Accreditation of physicians and LOK-GLEM Bart DE VOS Attaché
What? Continued medical education
Voluntary = Atypical Eg. Austria, France, Germany, Ireland, NL, UK, Greece, Italy, Poland, Sanctions: Financial sanctions Withdrawal / suspension of license
8 Le médecin généraliste agréé entretient et développe régulièrement ses connaissances, sa compétence et sa performance médicale de manière à pouvoir dispenser des soins de santé en médecine générale conformément aux données actuelles de la science. La preuve de l accréditation, organisée dans le cadre de l Institut national d assurance maladie invalidité, peut servir d élément de vérification. A défaut, le médecin lui-même apporte des éléments de vérification équivalents à 20 unités de formation continue par an, reconnues par la commission d agrément des médecins généralistes. -MD 1 mars 2010
Why? Name & fame Financial benefits Annuity of 600 Addition to doctor s fee
Non-Acc Acc GP 19,63 23,32 Specialist 19,61 23,32 Eg.GP 3000 contacts * 3,39 = 10.170
Conditions Recording and sharing of patient files; Decent prescription behaviour; Participation in projects of quality peer review; Minimal activity GP: 1.250 C/Y Sp: 13 h/w Education sensu stricto
Education 20 Credit point / period of 12 month 2 GLEM/LOK participations 3 CP in ethics & economics (1 CP = 1h)
LOK / GLEM Lokale kwaliteitskringen / Groupes Loucaux d Evaluation Médicale Meeting peers & exchanging practices 8-25 members [Obligation to organize 4 meetings a year; every member has to participate in 2]
Ethics & economics Idea: diminishing cost social security by better informed prescription behaviour. Eg. euthanasia, doctor-patient communication, legal issues, health care reform,
20 CP EU Comparison Compulsory CME Systems CP/y 150: Bulgaria 50: Austria, Germany, France, Hungary, Ireland, Italy, Latvia, Poland, Slovakia, UK 40: NL, Romania 20: Greece, CzeR Voluntary CME Systems CP/y 60: Estonia 50: Cyprus, Denmark 20: Belgium
Content Lectures Workshops E-learning Publications [6 CP first author, 2 CP second and third author] Excluded: reading medical journals, participating in ethical committees, jury s,
Effective? Traditional lecture-based CE has proven to be largely ineffective in changing health professionals performance and in improving patient care. Lecture formats are employed excessively in relation top their demonstrated value. Continuing Education in the Health Professions: Improving Healthcare Through Lifelong Learning, New York 2008, 18. What I hear I forget, what I see I remember, what I do I understand. Xunzi
Alternatives Interactive workshop Technical workshop Evaluation of practice Portfolio Etc.
How to Demand @ NIHDI Provisional accreditation: 1 year (starters,foreigners,...) [ No previous CME required, no minimal activity required*] Regular accreditation: 3 years End of career -accreditation: 1 or 3 years [No minimal activity required]
Participation Act. Tot Accr. Tot % Accr. GP 000-002 2.337 0 0 GP 003-004 14.162 9.798 69,19 GP 005-006 709 0 0 GP 007-009 726 0 0 Tot. GP 17.934 9.798 54,63 Tot. Spec 23.102 14.679 63,54 Tot. Spec + IT 26.917 14.679 54,53 Tot. 44.851 24.477 54,57 Neuropsychiatrists: 30% - Pulmonologists 81%
Budget Mil. / Y 2010 209,4 2009 213,3 2008 195,1 2007 147,4 2006 139,7
Administrative spine NIHDI [+-12 FTE] 29 Joint committees [1 for GP; 1 for each officially recognised specialty; 12 members representing the unions + 12 members representing universities and scientific organisations] 1 Accreditation Steering Group [12 members for the unions, 7 members for the universities and scientific organisations & 12 members for the health insurance funds] 1 Commission of Appeal [4 members professional syndicates, 4 members for the universities and scientific organisations & 4 members of the health insurance funds]
Procedure: Accreditation of individuals [NIHDI] [-> WG Accreditation Steering Group] -> Accreditation Steering Group -> Commission of Appeal -> Council of State ->.
Procedure: Accreditation of courses [NIHDI] -> 1 of the joint committees [or working group Ethics & economics] -> Accreditation Steering Group -> Council of State ->. = 1780 organisers; 998 organised 12629 activities in 2010. [Organisation = open to all but quality has to be guaranteed by a doctor with an NIDHI-number and restrictions are imposed on intervention by commercial firms] + Courses recognized by ACCME & EACCME