What’s New in the Maintenance of Certification Program for Psychiatrists?

I can’t remember the last time I received an e-mail message from the American Board of Psychiatry and Neurology (ABPN), but I got one about the Maintenance of Certification (MOC) on July 7, 2011. I’ve posted a few times on this issue, and you can find the latest at shortlink http://wp.me/p1glcu-Eh. The challenge is to find a practical way to help psychiatrists not just maintain their skills but adopt habits of continuous improvement in the way we practice so that we provide high quality care to patients. I’m enthusiastic about the new program ABPN offers. It’s called the Continuous Pathway to Lifelong Learning Program (CPLLP). It will help psychiatrists track their MOC activities (the Physician Folio system) so that we always know what we need to collect to stay certified in our profession. The CPLLP will also charge an annual fee of $175 to cover the cost of collecting and storing data that will help document that modules are being completed toward maintaining certification and will also cover the cost of one MOC cognitive examination in a 10 year period.

The impression I have on first reading the message is that the CPLLP will mainly help us track our activities. However, it’s still not clear how we are to operationalize the gathering of the Performance in Practice (PIP) modules. For many of us the first PIP module will be due in 2014. A module consists of:

A) Clinical modules (Chart Review) that requires the diplomate to collect data from at least five patient cases in a specific category from personal practice over the previous 3-year period.

B) Feedback modules (Patient or Peer review) that requires the diplomate to solicit personal performance feedback from at least five peers and five patients over the previous 3 years. “Peers” could include psychologists, social workers, physicians, counselors, and nurses. There are model peer and patient feedback forms available from ABPN on the web site http://www.abpn.com/moc_products.asp.

Although I think the ABPN rollout of a new program for helping us collect and store data to document completion of modules needed to maintain certification is a step in the right direction. I’m still unsure about the PIP component.

Is is appropriate for the diplomate to solicit feedback from patients, or would it be preferable for a neutral third-party to do that? I’d like to think I’m unbiased enough not to cherry-pick–but I’m also realistic.

And who are the peers who would be in a best position to provide feedback to a consulting psychiatrist? What I see most of the time in the general hospital is delirium. There are established guidelines about evaluation and management of delirium. They’re not listed on the ABPN website, though. They do provide some guidance and resources.

I’m not so sure I want to continue maintaining certification in more than one specialty. Maintaining the Physician Folio for two or more specialties in addition to everything else I’m responsible for in an academic center sounds onerous.  I think it’s great that ABPN is providing the CPLLP which will help defray the cost of one cognitive exam, though.

I wonder if others out there are wondering the same things. I wonder if others have found solutions and would be willing to share them. These are my thoughts. How about yours?

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