Performance measures may be part of recertification

Older doctors still might resist periodic retesting, but younger ones recognize it as a "necessary evil."

By Andis Robeznieks, AMNews staff. March 8, 2004.

A medical school diploma on the wall only goes so far these days.

It seems that everyone is demanding more evidence that doctors know what they're doing and more proof that they are keeping up with the latest medical advances. Public reporting of performance measures and required recertification are often cited as methods for achieving this objective.

In fact, some proponents of performance measures advocate weaving them into the recertification process to get physician buy-in. But such a plan is not without peril.

While recertification has its advocates among health care leaders, it is not uniformly accepted among physicians. In addition, the process is in the midst of a transformation from a requirement imposed every seven or 10 years to an ongoing "maintenance" program involving continuous education and assessment. Technology also is likely to be key to future recertification efforts, and physicians are known to grumble when forced to incur new technology costs.

"What we're resisting wholeheartedly is the intrusion into our practice," said San Fernando Valley, Calif.-based internist Sam Fink, MD. "I don't know any physician who speaks in favor of performance measures. I think we're tired of being capitated, manipulated and frustrated."

Jasper, Texas-based family physician Peter Bidwell, MD, said the problem with recertification is that it emphasizes the science of medicine while diminishing the art.

"There are a lot of parameters that make up a good doctor that can't be measured with ones and zeroes," he said. "Qualities like building patient morale, being empathetic and helping families make the right decisions -- these are things you can't test for."