Abstract
ABSTRACTContinuous quality improvement is a component of professionalism. Maintenance of Certification (MOC) is a mechanism in the USA for physicians to keep current with medical knowledge and contribute to practice improvement. Little is known about primary care physicians’ perceptions of the practice improvement (Part IV) components of MOC. We aimed to determine primary care physicians’ perceptions of their professional responsibility to participate in Part IV MOC. This was a cross-sectional study of primary care physicians using the American Medical Association Masterfile. We developed a nine-item survey, designed from expert consensus and literature to determine views on Part IV MOC as a professional responsibility. We surveyed 1500 randomly selected primary care physicians via mail from November 2014 to May 2015. The response rate was 42% (627 of 1,500): 47% (273 of 585) were family practitioners and 49% (289 of 585) were internists. Factor analysis revealed a two-factor survey, with five items pertaining to positive views of MOC Part IV and four items pertaining to negative views. Internists were more likely to view MOC Part IV as time consuming (82.0% vs. 70.3%, P = .001), expensive (50.9% vs. 38.8%, P = .004), and not relevant to practice (39.1% vs. 23.8%, P < .001). Family medicine practitioners were more likely to view MOC Part IV as improving patient care (64.5% vs. 48.8%, P < .001) and maintaining professional responsibility (48.7% vs. 32.5%, P < .001). Regardless of specialty, most physicians viewed MOC Part IV as time intensive, not beneficial for career advancement, and not a professional responsibility. Family medicine practitioners demonstrated more positive views of MOC Part IV. The difference between family medicine practitioners and internists could be related to the ABIM MOC controversy. Future changes to practice improvement requirements could focus on limiting time requirements and on clinical relevance.Abbreviations: ABIM: American Board of Internal Medicine; AMA: American Medical Association; CQI: continuous quality improvement; IRB: institutional review board; MOC: Maintenance of Certification; QI: quality improvement
Highlights
Maintaining a commitment to lifelong learning, including continuous quality improvement (CQI) in health care, is a core component of medical professionalism [1,2]
Board certification has been the primary method for physicians to demonstrate their competence; recently, with the creation of the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) Part IV activities, it has been used to demonstrate commitment to quality improvement (QI) [3,4,5]
As part of a national survey of primary care physicians on QI, we examined their views toward requiring QI to maintain board certification
Summary
Maintaining a commitment to lifelong learning, including continuous quality improvement (CQI) in health care, is a core component of medical professionalism [1,2]. Current implementation for MOC is costly, with limited data on its relevance for clinical practice [17,18,19,20,21]. Despite this dissatisfaction, evidence suggests that MOC can improve some clinical measures, such as self-reported knowledge, communication with patients, and clinical care [22,23,24,25]. Previous studies have assessed physicians’ views on MOC in general, but less is known about the specific issue of requiring CQI work as part of MOC
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
