Continuing Physician Professional Development

New, growing model of CME linked to physician quality improvement

Introduced in the early 2000s, Performance Improvement Continuing Medical Education (PI CME) helps doctors assess the care they provide patients and make measurable enhancements, reports American Medical News.

"In 2011, 44,275 physicians and 7,492 nonphysician health professionals participated in 502 PI CME activities offered in the U.S., according to the Accrediting Council for Continuing Medical Education," according to the story in American Medical News. "That's a steep increase from the 744 physicians and 175 nonphysician health professionals who participated in 22 PI CME activities offered just six years earlier."

This is still less than one percent of all CME activities offered nationwide, but demand for PI CME "is expected to grow as the country shifts to a pay-for-performance system of care that emphasizes quality over volume."

The genesis for PI CME arose from widespread calls for better patient safety and quality of care, from the Institute of Medicine and other advocates for quality improvement. In 2004, the AMA and the American Academy of Family Physicians approved the standards for PI CME.

Better quality of care: Is Maintenance of Certification the answer?

A recent article in the New England Journal of Medicine looks at efforts by the American Board of Medical Specialties (ABMS) to ensure physician competence through development of the Maintenance of Certification (MOC) program. MOC "requires most certified specialists to seek recertification on a periodic basis — typically every 10 years — by successfully completing a four-part assessment designed to test their medical knowledge, clinical competence, and skills in communicating with patients."

Some physicians have criticized MOC as overly expensive, time-consuming and burdensome. In addition, some younger physicians have raised questions about "grandfathering" of physicians who obtained certification before MOC was implemented and now have time-unlimited credentials.

The AMA has several policies that focus on MOC. For example:

• "Any changes in the MOC process should not result in significantly increased cost or burden to physician participants."
• "Our AMA will exercise its full influence to protect physicians from undue burden and expense in the Maintenance of Certification process"
• "Our AMA will work with the American Board of Medical Specialties to streamline MOC to reduce the cost, inconvenience, and the disruption of practice due to MOC requirements for all of their member boards, including subspecialty requirements."