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Ming-Chen Final Essay

Page history last edited by Ming-Chen Hsieh 12 years, 7 months ago

Properly conceived and executed, regulation can both protect the public’s interest and support the ability of health care professionals and organizations to innovate and change to meet the needs of their patients.

–   Crossing the Quality Chasm, 2001


Firstly, the most obvious thing that I discovered was the advantage of working as part of a group. I learned that good teamwork is the key to success in study activities when time and resources are limited. As everyone had their own point of view, many different ideas could be produced and I found the energy of group participation made me feel more energetic about contributing something.

Secondly, I like all discussion sections, we challenged each other’s preconceptions about what agree and disagree, especially Bev, all your inspired, challenged, and stimulated comments! In this course, we known continued competence is a critical challenge for regulatory boards in the 21st century. It is time to address that challenge. This difference forced me to reflect on the aims of this course—I have made into the following inspiring ideas:


1. How can boards of medical be more effective in protecting the public?

Boards could be more proactive in providing the public assurance that practitioners continue to be safe years after completing education and first becoming licensed. In this time of unprecedented challenges and coping with new knowledge and advancements in technology knowing that at one point in time a doctor was qualified is not enough. Boards have a role in assuring the public that licensed doctors meet minimum standards of competence throughout their professional lives. It means their courses that directly relate to one of the following: patient care, community or public health, preventive medicine, quality assurance or improvement, risk management, health facility standards, the legal aspects of clinical medicine, bioethics, professional ethics, or improvement of the physician-patient relationship


2. Why should physicians have to do more to maintain competence?

They should have responsibility includes the duty to attain and maintain medical knowledge. Just as the board identifies the requirements for initial licensure, the board identifies the requirements to renew licensure. Currently, for most boards, even in Taiwan that means paying a fee and avoiding serious disciplinary action. Recertification to maintain licensure means the stakeholder would need to articulate credible and meaningful requirements for ongoing licensure.


Competence maintenance could include multiple elements, but should start with an assessment of the doctor’s practice to direct professional development activities. In 1995, in my country we also first articulated that learning strategies, such as continuing education, should be selected on the basis of assessment to identify learning needs.


3. What are activities and competences that have credibility with the public and are meaningful to doctors?

The public needs assurance that physicians have current knowledge and are safe practitioners. The doctor needs the incentive of value added to one’s career and practice. Accordingly, the public looks for requirements that demonstrate currency and ability to practice safely. Doctors would benefit from requirements that are relevant to the their practice, promote professional development and can be used to meet the multiple demands of employers, boards and others.


4. What are the essential components of an effective regulatory model for the maintenance of competence?

The Road Map to Continued Competence, ten principles:

1.         Using collaboration among a broad base of stakeholders

2.         For the purpose of quality

3.         Using evidence-based approaches

4.         That builds upon what works

5.         With a uniform definition of competence across all health field professions.

6.         It must be mandated to be successful.

7.         It must be a clinician responsibility that positively develops careers.

8.         The cost should be borne by health professionals, using licensing fees to pay for competency          


9.         Due process must be respected and balanced with the public’s right to know, 10. Licensing boards

            should have ultimate authority



Commitment to life-long learning is currently documented by participation in continuing medical educational activities.  We should further create an evaluation of performance in practice could be obtained through the use of practice performance information (such as surgical outcomes, mortality and morbidity statistics, peer evaluation) and medical simulators.

It is clear that many options are “on the table.” Which options or strategies will ultimately be selected is not yet apparent. But change will occur, and practicing physicians should be an integral part of the decision-making process.


Comments (2)

Bev Wood said

at 8:23 am on Oct 23, 2011

I am glad that you learned by working in a team. As medicine becomes more interprofessional, the importance of team skills and respect increase.
You are certainly correct that physicians (and all health professionals) must stay up to date with procedures, medical care, new knowledge, etc in order to deliver and direct excellent patient care. The public does expect that, though they do not always receive it. Part of being a professional is doing so.

Just a board certification is not ernough, and this is a responsibility to be taken on by all health care professionals. It is impossible to test and credential, no matter how one or a board refines what it is testing. I think a credential or certification is a stamp of approval, but it is up to us to maintain our standards.

elango.edhayan@... said

at 11:36 am on Oct 23, 2011

Nice work Ming-Chen. The Boards are becoming more relevant in the regulatory environmnet but are seen as over-reaching and out of touch with reality. For example, I do not practice Thoracic surgery. Why should I be tested on Thoracic surgery in my recertification exam. Also, the boards do a poor job of testing and verifying professionalism which is essentital for success.
If the board wants to retain relevance in the long term it will have to redefine its role and reach a partnership with local organizations. A combinantion of local and central evaluations that are continuous and relevant to the practicioner is what is needed.
I do agree with you on the need for physicians to have verifiable competence and the need to continuously improve as innovations come in.

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