Influence of remedial professional development programs for poorly performing physicians.

Area of Science:

• Medical Education
• Physician Performance
• Quality Improvement

Background:

• The Collège des Médecins du Québec (CMQ) provides a remedial professional development program for physicians with clinical shortcomings.
• Physicians completing the program between 1993 and 2004 were evaluated using peer review.

Purpose of the Study:

• To measure the impact of the CMQ remedial professional development program on physician clinical performance.
• To assess changes in quality of care indicators before and after program participation.

Main Methods:

• A random selection of 30-50 patient records per physician was reviewed.
• Peer review ratings assessed record keeping, clinical investigation, diagnostic accuracy, and patient treatment/follow-up.
• The proportion of physicians with satisfactory ratings was compared pre- and post-program.

Main Results:

• Significant improvements (p < .05) were observed in satisfactory ratings for participating physicians (n=51).
• Record keeping improved from 20% to 54%.
• Clinical investigation plan improved from 13% to 59%.
• Diagnostic accuracy improved from 32% to 61%.
• Patient treatment and follow-up improved from 31% to 67%.

Conclusions:

• Participation in the CMQ remedial professional development program leads to enhanced clinical performance.
• Peer review is an effective method for assessing the impact of such programs.