Assessment of the practicing physician: challenges and opportunities

Despite spending a substantial amount of time in structured educational settings during early medical training, most physicians will spend the majority of their career in clinical practice. In the clinical practice setting, physicians become responsible for determining and implementing their own educational program in order to maintain, at a minimum, competence. Pressure to change the nature of continuing medical education (CME) parallels pressure from patients, payers, and policymakers to hold individual physicians more accountable for the care they provide. How can these two forces be brought together more deliberately and effectively? Comprehensive physician assessment provides such an opportunity with the potential to benefit all parties involved in health care, especially patients and physicians.Many assessment methods and tools exist today that can facilitate the integration of CME and quality. Using a multifaceted physician-level performance assessment system has substantial potential to align the public's need and desire to ensure their physician is competent, at a minimum, with providing the physician with meaningful, actionable information and data to improve performance and engage in transformative learning. CME programs need to incorporate more robust assessment as part of the learning activity to facilitate improvements in health care more directly.