News of Interest

The Secure Exam and Its Impact on Quality of Care

In the January 23, 2008 issue of JAMA, Eric S. Holmboe, MD; Rebecca Lipner, PhD; and Ann Greiner, MCP address how medical knowledge impacts the quality of care and what part the secure examination component of specialty board certification plays in improving the quality of health care in a commentary entitled, “Assessing Quality of Care: Knowledge Matters.” Research suggests that clinical skills tend to decline over time, and older physicians may rely too heavily on nonanalytic thinking. According to the ABIM authors, “Secure examinations of medical knowledge and clinical judgment can provide an effective means to assess whether physicians have incorporated new knowledge over time. This is one reason an examination is a required part of maintenance of certification programs.” Additionally, the authors cite evidence linking board certification examinations to improved quality of care in studies showing decreased mortality rates in patients treated by board-certified physicians. Medical specialty boards and others should continue to research and build evidence on the importance of medical knowledge as an essential component of the quality calculus. “Failure to do so,” say the authors, “will leave large gaps in the comprehensive performance measurement of patient care; knowledge matters to patients too.”

ABIM President Calls Health Care Crisis “A Perfect Storm”

On November 25, 2007, The New York Times published “The High Cost of Health Care,” an editorial overview of the various causes of and possible solutions to our nation’s health care crisis. ABIM’s President and CEO, Christine K. Cassel, MD, responded with a letter to the editor published December 1, calling the combination of the declining number of first-year residents in the primary care tract and the rising numbers of chronically-ill Americans ‘a perfect storm.’ She concludes, “So while I applaud you and the candidates for president who are including primary care in their health care plans, it is important to recognize that if we don’t have the … professionals who can deliver that care, the plans won’t succeed.”