Contents:
What is PAR?
PAR is designed to provide doctors with information about their medical practice through the eyes of those they work with and serve. The unbiased feedback is enormously helpful to doctors, who will be able to build on their strengths and correct any possible problems. Physicians are required to participate in this process once every five years.
PAR looks at the quality of medical care.
Alberta's doctors rank among the best in the world in training, expertise and a commitment to the highest standards of practice. And we all want to keep it that way. Which is why the College of Physicians & Surgeons of Alberta, the licensing body for doctors, has introduced PAR - the Physician Achievement Review Program.
Our goal as physicians is to improve the delivery of medical care in our province. Part of this process consists of regular appraisals of our own performance. And the best people to give us feedback are the people we work with - our colleagues - and the people we work for - our patients.
The College of Physicians & Surgeons of Alberta is committed to promoting a culture of ongoing quality improvement in medical practice. The Physician Achievement Review serves as the backbone for this process, providing the model and tools for a self-directed program of professional development and quality improvement.
Every five years, each physician in Alberta will be required to have their performance reviewed by way of questionnaires completed by 25 patients, 8 physician colleagues and 8 non-physician healthcare co-workers. Topics range from medical competency and management abilities to communication skills and patient management. An independent research firm, Pivotal Research Inc. receives these confidential replies, compiles them, and provides the doctor with detailed aggregate responses for their own practice, as well as a comparison to the summary profile of all physicians with similar types of practices.
Return to Contents.The benefits of PAR.
Quite simply, this program provides doctors with useful feedback about how they're doing. Each physician receives a brief, accurate snapshot of their practice through the eyes of the people they work with and serve. The survey will also provide a benchmark for how their patients and colleagues define good performance, as well as indicate areas for individual improvement and professional development.
Assessment programs elsewhere have found that physicians appreciate detailed, reliable feedback and particularly value clarification of what others consider exemplary medical practice.
The public will benefit from the opportunity to express their expectations of medical care and its delivery. Ultimately, the feedback they provide will lead to the improvement of medical care in this province.
How PAR works.
Every year, 1,000 doctors will participate in the program, receiving a package of questionnaires and a self-evaluation form. The questionnaires for each group (patient, co-worker and peer) cover five attributes of the physician's performance:
- clinical knowledge and skills
- communication skills
- psychosocial management
- office management and
- collegiality
Once the questionnaires have been completed, they're sent to an independent agency that has been contracted to manage all the collection, tabulation and reporting for the program. The resulting PAR profiles are then reviewed by members of the Physician Performance Committee (PPC), a nine-member Council-appointed group responsible for administering the program.
Should the PAR surveys flag a potential problem, the PPC will work with the physician from a quality-improvement perspective. Peer office reviews or other competency assessment tools may be used to assist these physicians.
Confidentiality of information gathered by the questionnaires is guaranteed under the Medical Professional Act. PAR information is strictly for educational purposes and cannot be used in legal or disciplinary proceedings.
Only in those rare instances when it is determined that,
- the public is at immediate risk of harm,
- there is a serious breach of ethics, or
- there is an unreasonable failure to comply with the requirements of the PAR process,
could a physician be referred for possible formal investigation.
PAR provides a focus for education and change.
The College of Physicians & Surgeons of Alberta is aware that some of the areas identified for improvement among doctors and medical practices may not have answers that can be found in medical textbooks or educational programs. The College is also aware that practice performance is also a function of the resources available to physicians and of the healthcare system itself.
Some of the learning needs identified by PAR, however, are met by traditional education sources and a database of those opportunities will be made available to physicians in print and through the program's web site.
The Universities of Calgary and Alberta are active partners in PAR and committed to the development of learning opportunities that match the needs of practicing physicians. Their experience and expertise in developing new programs will be invaluable.
Is PAR effective?
Yes. Studies by the University of Calgary have demonstrated that PAR is very effective.
Not only is PAR a reliable, valid and increasingly accepted way of assessing physician performance, it's very cost-effective since the program is administered by the College of Physicians & Surgeons of Alberta at no cost to the public.
PAR is about ongoing improvement and growth.
These initial survey tools are just the beginning. In keeping with its mandate of continual reassessment and evaluation, PAR will evolve to ensure its reliability as an accurate and useful source of information.
The PAR tools will be adapted, or new tools developed, for specialty practices. New avenues of communication will be developed to assist physicians in interpreting PAR results and implementing changes. Assessing and encouraging educational opportunities that address physicians' needs will be a vital part of the program in the future.
Commitment to PAR demonstrates that doctors in Alberta value the process of accountability, lifelong learning and continuous improvement. Through this program, individual physicians will be able to identify priorities for professional development, participate in the development of educational initiatives and institute changes to medical practice that will improve health care for all Albertans.
PAR is paid for by doctors.
No public money is used to fund this program. Physicians underwrite the costs which are built into their annual relicensure fee. The estimated administrative cost works out to $40 a year per physician.
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