Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.

Friday, February 19, 2016

Tequila MOC-kingbird

First, sorry about my prolonged absence. I've been writing an article for Carlat, and it's taking up all my time.

Second, sorry about the title. I'm pretty sure I saw a cocktail called, "Tequila Mockingbird" on some restaurant menu, but I can't remember where. And then an MOC topic came up, so.*

Got this email today:


February 18, 2016, Buffalo Grove, Illinois --- The American Board of Psychiatry and Neurology, Inc. (ABPN) has expanded the options for diplomates for their one required Improvement in Medical Practice (PIP) activity every three years to include any Clinical Module OR Feedback Module activity listed on the ABPN website.

Effective immediately, this development now gives diplomates more flexibility with the Part IV requirement for their maintenance of board certification.

The ABPN Improvement in Medical Practice Unit is a quality improvement exercise designed to identify and implement areas for improvement based on the review of one’s own patient charts (Clinical Module), involvement in personal or institutional quality improvement activities, or feedback from peers or patients via a questionnaire/survey (Feedback Module).

“These additional options for fulfilling the requirements of MOC Part IV recognize the importance of patient and/or peer feedback to the process of physician quality improvement, and it should also make it easier for many ABPN diplomates to document their quality improvement activities,” said Larry R. Faulkner, MD, ABPN President and CEO.

More details, including full option lists for both the Clinical and Feedback Module activities, are available on the ABPN website.

Reading this evoked a kind of comical fury in me. The ABPN is stooping pretty low, but it just won't bow to the pressure to remove Part IV. In case you've forgotten, and who wouldn't want to, there's lots of controversy about the Part IV Performance in Practice (PIP) modules, which you often need to pay for, and which have not been demonstrated to do anything but raise blood pressure. The American Board of Internal Medicine (ABIM) caved to its protesting diplomates, suspending Part IV until 2018. But the ABPN did not.

If the Board thinks PIP is so valuable, why agree to make it an either/or with a form that any diplomate can fill out five times by herself, asking her friends for their approval and signatures, in exchange for her own?

I checked out the ABPN products list page, and after a click or two, I got this:

The bottom part scrolls to more options, and it's almost this difficult to read. The important column here is, "PIP F", the feedback modules. It took me a little while to find the right one. There were a couple "page not available" dead ends, as well as ones that didn't apply, like the adolescent feedback and patient forms. I've discussed my thoughts about patient feedback forms elsewhere.

The main form you need, if you're willing to be the ABPN's bitch and do this, is the ABPN's Peer Feedback Form (NOT the AACAP's form, which gets you a description of MOC). It gives you a 1-6 Likert scale in six areas:

Patient Care
Medical Knowledge
Interpersonal and Communication Skills
Practice-Based Learning and Improvement
Systems-Based Practice

'Nuff said.

I had already decided to wait to see if the ABPN makes any concessions about Part IV and the meaningless, expensive recertification exam that exists to pay ABPN salaries, to decide if I want to bother re-certifying again, or to fulfill any of the requirements other than CME. I'm taking this concession as a sign that I should keep waiting.

* I just Googled "Tequila Mockingbird", and I got a link to this book:

Maybe I saw it in a bookstore? The drinks have names like, "Last of the Mojitos", "One Hundred Beers of Solitude", and, "The Rye in the Catcher". It looks like fun.