Physicians react: IOM calls for more stringent recertification requirements

Some physicians have expressed concern over an Institute of Medicine report released in April that calls for licensed physicians to face more rigorous recertification requirements, according to Medical Economics (9/5/03). Some rank-and-file physicians are concerned that the new recommendations, if implemented, could translate into a heavier workload and more stress.

The IOM report, "Health Professions Education: A Bridge to Quality," recommends that physicians demonstrate five "core competencies." Namely, physicians and other providers should:

• provide patient-centered care;

• work in interdisciplinary teams to ensure continuous and reliable patient care;

• employ evidence-based practice;

• identify errors and hazards in care and implement safety design principles;

• use information technology to support the provider's practice.

With the IOM calling for state medical and certification boards—and also asking the Agency for Healthcare Research and Quality to require, or encourage, physicians to demonstrate their competence to practice—physicians are questioning the need. Physicians interviewed by Medical Economics, a sister publication of Contemporary Ob/Gyn, questioned how competence, and the core competencies, would be gauged, and whether the addition of new credentialing requirements would further overwhelm beleaguered physicians and add to the cost of health care.

While numerous questions have been raised, Edward M. Hundert, a psychiatrist and head of the IOM committee that made the recommendations, notes that integrating core competencies into oversight processes could take as long as 10 years and will require mechanisms for funding. Still, he is optimistic.

"The report isn't suggesting that we keep all the burdensome CME and recredentialing requirements we have now and add more," he told Medical Economics. "Rather, because medicine changes so rapidly, we need to begin a comprehensive reassessment of the whole process across the health professions."