All Entries in the "competency" Category
More talk of board certification
Yes, folks, the conversation regarding board certification as a measure of physician competency is till rolling. More of your colleagues have written in to share their opinions. Here’s what they have to say:
“Board certification is obviously one item of many that should be considered in the evaluation of a physician, either at initial appointment or at re-appointment. However, that is not its only purpose. More important in this discussion is whether a hospital medical staff should require board certification, independent of any use for credentialing. Requiring board certification makes a statement to the medical staff, to the board, and to the public that the hospital is trying to be the best that it can be. That institutional attitude counts for a lot.
“Our own healthcare system is going to be visited soon by the investigation team for the Baldridge Award. Why should we try for such an award? Just the effort needed to apply for the award makes a statement about the institutional attitude, whether or not we receive the award. Cultivate that attitude, build and expand on it, and let that attitude be expressed in everything we do. The plaque on the wall, the congratulatory letter in the doctor’s file, the monthly newsletter announcement that one of our doctors recently was re-certified: all of these help to tell the world who we are and what we stand for. Just as important is that they tell us who we are.”
~Van Swan, MD
Presbyterian Medical Group
“Rather than the idea that medical staffs and boards do not consider that certification is a reflection of physician competence, I believe they are reluctant to enforce the regulation for other reasons. I have seen these groups not enforce the decision at the time of appointment or reappointment because the physician was needed or has been a loyal colleague. For the most part, the regulations began with grandfathering of the current medical staff membership, which may make some believe an unfairness exists. I believe that the few hospitals that enforce this requirement have an higher quality medical staff. Even though I was in an administrative position in 2000 at the age of 70, I re-certified in internal medicine. This did require the appropriate time commitment, something that busy practitioners may find difficult to do.
“I also have noticed that committees or boards sometimes opt to extend deadlines for individual medical staff members to pass their boards. We had a bylaw that indicated the requirement to have board certification or the equivalent. The equivalent was hard to define and carry out. A member of our bylaws committee suggested a procedure that he had seen in the orthopedic association that required a review of office records. This did not work out.”
~Francis M. Wilson MD, FACP
Retired Chief Medical Officer
St. John Health
You can find more food for thought about board certification here.
Board certification conversation still going!
The conversation regarding the relationship between board certification and physician competence continues! I’ve received several more e-mails, so I thought I’d share what your colleagues have to say.
“I believe that expiration of board certification occurs for various reasons not related to competency. It seems ludicrous to assume that a practitioner’s competence diminishes if he/she does not recertify. The measure of true competence should not be confined to board certification, and in fact that runs contrary to CMS conditions of participation.”
~Jill Jourden, CPMSM
Medical Staff Administration
Saint Francis Memorial Hospital
“My hospital established a board certification requirement in 2002. It requires all physicians to obtain board certification within five years of completing their residency or fellowship. All members, with few exceptions, are required to maintain board certification. When the bylaws amendment was created, a grandfather clause was included for those physicians who did not qualify for board certification. Most of those physicians have retired from staff by now. We’ve had a few physicians challenge the bylaws. One physician went as far of the state supreme court. We’ve had physicians who left the medical staff because they failed their board exams, allowed their certifications to lapse, or chose not to recertify at the end of their careers. All of these issues have been dealt with thoughtfully by the medical executive committee. At times, enforcement of the bylaws can be difficult, but consistency is the key.”
~Anonymous
“Board certification, within itself, does not prove physician competence. It is simply one measure, one tool if you will, to determine whether or not a physician is qualified to perform in a particular specialty. Other considerations such as training, experience, teaching, and continuing medical education should also be considered when evaluating a physician’s competence. Our medical group believes that board certification provides a unique and widely accepted measurable objective upon which to base decisions. We have mirrored our internal policy to that of surrounding hospital and insurance carrier partners.“
~Sheri Wahl
Manager, provider credentialing and enrollment
UT Medical Group, Inc.
I’d love to hear your thoughts! Keep the comments coming in!
Join the conversation: Board certification and competency
Little did I know how many responses I would get when I included a news bite in this week’s issue of Medical Staff Leader Connection regarding a new study that explores the relationship between board certification and privileging!
A study in the Archives of Surgery suggests that hospitals do not consistently require physicians to be board certified to receive privileges. Out of the 109 hospitals that were surveyed, only 5% required surgeons to be board certified when they received initial privileges. In addition, 82% of all hospitals surveyed allowed surgeons ad non-surgical subspecialists to retain privileges after their board certification expired.
Here are some of the comments you had to share:
NCQA’s take on ongoing monitoring requirements
The biggest stumbling block for medical staff offices these days seems to be complying with The Joint Commission’s standards for ongoing monitoring. But that’s not the only accrediting organization to have such a standard.
NCQA also has an ongoing monitoring standard as part of its health plan accreditation. The September issue of Briefings on Credentialing (available online in mid-August) features a Q & A with Frank Stelling, MEd, MPH, assistant director of policy at NCQA. He says that NCQA-accredited organizations have not struggled to comply with this standard. He also outlines ways NCQA-accredited organizations meet this standard. Some of their techniques may be applicable to Joint Commission-accredited organizations, too.
Here’s what he told BOC:
Free demonstration of Physician Profile Reporter software June 30
As editor of Medical Staff Briefing, I get a lot of feedback about the struggles medical staffs have with designing an effective way to provide physicians with performance feedback. If deciding what to measure isn’t hard enough, compiling the data can make you want to tear your hair out if your technology systems don’t cooperate.
To help get your organization moving in the right direction, I’d like to let you know about a free on-line demonstration for Physician Profile Reporter software on June 30 at 1:00 ET. During the demonstration, Marla Smith, MHSA, a consultant with The Greeley Company, will walk you through how to generate reliable performance reports that can be easily distributed to each medical staff member.
Complying with the Joint Commission’s FPPE and OPPE requirements doesn’t have to take over your life if you have the right tools, so I encourage you to sign up for this free demonstration.
Disclosing practitioner credentials, competency to patients
MSPs have a special privilege when it comes time to choose their own healthcare provider. They know which doctors have the most training in a particular field and which ones have the best competency results performing a particular procedure. They know this because they’ve seen the data on the practitioners.
But – asks today’s Wall Street Journal Health blog – should all patients have this information? What about risky procedures that practitioners can only improve on with on-the-job training. They have to learn on someone, right?
While there are some national Web sites that disclose practitioner quality data, studies have found that most patients aren’t querying them.
What about the data that your medical staff services department collects? Has a patient ever asked you to share that information? Does your organization already share some of that information on a quality Web site patients can access?
Simulation training worth the high costs
A study recently released by Danish researchers highlighted findings well-known to Children’s Hospitals and Clinics of Minnesota: Simulation training makes better practitioners.
The Children’s Hospitals developed a mobile pediatric simulation training unit-the first of its kind in the nation-after receiving a donation from Kohl’s Department Stores in 2006. It cost about $750,000 to build and initially stock the training van, and additional funds to maintain it.
“I can’t tell you there’s a huge return on the actual investment other than training,” says Phillip Kibort, MD, MBA, chief medical officer and vice president of medical affairs at Children’s Hospitals and Clinics of Minnesota. However, good clinical training is priceless. “If CEOs have a basic understanding of quality and safety principles, they know simulation is important and the better your simulation the better, probably, your outcomes are going to be,” he says.
CRC Symposium: Mark Smith, MD reports live from Las Vegas
Greetings from the Credentialing Resource Center in sunny Las Vegas, NV! This morning kicked off our 12th annual Symposium. Listen to Mark Smith, MD, MBA, CMSL give participants a preview of what’s to come over the next several days.
Hot topic: Low-volume providers
The medical staff crowd is buzzing with questions regarding credentialing and privileging low- and no-volume practitioners. The topic gets hotter as more physicians abandon hospital care to focus on their more lucrative outpatient practices, which inevitably makes it difficult for the medical staff services department to assess their clinical competence.
The Greeley Company is addressing low- and no-volume providers in its new white paper: Low-Volume/No-Volume Practitioners: Best Practices for Competency, Privileging, and Strategy. Check out this excerpt:
A best practice is to develop your approach to low-volume/no-volume providers,
including the design and implementation of an effective outreach program, as part of a comprehensive strategic medical staff plan. In the past, healthcare organizations created physician recruitment plans based on the demographic analysis of current physician-to-population ratios and an aging analysis of current members on the medical staff roster. Such medical staff development plans were adequate for demonstrating community need and justifying recruitment and salary guarantee support, but they are no longer adequate to meet today’s challenges. Now, a strategic medical staff development plan needs to begin by recognizing the medical staff as one of the hospital’s most valuable resources.
If there is one thing that I’ve learned from all the buzz, it’s that this issue needs to be tackled from two angles: the credentialing and privileging issues related to low- and no-volume providers to help MSPs do their jobs more effectively, and strategic development planning spearheaded by leaders. If medical staff leaders aren’t tackling strategic planning issues, MSPs will have a more difficult time helping the hospital comply with the Joint Commission’s FPPE and OPPE standards.
I’d love to hear from you if your facility has questions or concerns regarding low- and no-volume practitioners. And of course, we’re always looking great tips, so e-mail me at ejones@hcpro.com if you want to share your formula for success! I’d also suggest picking up a copy of Assessing the Competency of Low-Volume Practitioners, Second Edition. I may be a bit biased, but I think it’s a great resource for MSPs and medical staff leaders alike.
Sample letter for the Criteria-Based Core Privileges seminar
In addition to the sample letter Emily posted below explaining the merits of the CRC symposium you can use with your superiors, we’ve also created a similar letter for the Criteria-Based Core Privileges seminar to be held May 13, one day before the CRC symposium begins. Though it’s drafted as a “stand-alone” letter, it can easily be combined with the CRC letter given that the two events are held at the same location.
More information on the seminar, including the cost, can be found by clicking here. Let me know if you have any questions about the agenda, or any other aspects of this one-day seminar.
The letter can be found by clicking here: criteria-based-core-privileges-seminar-letter
Todd Morrison
Managing Editor