What Do Certification Examinations Tell Us About Quality?

摘要

OVER THE PAST DECADE, EFFORTS TO MEA-sure, publicly report, and reward the performance of individual physicians have become commonplace. Stimulated by influential reports from the Institute of Medicine in 1999 and 2001 and a 2003 report by McGlynn et al highlighting the problems with quality of care in the United States, these performance measurement activities are increasingly being used to assess the competence of individual physicians and physician groups, with a focus on both the quality and the efficiency of care.Yet, ready availability of accurate and easily interpret-able information on the quality of care provided by individual physicians remains an elusive goal. Such information could be of substantial use both to patients in choosing high-quality physicians and to physicians and provider systems in implementing quality improvement and monitoring programs. To date, however, clinical and administrative measures often cover a small proportion of care and are not representative of the often complex decisions that physicians must make. Therefore, they are not optimal for comparative decision making