News: Do recertification exams improve quality of care?

Results of a recent study suggest that physicians with higher cognitive skills, demonstrated by higher scores on a maintenance of certification (MOC) examination, provide better quality of care than physicians with lesser cognitive skills. Although the investigation, reported in Archives of Internal Medicine (07/2008), was for internists, ob/gyns may well wonder if its findings apply to them, as well.

Investigators linked about 3,600 physicians who completed the internal medicine MOC program during a 5-year period to about 220,000 Medicare beneficiaries. They then examined performance on five claims-based process-of-care measures: three for patients with diabetes, mammography screening for women, and lipid testing for patients with cardiovascular disease. Scores on the MOC examination correlated with the likelihood of performing all three diabetes processes of care as well as mammography screening. Although the performance of lipid testing was the one measure that was not significantly associated with MOC scores, investigators noted that nearly 60% of patients with cardiac disease were also under the care of a cardiologist, mitigating the influence of the general internist.

Foreign medical school graduates, older physicians, and solo practitioners had lower examination scores and lower performance quality scores.