Physicians tested, observed, re-educated, if needed

The Colorado Personalized Education for Physicians (CPEP) program in Aurora is an intense assessment, often followed by a re-education program aimed at helping the physician overcome his or her problems. Martha Illige, MD, medical director of the program and an assistant professor at the University of Colorado Health Sciences in Denver, offers this example of how the program would help a typical physician:

The physician visits the CPEP offices and undergoes two days of testing and interviews. (For contact information, see "Remedial program good for those who can improve," in this issue.) The testing includes a four-hour multiple-choice test in the physician’s specialty, plus an hour-long computerized test that measures attention, concentration, memory, and learning ability. That test can help identify neurologic conditions such as Alzheimer’s or Parkinson’s disease.

Then the physician participates in role-playing scenarios in which actors impersonate patients coming to him or her for treatment. A video camera records the interactions, and a communications consultant observes from the next room. After the patient encounters, the physician writes up chart notes just as he would in the office. 

Afterward, the physician is interviewed by three physicians in his specialty, drawn from CPEP’s bank of consultants. Prior to the interviews, the consulting physicians review actual patient charts from the subject physician’s practice. The next day, the physician spends an afternoon treating "patients" at a computerized workstation, providing treatment and ordering tests as he would in normal practice while the computer keeps track of everything the physician does or doesn’t do.

All of the testing results are reviewed, along with the peer physicians’ assessments. Several weeks later, CPEP sends a report of about 15 or 20 pages to the physician and the referring hospital or other organization.

The report concludes that the physician has serious deficiencies in certain areas but could be helped by some remedial education. The referring hospital and the physician agree to a plan in which he submits cases to a preceptor for regular reviews, attends a number of medical conferences each year, and spends an hour each morning reading medical journals and discussing them with his preceptor.

A year later, the physician returns to Colorado for another two-day assessment, where it’s determined that he is much improved but still lacking somewhat in specific areas. This time, CPEP recommends he continue working on those issues on his own, with no formal supervision.