“ACP, to their credit, also has hospital-based modules,” Dr. Holmboe says. “So if somebody is a dual member, they can certainly use the ACP’s MKSAP (Medical Knowledge Self-Assessment Program) hospital-based modules as well. We’re also working with SHM, looking for areas they might fill in around knowledge and updates—things that could be brought into the program over time.”
In regard to the evaluation and performance modules, ABIM offers three main pathways, including the Hospital-Based PIM, which targets core measure sets like community-acquired pneumonia and congestive heart failure and DVT prophylaxis. “Hospitalists can use those PIMs to start a quality-improvement program, or they can use it to report on one they are working on,” Dr. Holmboe says, adding the Hospital Based PIM’s online module will be redesigned this summer to improve the user experience.
Two other approaches are the Self-Directed PIM and the Accepted Quality Improvement programs. “That would be for hospitalists who may not be working on the core measure sets in the hospital-based PIM, but are still important,” he says. “They can use that module to report on those activities and get the points they need.”
Dr. Holmboe also points out that diplomates do not have to complete all the other requirements before they take the exam. “Some people get confused; you don’t have to cram in the 100 points before the exam,” Dr. Holmboe explains. He notes that the exam can, for example, be taken this year and the remainder of the requirements completed at a later date.
“If it was up to me, you should do a [PIM] every year,” says Larry Wellikson, MD, SFHM, CEO of SHM and one of the architects of the new FPHM pathway. “If you are a real hospitalist, completing a PIM every three years shouldn’t be a big deal. You should be able to say, ‘I’ve looked at 10 things: how I’m doing in pneumonia, how I’m doing in DVT, how I’m doing in glycemic control. This isn’t work for me; it’s part of my workflow.’ It’s like asking a salesman how many sales calls have you made, how many miles have you driven, and how many sales have you closed.”
Dr. Wiese, associate dean of Graduate Medical Education and professor of medicine at Tulane University in New Orleans, completed his 10-year MOC in 2008, and he says the process made him “a better physician.” As president of SHM and chair of the FPHM test-writing committee, he envisions that the new MOC pathway will help “ramp up the quality of care for the hospitalized patient.”
“The FPHM MOC process is much more than just a different exam,” he says. “It is true the secure examination will have a lot more hospital-medicine-patient content focus, but not to the exclusion of ambulatory content.”
The FPHM MOC process is much more than just a different exam. It is true the secure examination will have a lot more hospital-medicine-patient content focus, but not to the exclusion of ambulatory content. If there is one component of the exam that will [be HM-focused], it’s the questions of the exam that are focusing on the core principles of quality and patient safety.
—Jeff Wiese, SHM president, ABIM Focused Practice in Hospital Medicine Test Writing Committee chair