First Steps Toward an Early Assessment System for Physician Performance Problems

Laying the groundwork and providing a framework for an early warning system to identify physicians at risk for performance issues

During 2006 and 2007, researchers at the National Board of Medical Examiners and the Department of Family Medicine at the Robert Wood Johnson Medical School laid the groundwork for an early warning system to identify physicians at risk for performance problems and detect and remedy deficits in physician competence and performance early enough to reduce the potential for patient harm. Researchers:

  • Characterized the types of physician problems encountered by state medical licensing boards and other organizations involved in physician education and assessment.
  • Developed an understanding of the physician assessment and remedial intervention needs of the licensing boards and other stakeholders, especially their degree of acceptance of a set of six core competencies as an organizing framework for physician performance assessment.

Key Findings: Data from the Board Action Data Bank of the Federation of State Medical Boards as well as surveys of state medical board members showed that the most frequently received complaint about physicians related to "conforming to minimal standards of acceptable medical practice."

  • A survey of physicians identified "assisting patients in dealing with health system complexities" as needing the most improvement among their peers.
  • Despite much agreement about the importance of the individual areas covered by the six competencies, state medical boards and other stakeholders do not universally accept the set of six competencies as an organizing framework.
  • Health care system issues and physician performance are often interrelated, and it is difficult for state medical boards to separate out practitioner issues from hospital or health care system issues.

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