Posted by Phillipa on October 11, 2010, at 12:46:02
Seems the APA is going to require Pdocs and neurologists to do l0 year recertifications some based on self assessment. Good or bad? Phillipa
From Medscape Medical News
New Board Certification Requirements for Psychiatrists Are on the Way
APA says those recertifying in 2013 should start now to meet deadlines
Deborah BrauserAuthors and Disclosures
October 8, 2010 With an array of new certification requirements from the American Board of Psychiatry and Neurology (ABPN) looming, the American Psychiatric Association (APA) is offering checklists, extensive information, activity modules, and other tools to make sure psychiatrists understand and are well prepared for what lies ahead.
Designed to improve clinical practice and patient care, the new ABPN requirements could take up to 2 years to complete, which means psychiatrists recertifying in 2013 should start now to meet deadlines.
This new maintenance of certification (MOC) program will affect most US and Canadian psychiatrists. In addition to the traditional exam and continuing medical education (CME) requirements, psychiatrists will also now need to participate in sanctioned self-assessment performance activities and meet new performance in practice (PIP) components. Plus, the new time-limited certificates will need to be updated every 10 years.
According to a statement posted on the board's Web site, "ABPN has tried to develop a clear MOC program that will enable a diplomate to demonstrate their competence throughout a 10-year certificate cycle."
Further, the ABPN notes that many physicians "are already participating in various components of MOC through institutional or practice group quality improvement programs and the MOC program will try to recognize those efforts."
Although those board certified before 1994 have been awarded lifetime credentials and will not be forced to meet the new requirements, it is anticipated that Medicaid and many employers will offer incentives to get these physicians to voluntarily recertify. In addition, PIP modules may be applied toward maintenance of licensure requirements.
All good doctors have always been doing this. So, I really don't think this is going to be a terrible burden to them.
"All good doctors have always been doing this," APA's Director of Education and Career Development Deborah Hales, MD, associate clinical professor at George Washington School of Medicine in Washington, DC, told Medscape Medical News."So, I really don't think this is going to be a terrible burden to them. [MOC] just formalizes everything. I think the fact that it's required now is what makes people more anxious about what's coming and whether it means more paperwork," she added. "They're concerned it will feel like Big Brother more than it actually will be in reality."
New Self-Assessment Activities
Physicians will now be required to participate in at least 2 major broad-based self-assessment activities during the 10-year certification cycle. These learning activities are tailored to areas that need to be strengthened, based on self-identified perceived weaknesses. Clinicians will then need to develop quality improvement programs based on their clinical practice.
At least 8 of the CME credits per year will need to involve self-assessment. These new requirements will be slowly phased in, beginning in 2011.
Phase-In Schedule for Self-Assessment Activity Requirements
Original Year or Recertification Application Due Exam CME Credits Required First Self-Assessment Second Self-Assessment
2000 2009 2010 120
2001 2010 2011 150 X
2002 2011 2012 180 X
2003 2012 2013 210 X
2004 2013 2014 240 X X
2005 2014 2015 270 X X
2006 2015 2016 300 X X
2007 2016 2017 300 X X
2008 2017 2018 300 X X
2009 2018 2019 300 X X
2010 2019 2020 300 X X"The standards are changing in all of medicine," said Dr. Hales. "The self-awareness part of the MOC used to be a 100-question multiple choice exam covering the entire field of psychiatry, with a critique and references so people could see what they got wrong and have a way to learn about the areas where they were weaker.
Now that the requirements for self-assessment have been changed to 8 hours a year, we're developing smaller activities that can be done quickly and easily. It's not as painful as people think, and certainly not as painful as sitting down with 100 questions.
"Now that the requirements for self-assessment have been changed to 8 hours a year, we're developing smaller activities that can be done quickly and easily. It's not as painful as people think, and certainly not as painful as sitting down with 100 questions," she added. "However, those exams will still be accepted as a self-assessment activity until 2014."The APA's journal Focus, which is aimed at physicians who need to recertify, publishes an ABPN-approved 100-question self-assessment exam every year for subscribers.
In addition, e-Focus, the emailed version of the journal, sends out small interactive cases that let physicians choose between clinical options. Once they choose, a colored chart immediately comes up online showing how other physicians answered the questions. "Two weeks later, an expert discusses why each option might be better in this case or not. And we're going to make that into a self-assessment activity for our members also," said Dr. Hales.
The American College of Psychiatrists also puts out a self-assessment exam.
New PIP Requirements
The new PIP requirements will include the completion of chart review through a clinical module and second-party external feedback.
"You can choose your own 5 charts for review," explained Dr. Hales. "The ABPN asks you to choose them either by location, so you could pick hospitalized patients or 5 outpatients, or by diagnosis, so you could do 5 with major depressive disorder, etcetera. So there's a lot of flexibility for the individual physician."
She noted that physicians will then need to confirm that they have done a feedback activity with 5 patients and with 5 peers, "but none of the feedback activities will have to be submitted to anyone. It's private to the physician, who is supposed to use that information to improve practice."
PIP, similar to the self-assessment requirements, will be phased in slowly, and goes into effect in 2013.
Phase-In Schedule for Performance in Practice Requirements
Original Year or Recertification< Application Due First Unit Required Second Unit Required Third Unit Required
2000 2009
2001 2010
2002 2011
2003 2012
2004 2013 X
2005 2014 X
2006 2015 X X
2007 2016 X X X
2008 2017 X X X
2009 2018 X X X
2010 2019 X X XThe APA is preparing new modules to help their members in fulfilling the PIP portion of the MOC. Although they are not interactive yet, 2 PIP exercises are currently available for download on the APA Web site 1 on major depression and 1 on posttraumatic stress disorder.
"We're putting out these modules right now to get feedback from our members on what's going to be most useful and helpful and beneficial to them, as well as easy to complete," explained Dr. Hales. "They're available only for APA members, are free, and provide 5 hours of CME."
Four other modules are currently in development. "We're trying to make them even more streamlined and with quality measures that are expert consensus and readily understood by all psychiatrists," she noted.
Next Steps
The APA Web site also lists their other activities for MOC, including CME courses and practice guidelines, and includes an information section detailing the ABPN's current requirements.
In addition, the ABPN will accept transcripts for all CME activities automatically entered from the APA's online programs or at their annual meeting.
Physicians who are certified in both psychiatry and neurology will only need to meet the CME, self-assessment, and PIP requirements for 1 specialty. However, cognitive examinations will need to be taken and passed in both disciplines.
Psychiatrists with certificates in subspecialties (including addiction psychiatry, geriatric psychiatry, and pain medicine) must maintain their overall specialty certification. If it lapses, certification in the subspecialty is no longer valid.
However, child and adolescent psychiatrists do not need to maintain current certification in general psychiatry, just in their subspecialty.
The ABPN is currently developing a new online Physician Folio Web page, where participants will be able to log on to a secure site and keep a record of all completed MOC components. This will be especially helpful in case of an audit, which the board plans to conduct in almost 5% of applicants. Those chosen will receive a letter requesting specific documentation.
Dr. Hales suggested that psychiatrists who are facing recertification should first go to the APA and the ABPN Web sites and read up on "everything you need to know about MOC."
"APA is absolutely stepping up to make sure its members know what's coming. Our role, basically, is to provide useful activities that meet these new requirements so that our doctors can do it easily and not be burdened," she concluded.
A printable document detailing the new MOC program is available online. The list of APA activities also is available on the association's Web site.
[CLOSE WINDOW]
Authors and Disclosures
Journalist
Deborah Brauser
is a freelance writer for Medscape.Deborah Brauser has disclosed no relevant financial relationships.
poster:Phillipa
thread:965375
URL: http://www.dr-bob.org/babble/20101009/msgs/965375.html