Professional competence and the professional organization. Editorial.
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Recognizing the steady expansion of medical knowledge, the societal desire to ensure the best possible medical care, and governmental concern for verification of physician competence, the American Board of Ophthalmology is preparing to offer a voluntary recertification program for Diplomates of the Board who wish to establish current professional competence. Pertinent to this program, consideration is given to the rationale for periodic recertification, relevant actions by representative specialty boards and the American Board of Medical Specialties, and fuidelines for development of a recertification process by the American Board of Ophthalmology. These guidelines are set forth to provide a basis for study and evaluation by all interested parties. By thoughtful, broadly based, and coordinated consideration, policies will evolve to serve concurrently the best interest of the general public and of the ophthalmic profession.
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Over the past half decade, there has been an increment in forces moving the profession toward recertification and a decrement in the restraining forces. The whole process will be catalyzed by available funding through grants to implement continuing medical education, development of performance-, and competency-based assessment measures and recertification. Specialty boards serving relatively small numbers of candidates have serious difficulty funding certification, to say nothing of recertification. An adequate mechanism to implement recertification can emerge only from the profession itself, working through the American Board of Medical Specialties and specialty boards. The means to discharge this responsibility should, at the outset, come from public and private sources. Eventually the system may become self-supporting through evaluation and certification fees. The public interest will be best served when there are adequate mechanisms to assess continuing competence of all physicians. As a minimum, there must be a system to guard against incompetence through obsolescence of any of the practicing professionals.
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Anyone using mammography should perform it seriously with one or two radiologists in any group as the primary physicians. It is only by being exposed to a high patient volume day after day and having a thorough knowledge of all the pathologic conditions that one can truly appreciate the subtle mammographic patterns present. In only this way is the diligent radiologist optimally helpful to the surgeon and pathologist, and this best serves patient welfare. Conversely, the part-time mammographer, although not necessarily besmirching his professional competence, will tend to give the examination a bad reputation by unnecessary hedges and reporting uncertainties characterized by long winded reports. Patients undergoing mammography should undergo a physical examination by the radiologist. Thus, accuracy rates for the detection of cancer can approach, 98 per cent. Liabilities consequent to mammography can be minimized by the professional competence of the radiologist, understanding the limitations of the examination and the expertise of the reporting style.