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1.
Dermatol Online J ; 26(1)2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-32155020

RESUMO

Medical board organizations have accumulated large asset balances, in part due to the monetization of physician board recertification, as well as capital gains in positive investment conditions. Physicians across the country have raised concerns regarding the effectiveness and efficiency of existing recertification processes, to which the American Board of Medical Specialties and independent accreditation boards have responded with newly instituted changes. The present article analyzes the publicly available F990 tax forms of the medical boards in an effort to provide data to the ongoing debate. Although some boards have begun to mobilize assets in recent years, many continue to accumulate wealth. It remains to be seen whether the new recertification programs will bring about change or perpetuate organizational wealth.


Assuntos
Certificação/economia , Declarações Financeiras/tendências , Conselhos de Especialidade Profissional/economia , Acreditação/economia , Conselhos de Especialidade Profissional/organização & administração , Conselhos de Especialidade Profissional/tendências , Estados Unidos
3.
Dis Colon Rectum ; 63(2): 226-232, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31914115

RESUMO

BACKGROUND: Online physician rating Web sites are used by over half of consumers to select doctors. No studies have examined physician rating Web sites for colon and rectal surgeons. OBJECTIVE: The purpose of this study was to evaluate the accuracy and rating patterns of colon and rectal surgeons on the largest physician rating Web site. DESIGN: Physician characteristics and ratings were collected from a randomly selected sample of 500 from 3043 Healthgrades "colon and rectal surgery specialists." Board certifications were verified with the American Board of Surgery and American Board of Colon and Rectal Surgery Web sites. SETTINGS: Data acquisition was completed on July 18, 2018. PATIENTS: Patients were not directly studied. MAIN OUTCOME MEASURES: The primary outcome was to assess the accuracy of Healthgrades in reporting American Board of Surgery and American Board of Colon and Rectal Surgery certification. The secondary outcome was to identify factors associated with high star ratings. RESULTS: A total of 48 (9.6%) of the 500 sampled were incorrectly identified as practicing US surgeons and excluded from subsequent analysis. Healthgrades showed 80.1% agreement with verified board certifications for American Board of Surgery and 85.4% for American Board of Colon and Rectal Surgery. The mean star rating was 4.2 of 5.0 (SD = 0.9), and 77 (21.6%) had 5-star ratings. In a multivariable logistic model (p < 0.001), 5-star rating was associated with 1 to 9 years (OR = 2.76; p = 0.04) or >40 years in practice (OR = 3.35; p = 0.04) and fewer reviews (OR = 0.88; p < 0.001). There were no significant associations with surgeon sex, age, geographic region, or board certification. LIMITATIONS: Data were limited to a single physician rating Web site. CONCLUSIONS: In the modern age of healthcare consumerism, physician rating Web sites should be used with caution given inaccuracies. More accurate online resources are needed to inform patient decisions in the selection of specialized colon and rectal surgical care. See Video Abstract at http://links.lww.com/DCR/B91. PRECISIÓN DE DATOS Y PREDICTORES DE ALTAS CALIFICACIONES DE CIRUJANOS DE COLON Y RECTO EN UN SITIO WEB DE CALIFICACIÓN MÉDICA EN LÍNEA: Más de la mitad de los consumidores utilizan los sitios web de calificación de médicos en línea para seleccionar médicos. Ningún estudio ha examinado los sitios web de calificación de médicos para cirujanos de colon y recto.Evaluar la precisión y los patrones de calificación de los cirujanos de colon y recto en el sitio web más grande de calificación de médicos.Las características y calificaciones de los médicos se obtuvieron de una muestra seleccionada al azar de 500 de 3,043 "especialistas en cirugía de colon y recto" de Healthgrades. Las certificaciones del Consejo se verificaron en los sitios web del Consejo Americano de Cirugía y del Consejo Americano de Cirugía de Colon y Recto.La adquisición de datos se completó el 18 de julio de 2018.Los pacientes no fueron estudiados directamente.El resultado primario fue evaluar la precisión de Healthgrades al informar la certificación por el Consejo Americano de Cirugía y por el Consejo Americano de Cirugía de Colon y Recto. El resultado secundario fue identificar factores asociados con altas calificaciones en estrellas.Un total de 48 (9.6%) de la muestra de 500 fueron identificados incorrectamente como cirujanos practicantes de EE. UU. y excluidos del análisis subsecuente. Healthgrades mostró un 80.1% de concordancia con las certificaciones verificadas del Consejo Americano de Cirugía y el 85.4% con el Consejo Americano de Cirugía de Colon y Recto. La calificación promedio de estrellas fue 4.2 / 5 (SD 0.9), y 77 (21.6%) tuvieron calificaciones de 5 estrellas. En un modelo logístico multivariable (p <0.001), la calificación de 5 estrellas se asoció con 1-9 años (OR 2.76, p = 0.04) o más de 40 años en la práctica (OR 3.35, p = 0.04) y menos evaluaciones (OR 0.88, p <0.001). No hubo asociaciones significativas con el género, edad, región geográfica o certificación por los Consejos del cirujano.Los datos se limitaron a un solo sitio web de calificación de médicos.En la era moderna del consumismo en atención médica, los sitios web de calificación de los médicos deben usarse con precaución debido a imprecisiones. Se necesitan recursos en línea más precisos para que las decisiones de los pacientes sean informadas en la selección de atención quirúrgica especializada de colon y recto. Consulte Video Resumen en http://links.lww.com/DCR/B91. (Traducción-Dr. Jorge Silva-Velazco).


Assuntos
Colo/cirurgia , Sistemas On-Line/instrumentação , Reto/cirurgia , Cirurgiões/estatística & dados numéricos , Confiabilidade dos Dados , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Valor Preditivo dos Testes , Conselhos de Especialidade Profissional/organização & administração , Cirurgiões/organização & administração
4.
Br J Hosp Med (Lond) ; 80(12): 726-729, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31822167

RESUMO

The General Medical Council was originally set up to 'protect, promote and maintain the health and safety of the public'. In 2012, the Privy Council instructed the General Medical Council to set up and run a licensing and revalidation system for all practicing doctors in the UK, to protect patients from actions of medical staff. Despite this mandate, the General Medical Council has been a bystander in a series of regulatory failures. Without these episodes having been highlighted by family members, public investigations would not have been carried out. The maintenance of medical performance is delegated to NHS employers, which could cause conflicts of interests when employers have to investigate doctors as part of a team. The other responsibility of the General Medical Council is to monitor teaching standards and curricula of medical schools in the UK, which it does by eliciting feedback from students and trainees. The General Medical Council has not responded to 'new ways of working' (especially in England) involving non-medical staff undertaking tasks previously carried out by doctors. Furthermore, the General Medical Council has not updated its description of the role of the future doctor in light of increasing use of technology, use or non-use of which could both be considered to be evidence of poor practice.


Assuntos
Médicos , Conselhos de Especialidade Profissional/organização & administração , Competência Clínica/normas , Currículo , Educação Médica/normas , Humanos , Imperícia/legislação & jurisprudência , Conselhos de Especialidade Profissional/normas , Reino Unido
5.
Keio J Med ; 68(3): 68, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31554774

RESUMO

In contrast to many other countries, training of medical specialists is funded by the Department of Health. The curriculum of medical specialist training including general surgery is well structured and lasts 6 years. Specialist (trainers) and hospitals involved in surgical training have been accredited by the Dutch Association of Surgeons. Surgical training includes 4 years of general surgery followed by two years of differentiation in one of the sub-specialities. These are gastrointestinal, oncological, vascular, pediatric and trauma surgery. The training program is competency based: there are key procedures and so called EPA (entrusted professional activities) that are defined to monitor the progress of an individual. Unique in the Dutch system is the quality control and governance of surgical training that will be discussed in my lecture.The number of positions available for surgical trainees is limited and determined by the government each year. Hence, to enter surgical training has always been very competitive and not easy for young doctors. This is one of the reasons why many students start a PhD program after medical school and to gain experience in basic or clinical research. These young and talented students usually work for 3-4 years full time and are well capable of coordinating trials. This is just one of the reasons that many clinical (randomised) studies come from the Netherlands. Besides this strong academic environment, lack of private practice, strong multidisciplinary working parties and the geographical situation in our small country facilitates multicenter studies. Some more crucial factors for success will be discussed in the lecture.(Presented at the 1983th Meeting, July 10, 2019).


Assuntos
Educação de Pós-Graduação em Medicina/organização & administração , Especialidades Cirúrgicas/organização & administração , Cirurgiões/organização & administração , Competência Clínica/normas , Currículo , Humanos , Países Baixos , Controle de Qualidade , Especialidades Cirúrgicas/educação , Conselhos de Especialidade Profissional/organização & administração , Cirurgiões/educação
6.
Pap. psicol ; 40(1): 21-30, ene.-abr. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-181995

RESUMO

El cuestionario para la Evaluación de los Tests (CET; Prieto y Muñiz, 2000) y su revisión (CET-R; Hernández et al., 2016) se han venido aplicando sistemáticamente desde 2010, impulsado por la Comisión de tests del Consejo General de la Psicología del Colegio Oficial de Psicólogos. El objetivo es proporcionar información contrastada sobre la calidad de las pruebas a los profesionales, con el fin de mejorar el uso de los tests. El presente trabajo tiene un doble objetivo. El primero, presentar los resultados de la sexta evaluación de tests psicológicos y educativos, en la que se han revisado un total de 10 tests. El segundo, evaluar el impacto que la aplicación del CET/CET-R ha tenido durante estos años en dos agentes cruciales: las editoriales de tests, y los profesores universitarios encargados de formar a los futuros profesionales usuarios de tests. Los resultados de la sexta evaluación, así como los resultados de la encuesta para evaluar el impacto del CET/CET-R, se pueden considerar en general satisfactorios. Sin embargo, se identifican varios aspectos que son susceptibles de mejora


The Questionnaire for the Assessment of Tests (CET; Prieto & Muñiz, 2000) and the revised version of this questionnaire (CET-R; Hernández et al., 2016) have been applied systematically since 2010 by the Test Commission of the Spanish Psychological Association. The main goal is to provide practitioners with reliable information on the quality of the tests in order to improve test use. The aim of this paper is twofold. First, to present the results of the sixth review of psychological and educational tests, in which a total of 10 tests have been evaluated. Second, to assess the impact that the application of CET/CET-R has had over these years on two key agents: test publishers and university lecturers who are responsible for training future test users. Both the results of the sixth review and the results of the survey to assess the impact of CET/CET-R are satisfactory in general terms. However, some issues where there is room for improvement have been identified


Assuntos
Humanos , Testes Psicológicos , Psicometria/educação , Psicologia Educacional/métodos , Psicologia Educacional/organização & administração , Docentes/estatística & dados numéricos , Inquéritos e Questionários , Conselhos de Especialidade Profissional/organização & administração , Conselhos de Especialidade Profissional/normas , Editoração/estatística & dados numéricos , Psicologia Educacional/estatística & dados numéricos
7.
Reumatol. clín. (Barc.) ; 15(2): 97-101, mar.-abr. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184356

RESUMO

Introducción: El Consejo Mexicano de Reumatología certifica anualmente reumatólogos mediante una prueba teórica y un examen clínico objetivo estructurado (ECOE). Desde el año 2015, se evalúan las habilidades de comunicación (HC) de los candidatos. Los objetivos fueron comparar las HC evaluadas por el paciente (HCP) y por el médico (HCM) y correlacionarlas con el desempeño de los candidatos en el ECOE. Material y métodos: Durante los años 2015, 2016 y 2017, se evaluaron las HC en las estaciones dinámicas, mediante una escala de Likert aplicada a 8 áreas. Pacientes y evaluadores fueron entrenados cada año para calificar a los aspirantes, lo cual se realizó el día del ECOE, de manera ciega, por ambos. Se calcularon coeficientes de correlación de Pearson. Resultados: En general, a lo largo de los 3años, los candidatos obtuvieron puntajes altos en las HC. Los pacientes puntuaron mejor a los candidatos que los evaluadores médicos. Las HCP y las HCM correlacionaron entre sí (de leve a moderado) en la mayoría de las estaciones. El puntaje de las HC de cada candidato correlacionó con su desempeño en la estación correspondiente; se encontraron mejores correlaciones con las HCP. El promedio de las HC de cada candidato correlacionó con el desempeño global en el ECOE, pero no así con la prueba teórica (salvo en el año 2017, cuando hubo una correlación baja). Conclusiones: Las HC evaluadas durante un examen de certificación en Reumatología correlacionan con el desempeño de cada candidato en cada estación y en el ECOE global


Background: The Mexican Accreditation Council for Rheumatology annually certifies trainees in Rheumatology using a multiple-choice test and an objective structured clinical examination (OSCE). Since 2015, candidate's communication skills (CS) have been rated by both patients and by physician examiners and correlated with results on the OSCE. This study compared the CS from candidates to annual accreditation in Rheumatology as rated by patients and by physician examiners, and assessed whether these correlated with candidate's performance in the OSCE. Material and methods: From 2015 to 2017, 8areas of CS were evaluated using a Likert scale, in each OSCE station that involved a patient. Both patient and physician evaluators were trained annually and their evaluations were performed blindly. The associations were calculated using the Pearson correlation coefficient. Results: In general, candidates were given high CS scores; the scores from patients of the candidate's CS were better than those of physician examiners; within the majority of the stations, both scores were found to correlate moderately. In addition, the scoring of CS correlated with trainee performance at the corresponding OSCE station. Interestingly, better correlations were found when the skills were rated by the patients compared to physician scores. The average CS score was correlated with the overall OSCE performance for each trainee, but not with the multiple-choice test, except in the 2017 accreditation process, when a weak correlation was found. Conclusions: CS assessed during a national accreditation process correlated with the candidate's performance at the station level and with the overall OSCE


Assuntos
Humanos , Habilidades Sociais , Reumatologia/educação , Especialização/estatística & dados numéricos , Comunicação , Certificação/estatística & dados numéricos , Educação de Pós-Graduação em Medicina/organização & administração , Conselhos de Especialidade Profissional/organização & administração
10.
Acad Med ; 94(6): 847-852, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30768464

RESUMO

PURPOSE: Lack of specialty board certification has been reported as a significant physician-level predictor of receiving a disciplinary action from a state medical board. This study investigated the association between family physicians receiving a disciplinary action from a state medical board and certification by the American Board of Family Medicine (ABFM). METHOD: Three datasets were merged and a series of logistic regressions were conducted examining the relationship between certification status and disciplinary actions when adjusting for covariates. Data were available from 1976 to 2017. Predictor variables were gender, age, medical training degree type, medical school location, and the severity of the action. RESULTS: Of the family physicians in this sample, 95% (114,454/120,443) had never received any disciplinary action. Having ever been certified was associated with a reduced likelihood of ever receiving an action (odds ratio [OR] = 0.35; 95% confidence interval [CI] = 0.30, 0.40; P < .001), and having held a prior but not current certification at the time of the action was associated with an increase in receiving the most severe type of action (OR = 3.71; 95% CI = 2.24, 6.13; P < .001). CONCLUSIONS: Disciplinary actions are uncommon events. Family physicians who had ever been ABFM certified were less likely to receive an action. The most severe actions were associated with decreased odds of being board certified at the time of the action. Receiving the most severe action type increased the likelihood of physicians holding a prior but not current certification.


Assuntos
Disciplina no Trabalho/estatística & dados numéricos , Médicos de Família/educação , Conselhos de Especialidade Profissional/organização & administração , Adulto , Certificação , Competência Clínica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Faculdades de Medicina , Estados Unidos
12.
J Am Board Fam Med ; 32(1): 79-88, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30610145

RESUMO

INTRODUCTION: Maintenance of Certification (MOC) was implemented to help physicians remain current with evolving medical standards, but has been criticized for being irrelevant to practice. We assessed family physicians' (FPs') opinions about the content of American Board of Family Medicine (ABFM) self-assessment modules (SAMs). METHODS: We used ABFM administrative data from feedback surveys completed after each of the 16 SAMs from 2006 to 2016. FPs rated agreement with 2 statements-1) "Content is appropriate for my practice," and 2) "Content was presented at an appropriate level"-on a scale of 1 (strongly disagree) to 6 (strongly agree). We calculated mean ratings of each statement by year and stratified by Knowledge Assessment (KA) and Clinical Simulation (CS) portions of the SAM. We plotted mean ratings by FPs' age at their first SAM completion and the total number of SAMs completed. RESULTS: SAMs were completed (n = 633,198) from 2006 to 2016 with 448,408 (71%) feedback surveys completed. The annual mean ratings of both statements varied little (less than 0.5) and were above 4.5 for all SAMs. CS ratings were consistently lower than KA ratings. FPs of all ages at first SAM provided similar ratings and agreement with content appropriateness increased with repeated exposure to SAMs. CONCLUSION: Over 11 years, the content of ABFM SAMs was regarded by FPs as appropriate for practice and presented at an appropriate level. Continued monitoring of feedback is necessary to keep the content of MOC programs relevant for physicians' practice.


Assuntos
Medicina de Família e Comunidade/organização & administração , Médicos de Família/organização & administração , Autoavaliação , Sociedades Médicas/organização & administração , Conselhos de Especialidade Profissional/organização & administração , Adulto , Competência Clínica/estatística & dados numéricos , Medicina de Família e Comunidade/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Conselhos de Especialidade Profissional/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos
13.
J Am Board Fam Med ; 32(1): 89-95, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30610146

RESUMO

BACKGROUND: Medical certifying boards' core mission is assuring the public that Diplomates have the requisite knowledge, skills, and professional character to provide high-quality medical care. By understanding their Diplomates' workforce and practice environments, Boards ensure that certification is relevant to the profession and accountable to the public. Current and reliable data are key to meeting this function. The objective of this article was to describe American Board of Family Medicine (ABFM) data collection procedures and demonstrate the capacity to compare cohorts by examination year. METHODS: We used data from ABFM examination application practice demographic questionnaires from 2013 to 2016. Descriptive and bivariate statistics assessed variation in Diplomate and certification candidate characteristics across examination cohorts. RESULTS: From 2013 to 2016, 55,532 family physicians applied for either initial certification (n = 15,388) or to continue their certification (n = 40,144). Diplomate characteristics varied slightly from year to year with more International Medical Graduates and fewer men in later cohorts but, these differences were not large between cohorts. Initial certification candidates were more likely to be women, and racial or ethnic minorities than Diplomates seeking to continue their certification, and each year's cohort was characterized by increasing numbers of female and US medical graduates. DISCUSSION: Data collected from Diplomates as part of examination registration have proved invaluable to serving the mission of the ABFM and advancing knowledge about the specialty of family medicine. Continued refinement of data collection to enhance data reliability and usefulness, while reducing collection burden, will continue.


Assuntos
Coleta de Dados/métodos , Medicina de Família e Comunidade/organização & administração , Médicos de Família/organização & administração , Melhoria de Qualidade , Conselhos de Especialidade Profissional/organização & administração , Adulto , Competência Clínica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estados Unidos
15.
Laryngoscope ; 129(9): 2031-2035, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30548863

RESUMO

OBJECTIVES: To determine the proportion and relative advancement of women in leadership positions at high-impact otolaryngology journals. METHODS: Nine clinical otolaryngology journals were selected based on high impact factor and subspecialty representation (journal impact factor, 2016: 1.16-2.95). The proportion of women editorial board members associate and/or section editors, and/or editor-in-chief was measured from 1997 to 2017. Comparisons were made to the proportion of women otolaryngology faculty at U.S. medical schools in 2017. RESULTS: From 1997 to 2017, female editorial board membership increased from 7.2% (range: 0.0%-12.8%) to 17.7% (range: 10.9%-38.9%) (P = 0.0001). In 2017, the proportion of female editorial board members was significantly less than the proportion of female academic otolaryngology faculty (17.7% vs. 27.7%, P = 0.0001), and there was threefold variation between journals. From 1997 to 2017, the proportion of female associate and/or section editors increased from 9.3% (range: 0.0-27.3) to 20.9% (range: 5.3% to 45.5%) (P = 0.09). In 2017, the proportion of female associate and/or section editors was not significantly different than the proportion of female associate or full professor academic otolaryngology faculty (20.9% vs. 19.5%, P = 0.73), but there was ninefold variation between journals. CONCLUSION: Women were underrepresented on eight of nine otolaryngology editorial boards but appropriately represented at the associate and/or section editorship level. There was remarkable variation in representation at individual journals, which may provide future opportunities to examine best practices. Disparity exists in leadership at the most senior level of these high-profile otolaryngology journals: none had women editor-in-chiefs. LEVEL OF EVIDENCE: NA Laryngoscope, 129:2031-2035, 2019.


Assuntos
Liderança , Otolaringologia/organização & administração , Publicações Periódicas como Assunto/tendências , Médicas/tendências , Conselhos de Especialidade Profissional/organização & administração , Feminino , Humanos
18.
J Natl Compr Canc Netw ; 16(10): 1209-1215, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30323091

RESUMO

Background: Tumor board conferences (TBCs) are used by oncologic specialists to review patient cases, exchange knowledge, and discuss options for cancer management. These multidisciplinary meetings are often a cornerstone of treatment at leading cancer centers and are required for accreditation by certain groups, such as the American College of Surgeons' Commission on Cancer. Little is known regarding skin cancer TBCs. The objective of this study was to characterize the structure, function, and impact of existing skin cancer TBCs in the United States. Methods: A cross-sectional online survey was administered to physician leaders of skin cancer TBCs at NCI-designated Comprehensive and Clinical Cancer Centers. Results: Of the 59 centers successfully contacted, 14 (24%) reported not having a conference where skin cancer cases were discussed, and 45 (76%) identified 53 physician leaders. A total of 38 physicians (72%) completed the survey. Half of the meeting leaders were medical and/or surgical oncologists, and dermatologists led one-third of meetings. TBCs had a moderate to significant impact on patient care according to 97% of respondents. All respondents indicated that the meetings enhanced communication among physicians and provided an opportunity for involved specialists and professionals to discuss cases. The most frequently cited barrier to organizing TBCs was determining a common available date and time for attendees (62%). The most common suggestion for improvement was to increase attendance, specialists, and/or motivation. Conclusions: Results showed overall consistency in meeting structure but variability in function, which may be a reflection of institutional resources and investment in the conference. Future directions include defining metrics to evaluate changes in diagnosis or management plan after tumor board discussion, attendance, clinical trial enrollment, and cost analysis. Results of this survey may aid other institutions striving to develop and refine skin cancer TBCs.


Assuntos
Institutos de Câncer/organização & administração , Oncologia/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Neoplasias Cutâneas/terapia , Conselhos de Especialidade Profissional/estatística & dados numéricos , Institutos de Câncer/estatística & dados numéricos , Congressos como Assunto , Humanos , Oncologia/estatística & dados numéricos , Equipe de Assistência ao Paciente/estatística & dados numéricos , Neoplasias Cutâneas/diagnóstico , Sociedades Médicas , Conselhos de Especialidade Profissional/organização & administração , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos
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