Competence Assessment and Structured Educational Remediation: Long-Term Impact on the Quality of Care Provided by Disciplined Physicians

Abstract

Medical licensing boards use competence assessment and educational intervention programs as tools in disciplinary actions. Few studies measure the impact of these remedial interventions on the quality of care provided by participants after such interventions. CPEP, the Center for Personalized Education for Professionals, provides clinical competence assessment/educational intervention services and practice monitoring, primarily for physicians complying with board orders due to substandard care. Depending on the board requirements, some physicians complete an assessment/educational intervention and, after completion, subsequently undergo practice monitoring (Intervention Group). Others participate in the practice monitoring without first completing an assessment/educational intervention (Non-Intervention Group). CPEP conducted a retrospective study of chart reviews (n=2073) performed as part of each group’s participation in the Practice Monitoring Program. When compared to the charts from the Intervention Group, charts from the Non-Intervention Group were more than five times more likely to demonstrate care below standard (P < 0.0001) and almost four times more likely to have documentation issues that prohibited the monitor’s ability to determine the quality of care (P < 0.0001). This study suggests that completion of a competence assessment/education intervention program is an effective means of achieving acceptable quality of care that is sustained over time (average 18 months) after completion of the intervention.