ABIM Foundation Focus – Spring 2018

Winners of the John A. Benson Jr., MD Professionalism Article Prize

The eighth annual John A. Benson Jr., MD Professionalism Article Prize has been awarded to four scholarly articles published in 2017 that explore opportunities to improve health care quality at all levels. Recipients of the eighth annual awards looked at how health care professionals can challenge medical misinformation and better understand transparency issues, and how organizations and educational institutions can build a positive culture. Awards are given in two categories: Commentary and Research.

The winners include:

“The Case of Dr. Oz: Ethics, Evidence, and Does Professional Self-Regulation Work?” by Jon C. Tilburt, MD, MPH; Megan Allyse, PhD; and Frederic W. Hafferty, PhD (Commentary)

This commentary, published in February 2017 in the AMA Journal of Ethics, confronts the challenges that physicians with popular platforms, such as Dr. Mehmet Oz, can present to the profession. While Dr. Oz meets high standards for surgical care, the authors focus on advice he gives millions of people through his TV show and social media platforms that is not evidence-based. The authors raise concerns that this misinformation could erode physician-patient trust. They encourage the medical profession to foster trusting patient relationships and to hold doctors—those with large followings and those who are less prominent—accountable for providing evidence-based information.

“The Charter on Professionalism for Health Care Organizations” by Barry E. Egener, MD; Diana J. Mason, RN, PhD; Walter J. McDonald, MD, Sally Okun, RN, MMHS; Martha E. Gaines, JD, LLM; David A. Fleming, MD, MA; Bernie M. Rosof, MD; David Gullen, MD; and May-Lynn Andresen, RN, BSN (Commentary)

Recognizing that individuals function within the cultures and policies of their organizations, several groups, including the ABIM Foundation, Commonwealth Fund, North Shore Long Island Jewish Health System, the Federation of American Hospitals, and the American Hospital Association supported the creation of a Charter on Professionalism for Health Care Organizations. The Charter, which was featured in a January 2017 Perspective in Academic Medicine, focuses on healthcare organization professional obligations that include patient partnerships, organizational culture, community partnerships and operations and business practices. The multidisciplinary effort recognized that these domains are critical for caring for patients, maintaining a professional and healthy staff and improving overall health of communities. The authors outlined potential challenges in enacting the Charter and detailed their aspirations for its use and dissemination.

“Bringing Transparency to Medicine: Exploring Physicians’ Views and Experiences of the Sunshine Act” by Susan Chimonas, PhD; Nicholas J. DeVito, MPH; and David J. Rothman, PhD (Research)

This research article, published in the May 2017 edition of The American Journal of Bioethics, shares the results of physician focus groups about The Physician Payments Sunshine Act (PPSA). The law, which requires product manufacturers to report physician payments to the federal government, was created to support proper reporting of conflicts of interest and inspire public trust. However, the authors reported that physicians in the focus groups were concerned that the law may undermine public trust in doctors and showed less concern about the influence of industry on care. The authors highlighted these findings as opportunities to help physicians and the public understand the PPSA.

“A Multi-Institutional Longitudinal Faculty Development Program in Humanism Supports the Professional Development of Faculty Teachers” by William T. Branch Jr., MD; Richard M. Frankel, PhD; Janet P. Hafler, EdD; Amy B. Weil, MD; MaryAnn C. Gilligan, MD, MPH; Debra K. Litzelman, MD; Margaret Plews-Ogan, MD; Elizabeth A. Rider, MSW, MD; Lars G. Osterberg, MD, MPH; Dana Dunne, MD; Natalie B. May, PhD; and Arthur R. Derse, MD, JD (Research)

The authors of this December 2017 research article in Academic Medicine describe a year-long program for faculty at 30 U.S. and Canadian medical schools. Their research looks at the first 11 academic years of the program, which brings faculty members together in small groups to learn about humanistic teaching, role modeling, experiential learning techniques and professional development. Results showed that participating faculty had higher medical humanism scores and that the program could serve as a model to empower faculty to create a positive learning culture at all levels of medical education.

Learn more about the selection process and the members of the committee.

New Grant to Continue Choosing Wisely Implementation Efforts

The Robert Wood Johnson Foundation (RWJF) has awarded a third round of funding to the ABIM Foundation to continue efforts to promote the implementation of Choosing Wisely. The grant will be administered over a three-year period.

The new grant dives further into implementation of Choosing Wisely recommendations, with a focus on sharing what the Foundation has learned about implementation and improving reach to diverse populations. This work includes providing technical assistance to health systems, hospitals and practices seeking to reduce overuse based on selected recommendations and strengthening the ability of the campaign to reach all audiences, and testing the best approaches to clinical implementation.

In 2013, RWJF funded the work of 21 projects led by state medical societies, specialty societies and regional health collaboratives to educate physicians about the Choosing Wisely recommendations and help them build skills to have conversations with patients.

In 2015, a second grant supported seven initiatives focused on reducing utilization of inappropriate tests and treatments. Each initiative included delivery systems, hospitals and/or medical groups collaborating with multi-stakeholder community-based groups and physician-led organizations.

Recent JAMA Article Addresses Challenges That Lie Ahead for Choosing Wisely

In a recent article published in JAMA entitled “Choosing Wisely Campaigns: A Work in Progress,” authors Wendy Levinson, MD, Karen Born, MD and Daniel Wolfson MPH, argue that the key to the success of the Choosing Wisely campaign can be explained through the concepts of diffusion of innovation. The authors break down the campaign per Don Berwick’s three characteristics of an effective spread of innovation in health care which are:

1. Perceptions of the innovation;
2. Characteristics of people who adopt it; and
3. Contextual factors influencing diffusion.

They conclude that while the campaign has been well-received and considered a success by many, Choosing Wisely now needs to “demonstrate effectiveness in improving outcomes and making a difference on measures of quality and safety to clinicians and patients.”

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