"All the boards decided to move toward a program where you didn't have the credential for life, one which had ongoing expectations for physicians to keep up to date during their practice careers, to maintain knowledge, and take on various other responsibilities that frankly, 20 years ago, physicians didn't have," Baron says.
Waited 'Til The Last Minute
"The board had an expectation that doctors would keep up continuously over each 10 year period, but most waited until year 8.5 and then did what was meant to be 10 years worth of programs in 1.5 years," Baron says. "They complained. 'Boy, it's so demanding all these things you're making us do and we don't have time.' "
So the ABIM put its foot down, saying that by January, 2014, doctors would have to satisfy certain performance and education criteria in a series of cycles rather than procrastinate until the last few months to do it all.
ABIM says it is listening to the doctors, and Baron issued this response to the petition in April. But so far, it is not about to budge, Baron says.
Much of the objection is coming from older doctors whose training did not include measuring and improving performance "as a core part of what you do as a doctor. And now, knowledge and expectations for what a doctor should do are changing."
Baron says that in the last 10 years, studies show enormous gaps between what doctors think they do and what they actually do for their patients, and that's why chart review is now being required to assess care.