Hospice, Palliative Medicine and the MOC

Some years ago, as part of my “Maintenance of Certification” (MOC), I needed to complete a “Self-Evaluation Process”. This involved a ‘Practice Improvement Module’ specifically focused on ‘Communication in Primary Care’. The module initially consisted of a patient survey with some 40 questions for my patients to answer either by touch-tone phone or via the internet. These questions were patient oriented and dealt with how satisfied the patients were with various aspects of my practice. This data was presented to me in order to show the forte and foibles of myself and my staff, especially as to how well we interacted and communicated with our patients. Additionally, I completed a ‘Quality Improvement Plan’ in which I used a practice plan (eg. for a group of hypertensive patients) with a set goal (ie. to improve blood pressure), a measure (ie. blood pressure effect), and an impact assessment (hypertension control). (I chose to use European guidelines, new for that time, for the treatment of hypertension). This enabled me to investigate and improve one aspect of my patient care.

Those of us who are ‘grandfathered’ in hospice and palliative medicine (HPM) will need to deal with the MOC over the next decade. In approaching our future HPM recertification what “practice” topics for the MOC could be best suited for our care (practice plans)? I’ve listed some thoughts of my own below; please recommend some of your own.

1. Family satisfaction with hospice post-mortem.
2. Effective palliative radiation or chemotherapy modalities.
3. Parameters of Failure-to-Thrive.

The American Academy of Hospice and Palliative Medicine has applied for MOC credit with the American Board of Internal Medicine (ABIM) for the HPM-PASS. The ABIM may, additionally, want to have modules that carry the same template, the same format, as is found in their other disciplines such as Primary Care.

Thank you for your thoughts and comments.

Robert Killeen MD