In the last column, we briefly mentioned the Physician Achievement Review (PAR) program. Some of you may have already participated in the program to evaluate your physician’s performance. Here is some background information.

In 1995, the College of Physicians and Surgeons of Alberta established the Physician Performance Advisory Committee to set up a proactive process to review physicians’ performance regularly and facilitate life long learning.

“The committee selected the program name Physician Achievement Review to denote supportive purpose and the goals of describing professional accomplishment and improving practice,” says Dr. William Hall, Chairman of the Physician Performance Committee in an article in the Canadian Medical Association Journal.

After going through several stages of development and pilot studies, the program was implemented for all physicians in Alberta in February 1999. There are 4700 physicians in Alberta, and it is planned that approximately 20 percent of physicians will be assessed each year over a 5-year cycle.

Is this program necessary? Is there any evidence that the quality of care provided by the majority of physicians is not up to the best standards acceptable to the College?

Every organisation or profession has few “bad apples”. Through the complaint process, the College has power to discipline such “bad apples.” Then why create the PAR program?

The College says, “Alberta’s doctors rank among the best in the world. In training, expertise and commitment to the highest standards of practice. And we all want to keep it that way”. PAR is designed to provide doctors with information about their medical practise through the eyes of those they work with and serve. The unbiased feedback is enormously helpful to the doctors, who will be able to build on their strengths and correct any possible problems, says a College document.

How does the process work?

The participating physician completes a self-assessment questionnaire and recruits 25 patients, 8 physician colleagues, and 8 non-physician co-workers to fill questionnaires. These questionnaires are processed by an independent body (Customer Information System –CSI) to maintain confidentiality.

The questions relate to the physician’s clinical knowledge and skills, communication skills, psychosocial management, office management, and collegiality. The CSI reviews the questionnaires and reports to the Survey Subcommittee. The Survey Subcommittee is responsible for contacting and advising physicians whose profiles are flagged. The committee also refers physicians for individualized assessment when appropriate.

It is quite an elaborate process with many committees and subcommittees. PAR ensures confidentiality of patient records and protection of the patient-doctor information. Studies by the University of Calgary have demonstrated that PAR is very effective. There is no cost to the taxpayers. The program is funded by the physicians.

But who is going to benefit the most from the program: the College, the physicians or the patients? Would such a program identify serial killers like Dr. Harold Shipman? Is the program trying to identify good and bad practices only? Would the program benefit the vast majority of physicians who are conciouscious and hard working anyway? Well, only time will tell.

What do you think? What is your definition of a good doctor? Is the College doing a good job to fulfill its mandate “to serve the public and guide the medical profession”? Do you have an opinion? Send it to me by e-mail or at 821A-5th Street SW, Medicine Hat, Ab T1A 4H7.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Leave a Reply

Your email address will not be published. Required fields are marked *