title: Physician Satisfaction With and Practice Changes Resulting From American Board of Family Medicine Maintenance of Certification Performance in Practice Modules.
abstract: BACKGROUND
  Physician payment in the United States will be increasingly tied to quality measurement and performance. Whether participation in quality improvement (QI) through Maintenance of Certification for Family Physicians Performance in Practice Modules (PPMs) is useful and results in practice change remains unknown.
  
  
  METHODS
  All PPM feedback data from inception to April 2014 were analyzed using descriptive statistics by year, topic, and number of PPMs completed. Qualitative content analysis was applied to analyze responses to open-ended questions on practice changes.
  
  
  RESULTS
  Of note, 29,755 diplomates completed 38,201 PPMs; median 1 interquartile range (1, 1). Nearly two-thirds (65.8%, n = 25,150) of PPMs had completed feedback surveys. Of note, 78.7% of respondents indicated that they would change patient care and 90.2% indicated that they would continue QI activities after completing the PPM. Respondents endorsed high relevance to practice (90.5%), high currency of clinical information (86.4%), and high usefulness of clinical information (80.5%). When feedback was analyzed by the number of PPMs completed, respondents were less likely to change care but reported increased usefulness to practice and stable intention to continue QI efforts with more PPMs completed. Of note, 86.0% of respondents who said that they would change care provided examples: these varied by PPM topic but "doing more," focusing on patients, and education were common.
  
  
  CONCLUSIONS
  These findings suggest that QI completed through the PPMs may assist family physicians in improving the care they provide. Furthermore, ratings by the number of PPMs completed suggest that repeated exposure to QI efforts produce continued relevance and usefulness, even when changes in practice decline.
authors.affiliation: Dr. Peterson: Research Director, American Board of Family Medicine, Lexington, KY. Dr. Eden: Medical Anthropologist, American Board of Family Medicine, Lexington, KY. Ms. Cochrane: Research Assistant, American Board of Family Medicine, Lexington, KY. Dr. Hagen: Senior Vice President, American Board of Family Medicine, Lexington, KY.
authors.forename: Lars E
authors.initials: LE
authors.lastname: Peterson
authors.forename: Aimee
authors.initials: A
authors.lastname: Eden
authors.forename: Anneli
authors.initials: A
authors.lastname: Cochrane
authors.forename: Michael
authors.initials: M
authors.lastname: Hagen
mesh_terms: D002568:Certification / Q000592:standards*; D003479:Curriculum / Q000592:standards*; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000628:therapy; D004502:Education, Medical, Continuing / Q000592:standards*; D005194:Family Practice / Q000458:organization & administration; D058005:General Practitioners / Q000523:psychology*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000628:therapy; D010549:Personal Satisfaction; D058996:Quality Improvement / Q000639:trends; D011787:Quality of Health Care; D014481:United States