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Remediation in Practicing Physicians: Current and Alternative Conceptualizations.

Gisèle Bourgeois-Law1, Pim W Teunissen, Glenn Regehr

  • 1G. Bourgeois-Law is clinical associate professor, Department of Obstetrics and Gynecology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada, and PhD candidate, School of Health Professions Education, Maastricht University, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0002-4726-3663. P.W. Teunissen is professor of medical education, School of Health Professions Education, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands, and gynecologist, Department of Obstetrics and Gynecology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands; ORCID: http://orcid.org/0000-0002-0930-0048. G. Regehr is professor, Department of Surgery, and associate director for research, Centre for Health Education Scholarship, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: https://orcid.org/0000-0002-3144-331X.

Academic Medicine : Journal of the Association of American Medical Colleges
|April 27, 2018
PubMed
Summary
This summary is machine-generated.

Physician remediation is a complex issue due to unclear definitions and lack of research. Reframing remediation as practice change support, rather than skill correction, may improve physician support and engagement.

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Area of Science:

  • Medical Education
  • Physician Performance
  • Professional Development

Background:

  • Suboptimal physician performance is a persistent challenge.
  • Current approaches to physician remediation lack clear definitions, research-backed practices, and consensus on institutional responsibility.
  • Logistical, political, and conceptual issues hinder meaningful engagement with physician remediation.

Purpose of the Study:

  • To examine current conceptualizations of physician remediation and the individuals undergoing it.
  • To explore how the culture of medicine influences these conceptualizations.
  • To assess the impact of these conceptions on the medical community's support for and engagement with physicians needing remediation.

Main Methods:

  • Literature review of medical education and related fields.
  • Analysis of conceptualizations of remediation and the physician being remediated.
  • Examination of the influence of medical culture on remediation practices.

Main Results:

  • Existing conceptualizations of remediation and the medical culture may impede effective support and engagement with physicians requiring remediation.
  • The medical community struggles to meaningfully address physician performance issues.
  • Professional autonomy is often prioritized over structured support for practice improvement.

Conclusions:

  • Rethinking remediation as a support for practice change, rather than solely addressing knowledge/skill gaps, offers a new research direction.
  • Effective physician remediation requires a shift in how struggling physicians are viewed.
  • A cultural change within medicine is needed to move beyond the premise of individual professional autonomy for practice improvement.