Maintaining Competence in General Internal Medicine

Excerpt

I believe that I am a competent physician. While I suppose that many people have an inflated sense of their own competence (and this is certainly true of physicians who consistently overestimate their performance on clinical quality indicators), this assessment is based, at least in part, on information from three reliable sources. First, our university-based internal medicine practice provides quarterly feedback to individual physicians on a number of quality measures. My results, compared both to my peers as well as to national standards, are comfortably above the mean. Second, the medical center provides us with patient satisfaction scores based on patient surveys. My scores have been consistently near the top. Third, as an active clinical teacher and preceptor, I have a thick portfolio of relatively decent teaching evaluations. I believe that they too provide insight into my clinical competence; certainly, physician-teachers with a poor grasp of medical reasoning or who have not kept up with the medical literature are unlikely to be assessed favorably. All of these measures are flawed and subject to one bias or another, but collectively, they give a consistently positive view of my competence as a general internist. …