P G Norton1, D Faulkner. 1. Department of Family Medicine, University of Calgary, Alberta, Canada.
Abstract
BACKGROUND: The College of Physicians and Surgeons of Ontario has conducted a Peer Assessment Program since 1980. All physicians who turn 70 years of age in a given year are automatically selected for assessment, and the program assesses a random selection of physicians within specific practice and specialty areas. Each assessor--a physician who practices in the same area of medicine as the physician undergoing assessment--reviews the physical facilities, the system of record keeping and the content of approximately 20-30 medical records, and the quality of care provided, as determined by the medical record content and discussions with the physician. The assessed physician is then assigned a grade. In 1998, program records for 109 nonspecialist physicians who had undergone two assessments more than 10 years apart (first assessment, 1981 to 1987; second, 1991 to 1997) were examined to determine possible changes in performance. RESULTS: The mean time between assessments was 12.2 years. Seventy (64.2%) of the 109 physicians showed a decline in grade, whereas 35 (32.1%) received the same grade, and only 4 (3.7%) had an improvement in grade. CONCLUSIONS: This report is consistent with previous observations that performance changes with age. In contrast to previous studies, this report is based on longitudinal rather than cross-sectional data.
BACKGROUND: The College of Physicians and Surgeons of Ontario has conducted a Peer Assessment Program since 1980. All physicians who turn 70 years of age in a given year are automatically selected for assessment, and the program assesses a random selection of physicians within specific practice and specialty areas. Each assessor--a physician who practices in the same area of medicine as the physician undergoing assessment--reviews the physical facilities, the system of record keeping and the content of approximately 20-30 medical records, and the quality of care provided, as determined by the medical record content and discussions with the physician. The assessed physician is then assigned a grade. In 1998, program records for 109 nonspecialist physicians who had undergone two assessments more than 10 years apart (first assessment, 1981 to 1987; second, 1991 to 1997) were examined to determine possible changes in performance. RESULTS: The mean time between assessments was 12.2 years. Seventy (64.2%) of the 109 physicians showed a decline in grade, whereas 35 (32.1%) received the same grade, and only 4 (3.7%) had an improvement in grade. CONCLUSIONS: This report is consistent with previous observations that performance changes with age. In contrast to previous studies, this report is based on longitudinal rather than cross-sectional data.