The Role of Physician Specialty Board Certification Status in the Quality Movement

Brennan, Troyen A.; Horwitz, Ralph I.; Duffy, F. Daniel; Cassel, Christine K.; Goode, Leslie D.; Lipner, Rebecca S.

doi:10.1001/jama.292.9.1038

Cited by 259 publications

(171 citation statements)

References 42 publications

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“…Considerable content and criterion validity evidence for IM-MOCE scores has been demonstrated. 5 We also examined factors known or hypothesized to affect examination performance, including physicians' age, gender, medical school location (United States or International), practice model (single or multi-specialty) and practice type (including private practice, academic medical center, hospital inpatient-based, residency clinic, and nursing home).…”

Section: Maintenance Of Certification Examination Scoresmentioning

confidence: 99%

“…4 Patients value certification and many indicate that they would change physicians if they discovered that their doctor had failed to maintain certification. 5 Maintenance of certification includes successfully passing a secure medical knowledge examination 1 ; for internists this examination is the American Board of Internal Medicine Maintenance of Certification Examination (IM-MOCE). 8 Substantial evidence for the validity of certification examinations has been demonstrated.…”

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confidence: 99%

“…8 Substantial evidence for the validity of certification examinations has been demonstrated. [5][6][7] Certification examination scores correlate with training factors (type of medical school and residency program) 9,10 and assessments of competency by program directors, 11 and recertification scores discriminate between individuals with and without subspecialty content expertise. 12 A growing body of evidence demonstrates relationships between certification status and quality of care including outcomes following acute MI, [13][14][15] colorectal surgery, 16 diabetes care, 17 mammography screening, 17 and other preventive services.…”

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confidence: 99%

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Relationship of Electronic Medical Knowledge Resource Use and Practice Characteristics with Internal Medicine Maintenance of Certification Examination Scores

et al. 2012

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BACKGROUND: Maintenance of certification examination performance is associated with quality of care. We aimed to examine relationships between electronic medical knowledge resource use, practice characteristics and examination scores among physicians recertifying in internal medicine. METHODS: We conducted a cross-sectional study of 3,958 United States physicians who took the Internal Medicine Maintenance of Certification Examination (IM-MOCE) between January 1, 2006 and December 31, 2008, and who held individual licenses to one or both of two large electronic knowledge resource programs. We examined associations between physicians' IM-MOCE scores and their days of electronic resource use, practice type (private practice, residency teaching clinic, inpatient, nursing home), practice model (single or multispecialty), sex, age, and medical school location. RESULTS: In the 365 days prior to the IM-MOCE, physicians used electronic resources on a mean (SD, range) of 20.3 (36.5, 0-265) days. In multivariate analyses, the number of days of resource use was independently associated with increased IM-MOCE scores (0.07-point increase per day of use, p=0.02). Increased age was associated with decreased IM-MOCE scores (1.8-point decrease per year of age, p< 0.001). Relative to physicians working in private practice settings, physicians working in residency teaching clinics and hospital inpatient practices had higher IM-MOCE scores by 29.1 and 20.0 points, respectively (both p<0.001). CONCLUSIONS: Frequent use of electronic resources was associated with modestly enhanced IM-MOCE performance. Physicians involved in residency education clinics and hospital inpatient practices had higher IM-MOCE scores than physicians working in private practice settings.

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Section: Maintenance Of Certification Examination Scoresmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Relationship of Electronic Medical Knowledge Resource Use and Practice Characteristics with Internal Medicine Maintenance of Certification Examination Scores

et al. 2012

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“…Maintaining a commitment to lifelong learning, including continuous quality improvement (CQI) in health care, is a core component of medical professionalism [1,2]. Traditionally, 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) [3–5].…”

Section: Introductionmentioning

confidence: 99%

Primary care physicians’ perceptions of practice improvement as a professional responsibility: a cross-sectional study

Stephenson

Wittich

Pacyna

et al. 2018

Medical Education Online

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Continuous 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

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“…1 Earlier work by Brennan provided evidence that maintenance of certification examination results correlate with the complexity and volume of patients seen by practicing physicians. 2 Turchin has shown the quality of care for patients being treated for hypertension, as measured by compliance with well-established practice guidelines, declines as the time since the physician's last maintenance of certification examination increases. 3 Dr. Volpintesta suggests that family physicians "take expensive board recertification courses or engorge themselves with information they don't use" to successfully pass the maintenance of certification examination.…”

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confidence: 99%

Response: Re: American Board of Family Medicine (ABFM) Launches New Exam Prep iPhone Application

Puffer¹

2011

The Journal of the American Board of Family Medicine

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The Role of Physician Specialty Board Certification Status in the Quality Movement

Cited by 259 publications

References 42 publications

Relationship of Electronic Medical Knowledge Resource Use and Practice Characteristics with Internal Medicine Maintenance of Certification Examination Scores

Relationship of Electronic Medical Knowledge Resource Use and Practice Characteristics with Internal Medicine Maintenance of Certification Examination Scores

Primary care physicians’ perceptions of practice improvement as a professional responsibility: a cross-sectional study

Response: Re: American Board of Family Medicine (ABFM) Launches New Exam Prep iPhone Application

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