1. Competency and Credentialing John Andazola, MD William Ellert, MD Phoenix, Arizona

2. “A well-trained, sensible family doctor is one of the most valuable assets in a community” Sir William Osler

3. ACGME Competencies Patient care Medical knowledge Practice-based learning & improvement Interpersonal & communication skills Professionalism System-based practice

4. Areas Where We Assess Competency Patient Care Advanced Procedures Medical Knowledge Systems-based practice

5. ACGME Suggested Best Methods for Evaluation Medical Procedures Checklist Simulations and Models 360 Global Rating Global Rating Procedure Logs

6. Method Used to Assess Competency Patient Care Global Rating (attending evals.) Direct observation and interactions Retrospective chart review Chart Stimulated Recall Mini (more for medical knowledge) C-section review Peer Review Procedure Logs Numbers?

7. Faculty Evaluation

9. Procedure Log Cards Cesarean Section Mini Evaluation Fellowship in Advanced Hospital Medicine Fellow:___________________________ Date:________ INSTRUCTIONS: Fellow completes top portion and asks teaching surgeon to complete the remainder. PID:_______________________ Teaching Surgeon: _______________________________ Indication:______________________________________  Primary  Repeat  BTL Complications: __________________________________ ……………………………………………………………. Areas to work on:________________________________ Fellow did well on:_______________________________ Sign:__________________________________________

10. Cui Bono? 1. Without a way to standardize competency for family physicians, colleagues in other specialties will frequently assume the lowest common denominator. 2. Credentialing becomes more cumbersome without standardization.

11. Credentialing 1. Education/Training/Board Certification – If this is not standardized, it becomes an ineffective tool for evaluation. 2. Additional Training/CME 3. Clinical “White Papers” – Bases competency on residency/fellowship, on months of clinical training, and on numbers. (http://www.hcpro.com)http://www.hcpro.com 4. Collegial References

12. Credentialing Politics 1. Who from the Department of Family Medicine sits on the Hospital Credential’s Committee? 2. Are applications reviewed by and recommendations for privileges made by the Chairman of the Department of Family Medicine or from other Departments? 3. Is peer review done by the Department of Family Medicine or by other Departments?