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Class 2 reflections

Page history last edited by Nancy.Mesiha@stjohn.org 12 years, 9 months ago

Mesiha Class 2 ACMD 615


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

The main reasons are:

  • ·        Physicians might be unaware of their own Gaps in knowledge, ‘do not know what they do not know, and hence may not feel the need or the benefit from MOC.
  • ·        Time factor and financial reasons, most physicians have busy practices, successful ones too, they do not have the time needed for MOC, especially if they do not see the benefits.
  • ·        Fear of failure and how this might affect them in the future
  • ·        Question of relevance? What does it add to me? How can it help my practice or my patients?



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


MOC fails to evaluate all 6 competencies, it mainly concentrates on Medical Knowledge.


  • Professionalism is not typically evaluated.
  • Communication skills with patients, families or other health care professionals are not assessed.
  • Cultural competencies and ethical behaviors.
  • Teaching skills
  • Ability to evaluate, mentor and provide constructive feedback
  • Moreover, leadership skills and team work are hard to gage or evaluate. According to the NEJM, ABIM has made changes We applaud the ABMS’s commitment to incorporate an assessment of communication skills into the MOC process, through a survey of each physician’s patients and colleagues, over the next few years.

Likewise, the ABMS plan to require participation in practice-assessment and quality-improvement activities, along with completion of a patientssafety self-assessment program, should add value to the MOC process.

The other elements that are not assessed, are technical skills. Technology is rapidly growing and everyday new techniques are available, physicians should demonstrate competency in that regards.



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

My opinion is that some sort of continued assessment of physicians is needed.

I agree with the article “Recertification has two potential benefits.

First, by reflecting that a given physician has kept abreast of his or her field, recertification can provide the type of “quality” measure of care that health care institutions, insurers, and the general public are seeking. Second, physicians

could actually improve the care they provide by participating in the recertification process. Both potential benefits are important goals…”

I would choose to recertify, again as I believe and feel that it will help me to take better care of my patients. I think part of the reason is that I am humbled and challenged on daily basis, taking care of my patients, trying to do my best and keep up to date in my medical knowledge and skills.


 4. Levinson comments that the biggest issues in signing up for the MOC are 'cost, time, relevance and fear', do you agree?

Yes, I do agree. I think in general these are the reasons, yet different physicians may argue which of the factors is more important. In my opinion, physicians in general will be more willing to sign up if they feel the relevance of the process. When I attend live CME conferences, it is clear to me that the most attended sessions are the questions and answers ones. In these sessions, attendee ask questions and get expert answers or opinions regarding their own patients’ issues that they deal with. This just reflects that most physicians really want to do the best for their patients. So relevance I think is very important. If physicians feel that the MOC is directed to their needs, they will be willing to put the effort, time and money needed to achieve that goal.




5. She also comments that  

"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 — fewer than 30% of physicians examine their own performance data, and physicians’ ability to independently and accurately assess and evaluate themselves has been shown to be poor. Furthermore, physicians typically overestimate their compliance with quality standards."

Do you agree or disagree, why?

I do agree. I think this statement applies to human beings in general. Unless, we learn how to self-reflect and seek feedback, we are unable to examine ourselves and hence unable to assess our knowledge and skills. I think also that physicians who work in academic or teaching settings, are more likely to receive feedback that is helpful to increase their awareness of needs, than those who work in smaller community hospitals or solo practices.


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

Very interesting article.

Even if no solid data supports humor and laughter in relation to outcomes, I believe that being able to share a joke with your patients when appropriate or even sharing your own funny story helps a lot. In my mind it helps the patient feel that we are also Humans, patients will be more willing to share their experiences and creates a more relaxed atmosphere.

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