PETITIONS

Update: Consider applying for continued board certification from the National Board of Physicians and Surgeons at www.NBPAS.org

PLEDGE OF NON-COMPLIANCE

ABIM is now under fire with many physician organizations (i.e. ACC, ACP, AACE, AAPS) calling for MOC change. Since there has been no meaningful change, many physicians are boycotting the MOC program. Even if you previously enrolled in MOC, you can pledge to boycott future participation.

TO VIEW, AND IF IN AGREEMENT, JOIN A PLEDGE OF NON-COMPLIANCE, CLICK HERE click-here-button

AGAINST MOC

The American Board of Internal Medicine (ABIM) has recently added significant time and expense to board certification. Beginning in 2014, to be reported as “Meeting MOC Requirements,” physicians must sign up for a complex system requiring they complete MOC activities every two years and pay significantly higher fees. Even if you are actively certified or recertified, failure to comply will result in your certification reading “Certified, Not Meeting MOC Requirements.” The new MOC are burdensome requiring MOC activities every two years. In addition, there is a yearly fee that requires payment of at least $3,335.00 (for subspecialty MOC) over ten years.

TO VIEW, AND IF IN AGREEMENT, JOIN AN ANTI-MOC PETITION, CLICK HERE     click-here-button

 

Against MOC

If you support these petitions, please send this to your colleagues.

 

47 comments

  1. It is my suggestion that physicians be given the option of attending a periodic certification course which would provide a review of current guidelines and update cardiologists on the most current information. Questions could be asked during the course but no formal exam would be required. This would be a more positive and enjoyable learning experience. I find taking courses telling one what is going to be on the exam and how to answer the question correctly to be a total waste of time. For those in busy practices taking the time to study for an exam in the evenings is difficult and long term information retention is difficult. Most physicians under these circumstances just try to memorize what they need to know to pass the test and quickly forget what they have learned after the test. I believe that the majority of physicians want and believe that is important to keep up with the cardiology field but the ABIM has made this an onerous task to satisfy their financial pocketbooks. There may be some physicians who enjoy studying for and taking exams but this should not be the standard for all physicians.

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  2. I spent hours entering manually into the MOC system the height, weight, cholesterol measurements and waist circumference of 50 of my patients in order to fulfill one of these MOC requirements in 2013. I felt like a secretary! The website was slow and it took me weeks. What a ridiculous way to test to see if I am a good doctor. Then I was asked to talk to my patients about diet, exercise, and weight loss (which I do anyways without the ABIM asking me to) and had to then RE-ENTER the same tedious data months later! It was a total waste of my time and I don’t think it tested anything about me as a physician. I have always and will always continue to educate my patients, and entering data like a school-girl is not the way to see if I am good at what I do.

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  3. Well I certainly support abolishing are changing MOC. I am employed physician and in my contract it states that I must stay current and therefore I am unable to boycott

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    1. Talk to your other employed associates about all boycotting together. It costs a lot of time and money to replace you and it’s very difficult to replace a group.

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    2. Actually, incorrect. You are entitled as an employed or salaried person to enjoy the benefits of organizations that have the legal right to engage in collective bargaining and even go on strike if felt indicated. In medicine the organization that is allowed to do just that, and has done just that repeatedly and successfully is the Union of American Physicians and Dentists, otherwise kinown as L 206 of AFSCME, AFL-CIO. The UAPD has about 5,000 members, mostly in California. Were you and enough others from your place of employment UAPD members it is likely that favorable changes could have been made in your contracts without going on strike. The choice to finish out your professional life as a dependent contractor and do what the boss says is your own. – robert L. weinmann, MD, formerly, president, UAPD, 1989 to 2006, now editor, The Weinmann Report (www.politicsofhealthcare.com)

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  4. I think many or even most physicians share the view that these new requirements do not make sense. However, many physicians are now employed by entities that require them to stay current with ABIM guidelines, and thus will not be able to support this pledge.

    I wonder if more light can be shed on what the ABIM does with their significantly increased income, and how much their officers or board members make.

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  5. I’m so sick of our elite administrative class of physicians treating the rank and file docs with such disrespect. We should stop trying to prove that we are “up to date” and be proud of our training and our work ethic. No other profession puts their members through the embarrassing ritual of continuing to take exams and do worthless projects to prove that we are competent.The more we try to show the public how up to date we are the more suspicious they become.

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  6. I think this movement can gain much more ground if you address the concerns that many colleagues have. What does one do if board recertification and MOC certification is required by their medical staff and their employer? Until ABIM or the specialty organizations change their policy regarding this, the medical staff and hospitals/employers are unlikely to change theirs.
    I am in this situation. Furthermore, my initial board certification expired at the end of 2012. I have completed the self assessment modules. I have registered for the written exam and a PIM module, both of which I have delayed and dragged my feet on for exactly the reasons many of us share – they are overly burdensome, tedious, and useless.

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    1. I would wait this out. I know people who are now actively letting their certification expire. There is a healthy percentage of physicians who can and will do this so we will not be alone.

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    2. Each physician must make their own independent choice. Let the medical staff, employers, hospitals figure it out. I wouldn’t fight them at all. What I would do is go work at a place where this MOC nonsense is not required. And if it means leaving medicine, then so be it. Why did we go into medicine in the first place? To be a low-level puppet with no input and say-so? Not me.

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  7. I want to be kept informed and try to practice to the highest degree I can. For me that means :
    Always reading up-to-date. 400 $ annually,,,,,great resource
    SHM annual membership 300$/year… Useful info
    society hospital medicine 2000 $ bi annual meetings……highly valuable
    CME at Emory.. 300- 400 $/year….worth every dollar !!!!
    ACP membership. 300+/ year. I just rejoined…will see if it’s worth it
    ACP educational material. 500+/ year…excellent
    Ohio state university online cme. 300/year. OSUCCME. Awesome web based telecast CME
    Local hospital. Free

    Now ABIM demands that I pay them as well or be labelled as not keeping up….so I guess
    I have to give up on one or two of the above to satisfy ABIM…does ABIM claim superiority over
    The other sources I use regularly ?

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  8. A rational approach to enhancing education among physicians is to reduce educational costs to a bare minimum…and therefore encouraging physician learning without a financial penalty.
    As outlined in the above petition… Keep it simple

    Th current ABIM approach is to raise costs of education and actually encourage physicians to abandon other valuable sources of continuing medical education. The current ABIM approach seems to encourage more busywork and proprietary obstacles.

    I am a proponent of 10 year exams , but if ABIM solely cared about education of physicians, they would write an exam that emphasizes recent high impact updates in the particular specialty.

    The physician should simply take the exam at a minimum cost and be given a computerized breakdown of specific areas that a physician did poorly on,…provide appropriate educational references links regarding those areas scored poorly on …and allow retakes the exam at a later date of the physician’s discretion.
    Moc mini exams should be optional and have the same educational links provided and offered at low cost

    On the prior moc mini exams there were links to mksap. Why not also allow publishers of UpToDate or other publishers the same opportunity to have a link to their resources ?

    It just seems smarter to utilize the resources that many physicians already use daily to provide patient care. ABIM is taking an educational step backward when they insist on using their materials just to pass their exam .

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  9. I am a mid-career academic internist who strongly believes in professional standards. I work hard, I read a great deal, I try to keep current, and I expect the same of my colleagues. This being said…
    I recently sat for the IM recertification exam after having purchased study books and reviewed them for a full year. Thankfully, I passed. I also did a number of on-line MOC modules. I am now faced with having to complete the practice-improvement portion of MOC.
    Earlier this year, I developed an extensive and well-researched patient-centered handbook covering topics of interest to people with disabilities. They make up the majority of my practice, and many of them have told me they feel better informed after having reviewed the book. I approached ABIM and asked whether I could submit this handbook as evidence of practice-improvment, and was told I could not. I haven’t (yet) kept formal data on patients’ responses, so the work I’d done was deemed inadequate.
    I am deeply disappointed in this organization, and earlier comments about an “elite” class of physicians certainly ring true. Random and unsupported requirements are being thrown at us without any substantial justification. And it seems the more displeasure we “ordinary” docs express, the more stubborn our “leaders” become. A very odd and frustrating dynamic.

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    1. That is simply terrible and your patients are lucky to have someone like you! The ABIM should be ashamed of themselves for not having the intelligence, insight or flexibility to accept your handbook.
      The practice improvement project I did with residents (CEX’s) was a joke beyond what feedback I gave to the residents directly. I had to enter tons of crap for no purpose. I too work in an academic center and have/want to keep up. The requirements are inappropriate and nonsensical. Obviously they are written by people not practicing medicine! This is more than frustrating and will drive good people away from the profession.

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  10. Another thing about the MOC is that we are already now all participating in quality metrics for ACOs and MAs. At some point it’s just too much – the activities pulling us away from the patients.

    Also, I hate to say it but it may be time to drop my membership in the ACP (and my workman’s comp w them and the annals, etc.). I just don’t think they realize how bad it is out here on the front lines.

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  11. I’ve signed the petition, therefore agree that ABIM MOC program is waste of our time and money. Unfortunately the system works as it is effectively mandatory to be Board certified, because if you are not, hospitals will not give privileges, if you don’t have hospital affiliation, insurance companies will not accept you in panel and you’ll lose most of your patients. This non-compliance movement will work only if it will be mass movement. As a related issue – why we should apply to be included in any insurance panels (including Medicare and Medicaid)? You are holding a valid state license, thus can see and treat patients! Period! Why we should to fill out multi-page applications (all this info is available through state’s DOH’s) and beg to be accepted? Again, majority should join to break this practice.
    The bottom line is that if insurance companies would pay to every physician holding valid state license regardless of hospital affiliation and “networks” the issue will be resolved.

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    1. that will never happen —YOU SEE, MDs do not stand together about much of anything .
      It is like hearding cats. So nothing can ever change –it is a lost cause .
      I am simply looiking towars early retirement as a solution.

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  12. Now that 17000 doctors have boycotted the MOC, they are trying to bribe us by getting 0.5% from CMS. They are promising us money from a broken and broke system.

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  13. All physicians share the frustration of dealing with a complicated, burdensome, and onerous healthcare system in this country. I do not need to mention the governmental, regulatory, insurance, financial, litigious, and yes, political issues that make our daily practice soooo miserable at times. MOC is especially onerous to us NOT because it is expensive and burdensome, but because we know DEEP DOWN it adds no value to what we do. We are the ultimate scientists who not only deal in rational data but have to filter this through the human experience. If there is evidenced based data that MOC improves patient OUTCOMES, I would be the first to support it. Having re certified twice, I know this is not the case. Therefore to support MOC is to perpetuate the non evidenced based “myth” that it is somehow of benefit. It is NOT. There are many areas of medicine where data is lacking and we still sense a “way forward” which may help patients and is unlikely to do harm. This is sensible. I will not re certify again. It is an “error in thought” that should have been vetted more fully by data and not politics and financial advantage. Sign the nomoc petition today!

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  14. I am a private practice psychiatrist who was Board Certified in 1995 and re-certified in 2005. I was Board Certified in Addiction Psychiatry in 1996 but did not re-certify in 2006 due to the time and expense (with no consequences 9 years later). For the 2015 recertification, MOC came upon me quickly and I attempted to meet the requirements. The process was completely different and exceedingly complex. I spent 2-3 hours navigating the American Board of Psychiatry and Neurology’s website(ABPN) and tried to decipher exactly what I needed to do. Only through the help of a colleague did I understand what was expected.

    I spent 5 hours collecting and manually entering 10 years worth of CME credits onto my “folio” on the ABPN website. I spent several hundred dollars in “Self Assessment” credits that I obtained through the website for “Approved Products”. Many more hours were spent obtaining the necessary total number of CME credit hours, exceeding my state licensure requirements. I became throughly exasperated with the Performance in Practice modules that required me to review charts and to survey 5 patients. They were as confused as I was as to the purpose. They all gave me perfect scores, rendering my performance improvement plan useless. Faced with a $1,700 exam fee, I decided to quietly refuse as the deadline loomed. Seven days have passed since I am no longer Board Certified and nothing has happened!

    There is a mental health crisis in this country that keeps me extremely busy and the physician shortage in my area is palpable. I am ashamed to have wasted so much valuable time being one of many sheep who did not challenge authority while being led to the slaughterhouse(until the last minute when my right to self determination kicked in). But, I refuse to live fear of the consequences of no longer being Board-certified. None of my patients has ever asked or seemed to care about this credential. They care about how I care for them and that is my highest priority. The only person who has ever inquired as to my board status was a lawyer deposing me in connection with the murder of one of my patients. What does that say about our system of credentialing?

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  15. 1st point: I am (was?) a board certified internist since 1984. I plan to retire in about 2 years, when I turn 65. I refuse to participate in MOC. If, as a result, I am denied hosp. privileges, insurance reimbursement, or state licensure, I will retire as soon as that happens. Then I will have to make the terrible sacrifice of giving up my Michigan winters and suffering through Florida winters earlier than planned. And 3,000 patients will lose their doctor that much sooner.

    2nd point: I have now practiced for 30 1/2 years as a general internist, as well as 3 years as a general medical officer in the U.S. Navy. Never once has a patient asked me if I was board certified. My patients do not know what that means. They don’t even know that it exists. In fact, I think most of them don’t know the difference between an internist and an intern. What they are interested in is a doctor who listens to them, examines them, counsels them, cares about them, and helps them with their problems.

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  16. Unfortunately, as with most things in this country, if you want to understand the true motivations of organizations and the individuals that run them… FOLLOW THE MONEY! When I read the following recent blog post by Westby G. Fisher, MD, FACC (http://drwes.blogspot.com/2014/12/the-abim-foundation-choosing-wisely-and.html), my initial suspicions about the real impetus behind the ABIM’s new and onerous MOC requirements appear to be more than confirmed. This sort of reminds me of the AMA’s “Sunbeam fiasco” back in the 90’s, from which the AMA never fully recovered.
    I became certified by the ABIM in 1985 and so was “grandfathered” for nearly 3 decades. Apparently those like me drove the current administration of the ABIM crazy trying to figure out some way to make us “pay to play”. My current position not only negates the need for MOC but discourages it because of the waste of my limited free time that it truly would be, so my decision to “boycott” the entire MOC process was relatively painless. Obviously that is not the case for the majority of ABIM diplomates. I have the greatest respect for those who are taking a stand and really do have a lot at stake.

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  17. In pediatrics the overwhelming majority chose a hand washing actively! Imagine asking our patients if I washed my hands before and after their visits. SHOCKINGLY it was 100% since randomization (as pointed out previously) was not a requirement. A waste of time, effort and paper. We even had an option to “dry lab” the work so as to not sully ourselves with patient visits. It is obvious it is all a money grab. Can anyone help point me in the direction for a similar pledge for MOC for the AAP? If there isn’t an out there can anyone point me in the direction for starting one?

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  18. I completed an FP residency and passed boards ABFP, as well as fellowship requirements. This seems to be only for ABIM. Correct?

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    1. ABFP has just as painful of a MOC. It appears from the replies on this page that MOC is a cancer that has infiltrated most specialty boards choking the life away from physicians. The self assessment modules are the worst. I voiced my displeasure and feedback after completion and submission. I never once got a courtesy reply, not even a form letter. I agree that we as physicians have been too permissive and submissive which has allowed is cancer to spread. We need to fight back.

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  19. This new recertification business has little to do with enhancing physician competence. It has every thing to do with money making and control by self appointed so called elite physicians.it is about time that we ordinary physician rise up against this nickel and diming.

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    1. My colleague is a grandfather board certified surgeon since 1978, and I am a multiple board re-certified surgeon since 1979. Compare both the clinical competence and knowledge in patient care between him and me, I don’t see any difference and I may have to consult him in some complicated cases. From my point of view, the re-certification and the MOC are not relevant to safe and effective patient care. If the ABS would ask me to take the same questions of board examination with this year’s graduate residents, I am sure I’ll fail the exam. but is it mean I am inferior to the new graduates in clinic competence? I think the MOC is too much over doing, and even the recertification should be modified only in one or two times, not in three or fourth, other wise majority of respected experienced doctors would become a group of being intimidated MOC failed physicians or surgeons. Probably it may let them to retire earlier, is it good for the profession, the patient or the society?

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  20. I am ABIM certified…and I don’t even practice internal medicine. I practice exclusively allergy and immunology. I am also ABAI certified. I refuse to manage diabetes or hypertension and refer patients out to internists or FPs. I frankly tell my patients that I haven’t managed any non-allergy conditions for years and they are better off with specialists who deal these conditions on regular basis.

    I AM LIVING PROOF THAT BOARD CERTIFICATION DOES NOT IMPLY QUALIFICATION.

    BTW, Wwhy did I bother with ABIM certification then?
    1. I was originally board certfied when I finished IM residency and felt compelled to continue to be board certified.. at least for now.
    2. The modules cross-over from ABAI so all I had to do is pass the 10 year test.
    3. The test review courses gave me tons of CME.
    4. I was genuinely eager to learn about conditions I used to treat.
    5. To keep my options open.
    6. Double board certification looks impressive.

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  21. We need to make a bold move .. we collectively strike or we will be fleeced. I for one will not renew my Boards or participate in ttheir Mockery. I would rather leave this country then do that.

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  22. Pearson Vue is the connection that is not yet talked about. It is the testing center that provides testing for all the medical boards. It is likely that it provides the “education” consultation as well as testing. They provide the testing for the “Common Core” for all of the United States for all K thru 12. They provide the testings for all professional groups. They are connected with both political parties and they are making lots of money from doctors. It is the “Common” denominator.

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  23. I was going to re-certify in Internal Medicine (2015) even though I am a gastroenterologist. I did my first re-cert in 2005, 10 years after the original board after residency. I am strongly opposed to the MOC process and decided to not enroll in IM MOC. I am hoping the alternative board is acceptable to hospitals and insurances so i can dump ABIM altogether in 2018 when i am due for GI re-cert. I am concerned that the strategy employed by ABIM to give some concessions and incentives to other baby organizations (ACP has already sold out and I revoked my membership as a result), will succeed in taking the momentum out of the NOMOC movement and we will all be worse off for that. I hope that day does not come. I will pay my re-certifying fee to NBPAS for the next two years to support the cause! Hang tight Paul Tierstein!

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  24. If one physician has to take the certification exam every ten year, then all the physicians should. Including those that were boarded before 2000. This will get all the physicians to pay attention to this issue.

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  25. Download and Review a certified pdf version of the ACA (Affordable Care Act), PPACA (Patient Protection Affordable Care Act).
    Search for the terms “MOC” “programs”
    The ACA gives the “Secretary” control over the requirements for MOC programs for provider participation in “qualified plans”

    Also, as of Jan. 1, 2015, the “Secretary” can now limit which providers are allowed to participate in all “qualified plans”, not just M’care and M’caid

    Remember, “you have to pass it to see what’s in it”

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  26. A group of doctors have gotten together to form Let My Doctor Practice, http://www.letmydoctorpractice.org/conference, a national movement to unite doctors and push back against MOC requirements and other burdensome regulations. We hope you can join our webcast (or in person at Keystone Resort, CO, in the beautiful Rocky mountains) and tell us your thoughts and ideas. Dr. Paul Teirstein will be speaking! Our conference, Summit at the Summit is designed to be solutions-based and address the issues that continue to plague physicians and sending many to retire early! The event is July 20-26, we hope you will bring your voice to this movement.

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  27. I applaud Dr. Teirstein’s efforts to give physicians an alternative to ABIM and to prevent us from (once again) being glibly herded into the veritable slaughter pen by agencies that have their own agendas (and not better medical care) as their objective. So many of these agencies are attempting to force us to accept MOC and other poorly-conceived measures of physician performance. as physicians, we should also start online petitions and further actions to oppose Medicare PQRS and other mandates. I fail to understand how medicare is allowed to issue standards and programs for physicians when it is clear that they have obfuscated website, phone “help” lines that require at least an hour wait per transfer, tons of confusing acronyms, countless repetitive registrations for every sub-set of the agency. as an example, i tried to fill out the application for PQRS last wee, i had a user name and password from april, 2015. i was tole (after 2 hours of hold time and numerous transfers) that having the user/pass set for pqrs was not enough, thata i also needed a second user /pass set for IAC. so, in addition to having separate user/password combinations for pecos, another set for the “enterprise portal<" another set for "medicare insite(to check eligibility)” who put these imbeciles in charge??? we need a grassrooots effort to protest the mandates that are spewing out from this agency.

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    1. Dr. Kent, I completely agree “we need a grassroots effort to protest the mandates that are spewing out from this agency”. We are creating a platform for all physicians to unite (Dr. Paul Teirstein is participating via webcast with a talk) online (and in-person) in Keystone, CO, July 20-26. We plan to discuss the main obstacles that impede doctors’ ability to simply be doctors and take care of the patients they serve. I hope you can join us – sounds like you have ideas and this is a solutions-based national discussion and townhall! http://www.letmydoctorpractice.org/conference

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      1. Ms. Berry- thanks so much for your comments and for sharing info. about the webcast and “letmydoctorpractice”– i probably cannot travel to CO but will definitely block out my schedule for the webcast.. am so glad that people like you promoting grassroot revolt! barb kent

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  28. This is on the ABMS 2013 Tax Return Form 990…. which must be furnished to the public by law.

    Total Revenue $2,525,604

    Salaries:
    Lois Nora President $779,587
    John Mandlebaum CLO $307,542
    Laura Skarnules COO $269,547
    Thomas Granatir SVP $280,699
    Krista Allbee VP $253,271
    Lisa Wasserman CFO $228,150
    Kathleen Ruff COS $200,468
    Carol Clothier VP $210,495
    Mellie Pouwels VP $209,330
    Jenn Michael CIO $209,538

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