First, the ABR has been having their retreats at 'expensive' locations for many years now, not just since the implementation of MOC. im sure their budget accounts for this...and that they did not implement all these charges just for their working conference. also, if you know anyone in the abr, they routinely work for 12-15 hours/day...its not just for fun, like many other conferences are.
second, organizations offer SAMs for no charge if you are a member of their organization, like the RSNA. also, SAM's count as CME, depending on the sponsoring organization. True, state licenses do require CME's...but many do not check up on them, and only audit a percentage of their license holders.
PQI is a joke? what is a joke is that only 69% of patients in ASCO's QOPI had pain recorded in the patients last visit before death or that only 92% (not 100%) had chemotherapy consent in the chart. not only will PQI improve quality, but it provides physicians some method of identifying medico-legal liabilities. MOC was just implemented in the past 2 years, and it will take time for PQI to catch up with it.
pqi can take the following formats, and this is what is being proposed by the abr for type 1 pqi:
Proposed Type 1 project-National Protocol Enrollment. A Type 1 project is envisioned for physicians enrolling patients on national protocols in which central quality assessment of radiotherapy includes feedback to the individual or department.
Proposed Type 1 project-Prostate Implants: Postimplant Dosimteric Assessment. A second Type 1 PQI example has been suggested by the American Brachytherapy Society (ABS) related to permanent source prostate brachytherapy
Proposed Type 1 project-retrospective review. A third Type 1 project might focus on a retrospective review of treatment policies and/or outcomes related to a practitioner's practice in a specific disease setting
Type 2 pqi compares a treating physicians record with that of evidence-based guidelines, consensus statements, or peer comparisons.
yes MOC is a pain in the arse. yes it is expensive. yes it may not make complete sense to people. but can you put a price tag on treating a patient properly? or a future lawsuit that may arise from improper documentation or treatment?
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Radonc...I'm not trying to flame anyone here. Certainly, with your staunch defense, I have to believe in someway you are an ABR or former ABR rep.
Whether exquisite travel was built into the ABRs budget before or after MOC went into effect is irrelevant. The ABR should not be wasting it's members money on hotels that most of us would not stay in on a regular basis. Defense of that is like telling a government worker that a $10,000 plunger is ok - wasting of taxpayer dollars....or in this case, diplomate's dollars. Whether they work 12-15 hours or not, doesn't mean they should go to one of the most expensive places in this country for their retreat. Why bother if they are working so 'hard.' I've been to many COG, RTOG, CALGB meetings where I've worked 12 hour days on committees at 2nd rate hotels.
As for SAMs, why is it that ASTRO, of which I am a member, still makes me pay for SAMs.....if other societies are including this, perhaps ASTRO should as well.
As for PQI - sure it has a meaning, but I know hundreds of radoncs who basically think it is a joke (I hate to tell you you're more likely in the minority). While the intent is great, the reality of the busy work for those of us who are in practice seems a bit out of proportion. Sure an academician can use one of their residents retrospective reviews to do their PQI. As for our practice, we are active in ACR and I know this will count for one PQI, as does my national protocol enrollment. But the fact that the type 2 PQI is still vague, and no actual program is up and running is always a concern when the ABR is currently mandating this.
I am fortunate in that I am in a progressive practice, and prominent NCI cancer center where we are forced to constantly evaluate our practice for our patients and for our professional development, but if the ABR thinks I'm going to write up a written report so that no one can look at it, they're wrong - I don't believe in that busy work.
The MOC process is a reasonable one, but the ABR went full throtle, without examing the consequences of it, and with out examining how all the components would work. And it's not based on any validated model - just what some administrators thought would be a way to justify core principles in life long learning. Unfortunately, the MOC process will inconvenience many who already do what MOC is asking because a few old school practioners who don't keep up to date don't do (and incidentally are exempt from MOC).
Finally, the price............I still don't see the justification of where all the money is going. I'd love for the ABR to present this to all diplomates.....my hospital would this if a patient questioned the charges. I would think this process could be done for at least half the current ABR cost.
my 2 cents