Predictors of physician performance on competence assessment: Findings from CPEP, the Center for Personalized...

To identify factors associated with physician performance in a comprehensive competence assessment.

The authors conducted a retrospective analysis of 683 physicians referred for assessment at the Center for Personalized Education for Physicians from 2000 to 2010, who were evaluated as either safe or unsafe to return to practice. Multivariate logistic regression was used to determine factors predictive of unsafe assessment outcome. Covariates included personal characteristics (e.g., age), practice context (e.g., solo practice), and referral information (e.g., previous board license action).

Older physicians were more likely to have unsafe assessment outcomes (odds ratio [OR] = 1.07; P < .001). Board-certified individuals were less likely to have poor assessment outcomes (OR = 0.40; P = .003) than uncertified individuals. Physicians in solo practice were more likely (OR = 2.15; P = .037) to be deemed unsafe than physicians in other settings. Physicians with a practice scope that matched their training were less likely (OR = 0.29; P = .023) to have unsafe assessment outcomes than those whose did not. Physicians with current or previous board action (suspension, revocation, limitation, or stipulation) were more likely to be deemed unsafe (OR = 2.47; P = .003) than those without.

Findings suggest that important predictors of physician performance on competence assessment include personal characteristics, practice context, and reasons for assessment referral. These findings have implications for development of policies and programs designed to assess risk of poor physician performance and quality of care improvement efforts through organizational/practice design or remedial education.