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FP Report

For third consecutive year, AAFP Congress grapples with MC-FP issues

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"If you haven't done the SAMs, please do them. Give me some objective feedback," David Price, M.D., a member of the ABFP Board of Directors, told the delegates.

For the third year in a row, family physicians brought their concerns about the American Board of Family Practice's Maintenance of Certification Program for Family Physicians to the AAFP Congress of Delegates.  And for the third year in a row, the Academy will respond by urging the ABFP to modify its plans for implementing the MC-FP.

A flurry of resolutions considered by delegates Oct. 11 – 13 in Orlando, Fla., covered MC-FP-related issues -- from providing AAFP members more chance for input on MC-FP to calling for delayed implementation of some of its processes.

In testimony to a reference committee Oct. 12, many members recounted -- in great detail -- their experiences with portions of the process, most notably the self-assessment modules, or SAMs, that make up Part II of MC-FP.

District of Columbia alternate delegate Jeffrey Weinfield, M.D., of Silver Spring, Md., said he was currently working through one of the SAMs offered for 2004 and found it "extremely burdensome" in terms of both time and the computer resources needed to download and complete the associated forms.

"In my humble opinion, the product needs more user testing," Weinfield testified. He urged that members up for recertification be given the option of delaying at least that portion of the process until the problems could be addressed.

FP Russell Breish, M.D., of Philadelphia also spoke in favor of a delay to allow additional beta testing of the system. He said he's had to call ABFP for technical support numerous times while working through a SAM and has had difficulty getting his calls returned in a timely manner. He also noted that rather than taking the Web site down to work on it, for example, "at 3 o'clock on Monday morning, they take it down -- without sending an e-mail first to let you know it's down -- in the middle of the workday."

Delegates testified that information about MC-FP, its components and its processes has been inadequately communicated and that even today, some members are unaware of the new recertification requirements.

The Academy has taken numerous steps to address the communication issue, pointed out (then) Board Chair James Martin, M.D., of San Antonio, citing as an example a memorandum of understanding between the AAFP and ABFP signed last spring. That memo states, among other things, the two organizations are committed to a collaborative approach to discerning and responding to physicians' information needs about MC-FP.

Alain Montegut, M.D., of Portland, Maine, a former member of the AAFP Commission on Education and newly elected finalist for the AAFP seat on the ABFP Board of Directors, testified that both ABFP Executive Director James Puffer, M.D., and Deputy Executive Director Joseph Tollison, M.D., have become "regulars" at COE meetings. Communication between the two organizations continues to improve, he asserted.

Speaking on the floor of the Congress Oct. 13, Colorado delegate David Price, M.D., of Broomfield, a member of the ABFP Board of Directors, acknowledged that MC-FP is a work in progress but cautioned delegates not to, in effect, throw the baby out with the bath water. After all, he noted, the endpoint of MC-FP is to enhance patient care and outcomes.

 Price urged his FP colleagues in the Congress to try their hand at one of the ABFP's MC-FP Part II self-assessment modules and let him know -- personally -- their thoughts on how the process could be improved. "If you haven't done the SAMs, please do them. Give me some objective feedback," Price said, promising to take that feedback to the ABFP board.

On Oct. 13, delegates adopted two resolutions on MC-FP. The first resolution calls for the Academy to collaborate with the ABFP to develop a plan to educate members about "the process and importance" of MC-FP. The second directs the AAFP to urge the ABFP to suspend the SAMs as an MC-FP requirement "until technical and clinical problems are adequately resolved," to recommend that the ABFP develop a better beta-testing mechanism "to gather and disseminate evidence of effectiveness," and to "develop an alternative mechanism for those members who have unreliable access to the Internet."


FP Report is published by the AAFP News Department.
Copyright © 2004 by American Academy of Family Physicians.