Provider Certification — proving competance

fltsimDoctors could learn a lot from pilots.  Flight simulators have revolutionized commercial aviation so pilots can train without endangering passengers.  Patient-care simulators do the same for doctors yet doctors fight the idea.  See the article in the Wall Street Journal 7/21/14 by Melinda Beck “Doctors Upset Over Skill Reviews.

There are cognitive skills and procedural skills; both are amenable to testing and training.  The current buzz words are “maintenance of certification” or MOC.  The specialty societies have raised the bar –and the price –for the MOC tests.  Each state empowers a board, or group of people, to oversee medical quality and issue licenses to practice medicine at a much lower educational standard than the MOC.  So, many physicians feel the specialty boards have gone too far.

Examples of specialties include: family medicine, internal medicine, general surgery, ophthalmology, and gynecology just to name a few.  The MOC process requires many hours of education each year and periodic tests.  If  the process is not completed the physician is designated “not meeting MOC requirements”  which is a black mark for any specialist.

The offended doctors object to being forced to learn about subjects like:

  • how to recognize abuse of children and elderly adults
  • teamwork during operating room emergencies (a simulator lab)
  • how to review a chart to identify areas for improvement
  • principles of quality improvement
  • new information about cost effective drugs

Of course, all those topics are a waste of time for busy doctors that stay on the cutting edge of medicine by getting information from drug reps and journal ads.  The high cost of continuing education, $2000 for a refresher course, is ridiculous since that is the usual salary doctor receives for 3 days of work.  Who ever heard of using a simulation laboratory;  it’s not proven.  Practicing on live patients to see what works and what doesn’t  is the way — some live and some die.  Besides, what does a pilot really learn when they crash a simulator rather than a real plane!



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