The Institute of Medicine's reports and discussions on quality of medical
care have focused on a systems-based approach to quality improvement. Our
objective is to summarize evidence and theory about the role of a physician's
current board certification status in quality improvement. The first body
of evidence includes the validity of board certification demonstrated by the
testing process, the relationship of examination scores with other measures
of physician competence, and the relationship between certification status
and clinical outcomes. The second body of evidence involves the adaptation
of error prevention theory to medical care. Patient safety is enhanced when
problem-solving uses readily accessed habits of behavior, the same behavior
necessary to achieve board certification. The third body of evidence, obtained
through a Gallup poll, demonstrates that certification and maintenance of
certification are highly valued by the public. The majority of respondents
thought it important for physicians to be reevaluated on their qualifications
every few years and that physicians should do more to demonstrate ongoing
competence than is currently required by the profession. We conclude that
a physician's current certification status should be among the evidence-based
measures used in the quality movement.
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