IMPLEMENTING ASSESSMENT OF PRACTICING PHYSICIANS: THE DEVELOPMENT AND BENEFITS OF A COLLABORATIVE MODEL

The Post-Licensure Assessment System of the Federation of State Medical Boards and the National Board of Medical Examiners has been evolving for nearly 10 years in its effort to develop a system of evaluation for practicing physicians. The development of such a system requires collaboration among a variety of assessment and educational institutions. To be credible, the system must be grounded in reliable and valid assessment tools, provide unbiased information about particular physician competencies, and be accepted by both licensing authorities and physicians. It also should provide feedback for planning remedial educational opportunities and be useful to physicians who wish to participate in continuing professional development. Assessments using the same standardized protocol addressing competence in medical knowledge, clinical reasoning, and patient management have been completed at three different sites for 79 physicians. Results show that when compared with non-certified physicians, certified physicians were twice as likely to achieve adequate levels of performance. In relation to licensure outcomes obtained for 53 physicians, of the 29 who performed in the less than adequate performance levels, eight remained in practice with restrictions and three returned to fully independent practice. All of the 24 whose performance was adequate were in practice. For nearly a decade, the Post-Licensure Assessment System (PLAS) has provided state licensing medical authorities information, in the form of objective assessment data, for use in making licensure decisions about physicians whose competence is in question. With membership of state licensing authorities changing, there are many representatives who may be unaware of the PLAS and the resources it offers now and for the future. This article first will briefly describe the origins and components of the PLAS and then focus on the initial years of work in the newer component, the Assessment Center Program. It will provide the rationale for a collaborative model of regional assessment programs and review the barriers to physician assessment. Then assessment data will be presented and discussed for its potential impact on licensure decisions. The article will conclude with plans for the future and the need to focus on how the educational recommendations resulting from assessments will contribute to the continuing professional development of physicians.