ABOS peer review and case list: Understand modifications, importance
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In my last article, I discussed the American Board of Orthopaedic Surgery Maintenance of Certification (MOC) Program and the modifications the ABOS Board has made to that program.
Two parts of the Maintenance of Certification (MOC) program that have been around for years are often the ones that are most misunderstood: peer review and the case list. In this article, I will explain the importance of each of those ABOS MOC elements and touch on a way that you can help our profession.
When individuals submit an initial Board Certification application or Recertification application (now known as a Professional Standing Update), they are required to list the names and email addresses of practice partners, hospital chiefs in various departments and other orthopedic surgeons familiar with the applicant’s practice. The ABOS then emails an ABOS Peer Review questionnaire to each of those listed, asking questions about patient care skills, surgical skills, behavior and communication. In addition, the ABOS emails Diplomates who practice nearby — and who were not included on the Professional Standing Update — the same questionnaire.
If you receive this questionnaire — and you know the ABOS Candidate or ABOS Diplomate — please complete it fairly. It should take less than 2 minutes. It is important to our profession that we conduct peer review; we have been given the privilege to self-regulate and the ABOS Board believes that one of the most effective ways to do that is through peer review. This is an important way that you can assist the ABOS and move our profession forward.
For each ABOS Candidate or ABOS Diplomate who receives peer review evaluations that are less than expected, further evaluation is performed. That often includes individual interviews conducted by orthopedic surgeons to verify the feedback that is received. A report is prepared that is presented to the ABOS Credentials Committee that performs a complete review and decides next steps. The committee is made up of 12 ABOS Directors, 11 of whom are practicing orthopedic surgeons and one who is a public member of the ABOS Board.
The committee has several options:
- deferral;
- required oral examination;
- practice site visit;
- revocation; and
- allow to sit for the Diplomate’s examination of choice.
Peer review is critical to the ABOS MOC Program and allows the ABOS to ensure safe, ethical and effective orthopedic care for our patients.
Another critical portion of the ABOS MOC evaluation process is an evaluation of a surgeon’s cases. When applying for initial ABOS Board Certification, all ABOS Candidates submit a Case List of all cases from January to June of the year prior to their ABOS Part II Oral Examination. During Recertification, all Diplomates (except those who no longer perform surgery) are required to submit a case list of 35 to 75 surgical cases.
Every case list is evaluated for various outliers – if questions arise, a further investigation may be triggered. The outliers include never events, complication rates and procedures with questionable indications. The ABOS Candidate or ABOS Diplomate attests that the case list is accurate, and the medical records office of each hospital also provides a signature indicating that all cases have been included. Each ABOS Candidate or ABOS Diplomate is provided with a case list feedback report that offers norms and allows a comparison to peers.
During the years, the ABOS Board has streamlined the peer review and case list processes. These have become less burdensome while providing more information than even a few years ago. For 90 years, the ABOS has designed programs that protect the public and provide a meaningful experience to orthopedic surgeons.
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