Maintenance of Certification for Orthopaedic Surgeons

Abstract

The American Board of Medical Specialties (ABMS) has declared that each of its member boards must show that the profession sets its standards, monitors its performance, and is improving the practice of patient-centered evidence-based medicine1,2. In the early 1990s, a series of highly publicized events increased public concerns regarding the competence of physicians. The medical liability insurance crisis further eroded public trust in our health-care system. In 2000, the Institute of Medicine published a book, To Err Is Human: Building a Safer Health Care System , which stated that between 44,000 and 98,000 Americans die each year as a result of preventable errors3. Most of these preventable medical errors are “caused by faulty systems, processes, and conditions that lead people to make mistakes or fail to prevent them.”3 A second publication by the Institute of Medicine noted that the health care system frequently fails to translate knowledge into practice4. It was further noted that “[a] highly fragmented delivery system … results in poorly designed care processes characterized by unnecessary duplication of services.”4 Furthermore, it has been shown that 3% of hospitalized patients risk experiencing a hospital error and that those who experience an error in treatment or care have a 25% chance of death. This amounts to 1.16 million preventable “patient safety instances,” with over 200,000 patients dying each year from potentially preventable problems5. The public's interest and concern regarding quality issues in health care have resulted in the establishment of many programs, including the National Practitioners' Databank, the National Quality Forum, and the Agency for Health Care Research and Quality. Additionally, the Joint Commission on Accreditation of Health Care Organizations (JCAHO) and the Centers for Medicare and Medicaid Services (CMS) have become more interested in the quality …