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Homework Posting Class 2

Page history last edited by Bev Wood 12 years, 9 months ago

Please post here your writings on 4 of the questions asked:




Maintenance of Competence in Health Professions/ACMD 615/ Fall 2011

Class 2-29 Aug-Reflection- Maintenance of Certification                 Name: Ming-Chen Hsieh


1. What are the reasons that physicians resist voluntarily taking the MOC?


    Taiwan’s compulsory national health care system, called the National Health Insurance (NHI) program. The NHI program, all citizens who have lived in Taiwan for at least four months are required to be insured under the program. Hospitals may receive accreditation from the DOH for three or four years, we must take 160 units CME. Its for an operating license. So in Taiwan, we don't have the problem about “resist” taking the MOC but we have the “grandparents” problem. But I think the gap is: the physicians who did not enrolled the MOC, the questions are: examination and clinical practice are somewhat different esp. you are in academic medical center or community hospital, knowledge is not the only thing in medicine for patients, how about any difference in patient's outcome?


2. What elements of practice, if any, are absent from the MOC exam?


    This "Superman Doc" era when medicine was complicated but could be mastered in its totality.  Complex tasks are skillfully accomplished through teams and knowledge, not super heroes.

Good Medical Practice and Continuing Professional Development

1. Good professional practice

            a. The principles of good medical practice and the standards of competence, care and behaviour expected of doctors.

            b. The ability to perform clinical and practical skills safely in line with current standards.

            f. Recognising personal and professional limits and being willing to ask for help when necessary.

            g. Recognising the duty to protect patients and others by taking action if a colleague's health, performance or behaviour is putting patients at risk.

2. Maintaining good medical practice

            a. Acquiring and using new knowledge to update practice and adapting to changing circumstances.

            b. Audit principles and the importance of using audit results to improve practice.

            c. Being willing to respond positively to the results of appraisals, performance reviews and assessments.

            d. Shared learning across professional boundaries.

3. Relationships with patients

            a. The rights of patients, for example, to be fully involved in decisions about their care

            b. The ability to communicate effectively with individuals and groups.

            c. The moral and ethical responsibilities involved in providing care to individual patients and communities.

            d. Respecting patients whatever their lifestyle, culture, beliefs, ethnic background, ethnic origin, sex, sexuality, disability, age, or social or economic status.

            e. The duty to understand and deal with patients' healthcare needs by consulting them and, if necessary, their relatives or carers.

4. Working with colleagues

            a. The roles and expertise of other health and social-care professionals.

            b. Effective team-working, management and, if necessary, leadership skills.

            c. Treating colleagues fairly, avoiding discrimination, valuing difference and not allowing views of colleagues' lifestyle, culture, beliefs, ethnic background, ethnic origin, sex, sexuality, disability, age, or social or economic status to affect the professional relationship.

            d. The principles and organisation of the service which the doctor may work in, and how care is managed.

5. Teaching and training

            a. Suitable teaching skills.

            b. Being willing to teach colleagues and to develop their own teaching skills.

6. Probity

            a. Professional ethical duties in relation to probity as set out in Good Medical Practice. These cover:

                        providing information about services;

                        writing reports;

                        giving evidence;

                        signing documents;


                        financial and commercial dealings; conflicts of interest;

                        financial interests in hospitals, nursing homes and other medical organisations.

            b. Professional ethical duties

7. Health

            a. Professional ethical duties in relation to each doctor's health.

            b. The health hazards of medical practice, the importance of their own health, and the effect that their health has on their ability to practise safely and effectively as a doctor.




3. How do you feel about recertification and how would you advise someone with a time unlimited certificate? What would you choose, why?


    The main reason they wouldn't enrol is the practice performance module. So just for the “need”, If they want more formal training in palliative care techniques to supplement the knowledge that they will have picked up along the way. Because those hours do not contribute to MOC but do improve their practice.


4.Comments: what physicians think they know and do in practice does not match what they actually know and do. In fact, physicians are not good at assessing their own skills.


    Problems with doctors’ manner and attitude constituted the more frequent type of problem and complaints from patients often arise as a result of communication problems. No matter how innovative and flexible the schemes become, the greatest challenge is to manage the interface between the requirements of professional bodies and those of employers, managers, and patients in trusts and primary care groups. The process of professional development needs to be managed.


As a profession we need to be self confident enough to embrace a culture where continuing education and development, peer review, appraisal, and revalidation are not threatening concepts.


5. What is your opinion about the two articles related to humour, if you decided to read them?



It’s tough to be a doctor these days. Whether it’s listening to the difficulties of our medical colleagues as they try to best care for their patients, or engaging other health professionals about the uncertainties surrounding health reform, we’ve noticed a tense, sometimes gloomy, atmosphere among physicians. Humor can be healing for both doctors and patients














Comments (1)

Bev Wood said

at 5:06 am on Sep 2, 2011

Your comments are extremely interesting. The emphasis on teamwork will certainly move medicine beyond physicians believing they can do it all themselves. Interesting that patients see communications as a major deficit; but, of course, they are not in the same position as a physician or team members' colleague are to spot deficits in knowledge, application and performance. Also, it is a common problem to "not enroll" in recertification as people feel no need to learn new information and may be very nervous about needing to incorporate or institute a new practice.

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