Thursday, May 04, 2006
With electronic records, monitoring by licensing groups easier

By Dr. Anthony Policastro
Nanticoke Memorial Hospital,
Medical director

I am a member of the Delaware Board of Medical Practice. I recently attended its annual meeting. Most of the meeting was devoted to assessment of physician current competence. Many years ago advancements in medicine were few. They occurred gradually. Medical journals contained the new information. They took time to have the articles approved. That meant that information could not be viewed very quickly. Physicians could keep up with things very easily. Now advancements are many. They occur rapidly. The Internet allows them to be viewed very quickly. Physicians have to work very hard to keep current. One of the concerns of national physician organizations is how to ensure that physicians continue learning all they need to know. The group that accredits internship and residency programs started this movement. They divided what is needed to be learned into six categories. The categories included medical knowledge. They included patient care procedures. They included interpersonal skills. All interns and residents are being judged on those six categories now. Other organizations are looking at the same kinds of things. These organizations include the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), which accredits hospitals, and the National Commission on Quality Assurance (NCQA), which accredits managed care companies. The American Medical Association (AMA) has started a program to look at individual physician office practices. They are beginning by looking at six physician practices. All of those practices have electronic medical records. Electronic records are necessary because that is the only way to review information. It is too complicated to get it from paper records. The kinds of things that will be looked at are those that meet the expected standards of care. For example, a pediatrician might have the immunization rates of patients checked. An obstetrician might have the completion of prenatal lab tests checked. An internist might have the percentage of patients getting colorectal cancer screening examinations looked at. All of these things require patient participation. For example, we know that nationally only about 60 percent of parents have their children immunized. Pediatricians do not have total control of that situation. This is one of the reasons that just looking at the total numbers will not tell the whole story.

State medical boards are also starting to look at these same things. Massachusetts has had a program in place for 10 years. The Web site is If you go to the Web site, you will see a link to online physician profiles. You can actually look up my name on the site since I have a Massachusetts license. However, since the license is currently inactive, all it will tell you is that. The site does give a description of all the things that patients can find. It is worth a look. We are just at the beginning of many of these things. As we move to electronic medical records, we will see more of these kinds of things happening. More information will be available to patients. It will allow them to evaluate a variety of things about potential physicians. However, with the immunizations example I used about physicians not having complete control of things, all information must be viewed with an understanding that it is only part of the story.

Nanticoke auxiliary will meet May 10 in Manor House
Members of the Nanticoke Health Services Auxiliary will meet at the Methodist Manor House on Wednesday, May 10, with lunch at 11:30 a.m. Guest speaker will be Dr. Mohammad Habra, board certified in endocrinology and internal medicine. Luncheon will feature cold plate selections, pasta salad and strawberry shortcake at a cost of $8. Callers will be contacting members for reservations. Auxiliary president Janet Hubbard will preside during the business meeting. A quorum is required for voting on changes to the bylaws. Members are encouraged to attend this special meeting. Membership in the hospital auxiliary is open to all residents. Those interested should attend the meeting at the Manor House or call Jan Grantz, 628-8478, or Jane Foskey, 875-5629, membership co-chairs; or Hubbard, 628-0417.