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Continuing education for the premium surgeon: Is the glass half empty or half full?
It is the surgeon’s responsibility to maintain education at the highest level possible through the recertification process in order to achieve the outcomes patients expect.
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Some people see the glass half full, others see the glass half empty; the enlightened are simply grateful to have a glass, as quoted by Mark Desvaux. What does this mean exactly to the premium surgeon in the context of continuing education? It is our duty to our patients to maintain premium outcomes, and the only way we can stay cutting edge is through continual education.
Recertification
The American Board of Ophthalmology (ABO), as the nation’s oldest medical specialty certifying board, founded in 1916, is to serve the public by improving the quality of ophthalmic practice through a process of certification and Maintenance of Certification (MOC) that fosters excellence and encourages continual learning. The ABO is one of 24 medical specialty certifying boards recognized by the American Board of Medical Specialties. Every 10 years, a diplomate of the ABO must submit an average of 25 CME per year for a total of 250 hours of AMA PRA Category 1 credit obtained from Accreditation Council for Continuing Medical Education-accredited CME providers. At least 80% of the Category 1 CME credits must be relevant to the practice of ophthalmology, with the remainder of the CME credit hours allowed to be in general medicine. As of summer 2014, one of the CME activities must qualify as patient safety, available as a free online 2-hour patient safety module through the ABO’s website or by completing the NPSF Patient Safety Curriculum. The latter module focuses on medical errors, the Plan-Do-Study-Act improvement cycle and the Situation, Background, Assessment, Recommendation technique.
The MOC program has different certificate requirements based on whether your current ABO certificate expires on or before Dec. 31, 2020, or Dec. 31, 2021. Besides CME, which is more of the lifelong/self-assessment portion of ABO recertification, an assessment of professional standing in the state where you practice and cognitive expertise via the Practice Improvement Modules, Periodic Ophthalmic Review Tests and Demonstration of Ophthalmic Cognitive Knowledge examination are the remaining portions of recertification requirements. There is a MOC content outline provided free of charge to serve as a study tool for these recertification exams.
CME
CME is not offered when a program is considered promotional, as many pharmaceutical companies offer, for example, dinner programs delivered by an invited speaker very knowledgeable on the pharmaceutical agent being discussed. These programs still have to follow PhRMA and/or AdvaMed guidelines, the latter if a surgical device is being discussed, and must remain on label in their discussions. CME programs, on the other hand, can discuss off-label uses of a product but must be fair-balanced and discuss all other available products that can do a similar task within that category of discussion. For example, a CME program speaker must discuss all femtosecond laser technologies that perform capsulotomy when discussing his or her experience with a specific platform in a presentation. CME can be achieved through many of our national organizations, such as the American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, American College of Eye Surgeons and Society for Excellence in Eyecare, and state/local organizations, such as the Illinois Society of Eye Physicians and Surgeons in my practicing state. All of these organizations offer annual meetings, online courses, regional seminars and various written supplements in journals that provide for the necessary annual CME requirement.
State requirements and incentives
In addition to ABO recertification CME requirements, each state has its own CME requirements to maintain licensure to practice in that state. For example, in the state of Illinois as of October 2014, for an MD or DO, 150 CME credits are required over a 3-year period, of which 60 of those hours must be AMA PRA Category 1. This state requirement will automatically meet my ABO requirements if I stay on track. Some states, however, are not as stringent in CME requirement for licensure maintenance, so it is advisable for each premium surgeon to determine the specifics for his or her state.
Lastly, certain malpractice carriers provide premium discounts up to 5% to 10% annually or over a 2- to 3-year period with additional CME obtained on ethics and other practicing CME programs such as the informed consent process and how to reduce medical errors. Diplomates of the ABO can also achieve the Centers for Medicare and Medicaid Services Physician Quality Reporting System (PQRS) MOC extra 0.5% bonus incentive payment for 2014, and ABO diplomates can also participate in standard PQRS reporting for a 0.5% bonus incentive payment using PQRS reporting-enabled Practice Improvement Modules containing CME-approved ophthalmic measures.
In the end, it is the premium surgeon’s responsibility to maintain education at the highest level possible through this process of CME and ABO recertification in order to achieve the outcomes our patients expect. Personally, I have completed two rounds of recertification after my initial certification post-residency.
Stay tuned for next month’s Premium Channel column on electrophysiology and the impact VEP and PERG testing can have for the comprehensive ophthalmologist.
References:
American Board of Ophthalmology. www.abop.org.Mark Desvaux. www.4000saturdays.com.
For more information:
Mitchell A. Jackson, MD, can be reached at Jacksoneye, 300 N. Milwaukee Avenue, Suite L, Lake Villa, IL 60046; email: mjlaserdoc@msn.com.Disclosure: Jackson has no relevant financial disclosures.