Abstract
Background
The Medical Council in Ireland is currently implementing Competence Assurance Structures (CAS). Peer review has been proposed as a tool to measure physician competence.
Aims
To assess the attitudes of physicians working in the Irish healthcare system to a peer review programme of competence assurance priorto its implementation.
Methods
A postal survey was sent to all physicians in the Irish Medical Directory in November 2003. Nine questions were asked to gauge attitudes to peer review as a CA tool.The returned questionnaires were collated and data extracted based on responses.
Results
The response rate was 67%. The majority of respondents (92%) felt peer review would inform competence assurance in Ireland. Most physicians who were surveyed felt an on-site assessment (88%) every 5 years (87%) was the preferred method. Over 30% responded that there should be a financial incentive for completing a review, and 70% would pay to be assessed.The UK model of competence assurance was the model most physicians preferred for the Irish setting (42%).
Conclusion
The majority of physicians practising in Ireland would favour a peer review system of competence assurance.The financial implications, and structure, of such a system would need to be explored prior to implementation.
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References
Competence Assurance Structures-An Agenda for Implementation. Irish Medical Council, Dublin, March 2002.
Fox RD, Mazmanian PE, Putnam RW, eds. Change and learning in the lives of physicians. New York: Praegar, 1989.
Finucane PM, Bourgeois-Law GA, Ineson SL et al. A comparison of performance assessment programs for medical practitioners in Canada, Australia, New Zealand, and the United Kingdom.Acad Med. 2003;78(8):837–43. PMID: 12915380 [PubMed — indexed for MEDLINE]
Jamtvedt G, Young JM, Kristoffersen DT et al. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2003;(3):CD000259. Review. PMID: 12917891 [PubMed -indexed forMEDLINE]
Davis DA, Thomson MA, Oxman A et al. Changing physician performance. A systematic review of the effect of continuing medical education strategies.JAMA. 1995 6;274(9):700–5. PMID: 7650822 [PubMed — indexed for MEDLINE]
Olcott C IV, Mitchell RS, Steinberg GK, Zarins CK. Institutional peer review can reduce the risk and cost of carotid endarterectomy.Arch Surg. 2000; 135(8):939–42. PMID: 10922256 [PubMed — indexed for MEDLINE]
Balla M, Knothe B, Lancaster J, Prager S, Beatson J. Group peer review in psychiatry: the relationship to quality improvement and quality care.Aust N ZJ Psychiatry. 1996 Oct; 30(5):653–9. PMID: 8902172 [PubMed — indexed for MEDLINE]
http://www.medicalcouncil.ie/assurance/default.asp
McManus IC, Gordon D, Winder BC. Duties of a doctor: UK doctors and good medical practice.Qual Healthcare. 2000 Mar; 9(1):14–22. PMID: 10848365 [PubMed — indexed for MEDLINE]
McManus IC, Winder BC, Gordon D. UK doctors’ attitudes to the General Medical Council’s Performance Procedures, 1997–99.Med Educ. 2001 Dec; 35 Suppl 1:60–9. PMID: 11895256 [PubMed — indexed for MEDLINE]
Chambers R, Bowyer S, Campbell I. Investigation into the attitudes of general practitioners in Staffordshire to medical audit.Qual Healthcare. 1996 Mar; 5(1):13–9. PMID: 10157267 [PubMed — indexed for MEDLINE]
Norcini JJ. Peer assessment of competence.Aled Educ. 2003 Jun; 37(6):539–43. PMID: 12787377 [PubMed — indexed for MEDLINE]
Margo CE. Peer and expert opinion and the reliability of implicit case review.Ophthalmology. 2002 Mar; 109(3):614–8. PMID: 11874771 [PubMed — indexed for MEDLINE]
Ramsey PG, Wenrich MD, Carline JD, Inui TS, Larson EB, LoGerfo JP. Use of peer ratings to evaluate physician performance.JAMA. 1993 Apr 7; 269(13):1655–60. PMID: 8240483 [PubMed — indexed for MEDLINE]
Lewis M, Elwyn G, Wood F. Appraisal of family doctors: an evaluation study.Br J Gen Pract. 2003 Jun; 53(491): 454–60. PMID: 12939890 [PubMed — indexed for MEDLINE]
Hunter N. Actual CA cost 75 euro per doctor p.a., but real cost priceless, says Medical Council.Irish Medical News 2003; 20(33):1
CA Brown, CR Belfield, SJ Field. Cost effectiveness of continuing professional development in healthcare: a critical review of the evidence. BM/ 2002; 324:652–655 (16 March).
Lock P, McElroy B, Mackenzie M. The hidden cost of clinical audit a questionnaire study of NHS staff. Health Policy. 2000 Apr;51(3):181–90. PMID: 10720687 [PubMed -indexed for MEDLINE]
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Moss, A.C., Dugal, T. & Silke, B. Attitudes to peer review as a competence assurance structure — results of a survey of Irish physicians. Ir J Med Sci 174, 43–46 (2005). https://doi.org/10.1007/BF03169147
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DOI: https://doi.org/10.1007/BF03169147