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Research shows that what doctors think they know does not match what they do, and that performance declines with years in practice, two members of the American Board of Internal Medicine wrote recently in the New England Journal of Medicine.
The authors of an opposing essay -- a medical school dean, a professor who teaches primary care and a practicing physician -- complain that testing emphasizes recall of facts rather than making full use of available sources of information, such as electronic references and the Internet, as modern doctors are taught to do.
The recertification tests are a work in progress. In the future, some boards plan to include assessment of a doctor's communication skills with patients. Eventually, testing may include rating a doctor's technical skills and directly observing performance, said the cardiology college's chief education officer, Joseph Green.
Dr. Michael Ring, a 53-year-old cardiologist from Providence Sacred Heart Medical Center in Spokane, Wash., put himself through this voluntarily in a training exercise at the Atlanta conference.
The people who really know how well a doctor performs are the nurses and other members of the team, Ring said. "If there was a way they could grade you without penalty to their careers," that would be best, he said.
On the Net:
Check a doctor's certification: http://www.abms.org/
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