Ahmed K, Ashrafian H, Hanna GB, et al. Assessment of specialists in cardiovascular practice. Nat Rev Cardiol. 2009;10:659-67.
Increasingly, there is a demand for professional accountability through recertification because of concerns about professional negligence and increased awareness of medical errors. The authors describe the process of recertification in different geographical regions and discuss the role of current tools used to recertify cardiovascular specialists and, in particular, how their use can contribute to the requirements of patient care.
Lowe MM, Aparicio A, Galbraith R, et al. Effectiveness of Continuing Medical Education: American College of Chest Physicians Evidence-Based Educational Guidelines. Chest 2009;135:69S-75S.
Among other factors affecting Continuing Medical Education (CME), the authors assess the impact of the MOC program and note that expectations and required performance changes will influence CME significantly. Self-assessments will spotlight learning needs that are not only unique and physician specific, but also critical for a physician to fulfill. This type of individualized self-assessment will create motivated learners who will want to become involved in a learning process that supports desired changes. Just as physicians are working with more informed patients, CME providers will target engaged physicians who have increased expectations for CME.
Miles P. Health information systems and physician quality: role of the American Board of Pediatrics Maintenance of Certification in improving children's health care. Pediatrics. 2009;123 Suppl 2:S108-10.
A second revolution in quality is occurring in U.S. health care, as profound as the Flexner revolution almost 100 years ago. Systems issues are the basis for most of the concern, but physician quality and professional development are also important. Specialty Board Certification and the MOC program are key drivers of professional development and improvement of care. Physicians are now required to document that they can assess and improve quality of care. Functional health information systems are essential for this process.
Holmboe ES, Wang Y, Meehan TP, et al. Association between Maintenance of Certification examination scores and quality of care for Medicare beneficiaries. Arch Intern Med. 2008; 168(13):1396-1403.
The authors looked at the associations between the performance of 3,602 general internists on the American Board of Internal Medicine MOC examination and Medicare patients’ receipt of important processes of care for diabetes (52,307 patients), mammography screening (133,731 patients) and lipid testing for coronary artery disease (49,526). Higher MOC program exam scores positively correlated with better performance on the diabetes and mammography measures, but not lipid testing.
Turchin A, Shubina M, Chodos AH, Einbinder JS, Pendergrass ML. Effect of Board Certification on antihypertensive treatment intensification in patients with diabetes. Circulation. 2008;117:623-28.
The study, which included 301 internists in academic practices, found an association between intensification of treatment for hypertension and the date of most recent Board Certification (which, in some cases, may reflect participation in the MOC program). Internists certified within the last 10 years were significantly more likely to intensify therapy compared to internists certified more than 10 years prior to the study.