Written By: Charlie Daschbach, MD, MPH and Dixie Swan
What could be more boring and mind-numbing than another CME article extolling the value of CME? How fast can we put you to sleep reminding you that Arizona requires 20 hours of ACCME / AMA PRA Category 1 credit or that CME should be tied to Quality Improvement? WAKE UP! Interesting changes ahead!
The Arizona Medical Association’s (ArMA) Committee on Accreditation is working with local CME Sponsors to pilot newer CME innovations that are of great interest to Arizona’s physicians:
Maintenance of Certification looms for most physicians and two ArMA providers are exploring how their CME Programs can help INDIVIDUALS with resources for an organized personal approach to MOC Preparation while awarding CME credit for their efforts. A confidential review of a physician’s strengths and weaknesses coupled with an individualized plan of efficient readings, expert prep tests and live / web courses, practice review, will take the anxiety from this cyclical requirement. A subsequent demonstration of clinical improvement is the ultimate goal and a global perspective on a physician’s clinical knowledge and practice can be further rewarding when a physician reflects on their career at the end of a long day.
The MOC program was well-intended as a robust component of ABIM recertification. In theory, it made a lot of sense. In practice, some feel that it has become an expensive aggravating data collecting with less-than intended help to improve practices. The ABIM lead their effort with a MOC program that has precipitated an avalanche of national criticism and organized resistance reaching into State legislatures (Texas and Tennessee) and the US Congress. Last fall the ABMS, ACCME, ACGME, and CMSS created a “Vision Commission” to re-brand MOC. Other Specialty Boards are wrestling with the same issues as Internal Medicine. How can they fashion an MOC program that avoids the pitfalls of the ABIM?
While national editorials and State Specialty Societies are railing at the bigger picture, ArMA’s Committee on Accreditation would like to assist at the most granular level. By assisting individual physicians to navigate MOC with a Personal MOC Plan, we can at the least lessen some of the anxiety and frustration that may interfere with the physician’s career satisfaction.
CME FOR TEACHING
With the AMA and AAMC’s initiative, the ACCME has opened up a new avenue for awarding CME Credit for physician teaching health science students and residents. Labeled “Learning From Teaching” this program recognizes the preparation for lecturing and office or bedside teaching. It recognizes that this noble effort is a valued component of the profession and that the preparation, execution, and evaluation of teaching students requires no less preparation than a Grand Rounds. This category of CME credit can also include test-writing, manuscript review and regularly teaching students on the wards or in your office.
The important element in this program is the documentation required. Templates can be used to simplify this process and can be modified for individual situations. As an example, you have medical students in your practice and their curriculum requires certain topics. You can work with the student for pre-assigned reading and discussion. You can also review individual ad hoc interesting cases and both prepare for a discussion. There are myriad possibilities, and, designing a good documentation template can lessen the paperwork required.
CME FOR COMMITTEE WORK
The ACCME has recognized that many physician meetings involve the kind of learning that often takes place in a format that in other settings would be considered formal CME. The best examples might include Quality Improvement, Resource Utilization, Ethics, and Patient Care Review meetings. If the learning that takes place in these meetings would also qualify as physician learning in another format, you can easily claim the meeting for CME credit.
CME is moving from a model of routine lectures of sometimes relevance to a more practical approach that honors a physician’s learning as we strive for better patient care, not just sitting through another lecture du jour.
ArMA’s Committee on Accreditation stands to catalyze these models at our local provider level. We welcome your input or membership this coming year. Please don’t hesitate to contact us with questions or a need to help you in these newer models.
Charlie Daschbach, MD, MPH
Dr. Daschbach serves as current Chair of the Committee on Accreditation. He is Emeritus Director of Academic Affairs at St. Joseph’s Hospital and past Board Chair of the ACCME. His medical education interests center on medical ethics, medical errors, teaching to the bottom half of the class, and what the ROI is per learning hour. He is semi-retired and thought growing old would take a lot longer.