This web site is documentation from the fourth in a series of Summit's with participants from throughout the healthcare system (to see an overview of all Summits click here). The question underlying this ongoing dialog is:
How does the healthcare community determine, measure, and assure the public concerning physician competence over the entire career of the physician?

The first Summit in March 2005 (see the documentation from that Summit here) focused on developing a set of scenarios of the future of healthcare over the next 15 to 20 years. Participants in this Summit ultimately developed 5 different scenarios. These scenarios were then distributed to the participating organizations as a discussion tool - as a way for engaging people in a conversation about the future of healthcare in which some system for determining, measuring and assuring physician competence would exist in. 

The second Summit in December 2005 (see the documentation from that Summit here) immersed the participants into these scenarios again as they began to look at the implications of these various future states on specific stakeholder groups, including patients/the public, payers, physicians, Health Systems, and Medical Education. The participants then began looking at various ways physician competence might be determined, measured and assured in each of these five different possible future states.

This lead to a dialog about defining what competence is, and what a good doctor is which resulted in several iterations of a statement of competence and a first draft of a table of contents for a document tentatively titled, Good Medical Practice. In addition, participants developed the idea of creating a new organization called, the Alliance for Physician Competence and ended with a strong sense of urgency among all the participants to move toward the establishment of a new organizational entity that would carry the competence issue forward as a multi-stakeholder organization.

In the third Summit, participants used the idea of forming a National Alliance as well as the development of a Good Medical Practice documents as the catalyst for most of the conversations. In this Summit participants used a wiki to craft a first draft of the contents of a Good Medical Practice document. This draft, along with many discussions about how something like a Good Medical Practice document might be used throughout the Healthcare System were the primary instigators for all the conversations and the group's work. One of the ideas that surfaced in this dialog was the idea of a trusted agent/portfolio system (a secure way of sharing data) that could be used throughout the medical system.

Between Summit III and Summit IV several work groups further developed some draft documents to be used as catalysts for conversations in the fourth Summit. A proposal for the formation of a National Alliance on Physician Competence, an outline for a Trusted Agent/Portfolio System could look like and a further iteration of the draft of the Good Medical Practice document, were completed prior to the Summit.

65 participants representing 42 different organizations convened in Tampa, Florida for Summit IV. Following a brief orientation to the work accomplished in the three prior Summits the group continued to explore how these 'products' being discussed might influence the way physician competence is determined, measured and assured.

In the Summit the group examined how a "continuum of competence" encompassing the system that includes Medical Schools, Residency Programs, Licensure, Specialty Certification, Credentialing and Privileging, the Accreditation of Institutions, and the long-term Maintenance of the physician's Competency throughout one's career might be impacted if something like a Good Medical Practice document and a Trusted Agent/Portfolio System were in use.

Then the group took a step back and looked at this entire initiative through the lens of what an ideal final result could be. That lead to the next conversation about gaps and contradictions in the current system that might be resolved if their ideal final result came to fruition.

Using the ideal final result and the gaps/contradictions as a backdrop the group then drove deeper into the conversations about a Good Medical Practice Document, a Trusted Agent/Portfolio System and the formation of a National Alliance for Physician Competence. At the same time several small groups began developing stories of how physicians might interact with these 'products' and also began exploring some ideas around how assessing competencies in the GMP might work.

At the end of this Summit participants decided to take the Good Medical Practice document through one more iteration of writing and editing before distributing this to get feedback from a broader constituent group. The group also decided to contiue to explore the formation of a National Alliance for Physician Competence but wanted to delay formalizing the organization while they take time to learn about the various options for an organizational structure. Several organizations are taking part in small pilot demonstrations to model the secure sharing of data and how something like a Trusted Agent/Portfolio system could work.

 
On behalf of all the co-sponsoring organizations, our sincere thanks to all the participants for their dedicated work throughout the session!  We made significant progress together on the vital issue, and we look forward to working with you all on the realization of this work.

We would like to acknowledge the following organizations for their contribution to making these Summits a success:

The Association of American Medical Colleges AARP Accreditation Council for Continuing Medical Education Accreditation Council for Graduate Medical Education American Board of Internal Medicine Foundation American Board of Medical Specialties American Medical Association American Osteopathic Association American Osteopathic Board of Emergency Medicine Association of American Medical Colleges Association for Hospital Medical Education Blue Cross/Blue Shield Association

Christiana Care Council of Medical Specialty Societies Crozer-Keystone Health System Educational Commission for Foreign Medical Graduates The Federation of State Medical Boards Iowa Board of Medical Examiners Michigan Board of Medicine National Board of Medical Examiners National Board of Osteopathic Medical Examiners Oregon Board of Medical Examiners The Robert Wood Johnson Foundation Texas A&M Health Science Center