and talking with leadership about how they can better serve the needs of patients is always a conversation worth having. It's always a conversation that a health system somewhere is open to. I think doctors have influential and important voices in helping to transform the systems that we work in. It’s more challenging and complicated, but it doesn't mean the opportunity isn't there.

Healio: What advice would you give to your successor?

Baron: I'd encourage my successor not to give up the belief that the program makes a difference. I have no doubt that more patients got better care across this country because of the ABIM. I think we have raised the standards of practice across internal medicine and all of its disciplines across the country at scale.

I'd also encourage my successor to be flexible and recognize that there are going to be different ways to achieve our mission, and we need to be as nimble and adaptable as we can be to put those things into practice.

Reference:

• Announcing the fall 2024 retirement of ABIM and ABIM Foundation CEO Richard Baron, MD, MACP. https://blog.abim.org/announcing-the-fall-2024-retirement-of-abim-and-abim-foundation-ceo-richard-baron-md-macp/. Published Sept. 26, 2023. Accessed Oct. 2, 2023.