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Joachim Sturmberg, MBBS, FRACGP, PhD

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I read with great interest the article by Holmboe et al¹ and the editorial by Landon² on the link between certifying examination performance and quality of care.

As these 2 articles highlight, there are substantial practical problems with collecting adequate data to demonstrate a reliable link between paper-based cognitive assessments and instrumental performance in clinical practice. In Australia, the Bettering the Evaluation of Care and Health (BEACH) study has shown similar links between the results of the fellowship examination and instrumental performance in practice.³

However, is it sufficient to judge quality of care solely in instrumental terms? I would suggest that quality of care is equally dependent on an interpersonal performance as on doing the "right thing" in terms of disease-specific care. We should not forget that the essence of health and health care is the personal health experience and coping by the patient with . . . [Full Text of this Article]

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RELATED ARTICLE

Association Between Maintenance of Certification Examination Scores and Quality of Care for Medicare Beneficiaries
Eric S. Holmboe, Yun Wang, Thomas P. Meehan, Janet P. Tate, Shih-Yieh Ho, Katie S. Starkey, and Rebecca S. Lipner
Arch Intern Med. 2008;168(13):1396-1403.
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RELATED LETTER

Is Quality of Care Only Instrumental?—Reply
Eric S. Holmboe, Yun Wang, Thomas P. Meehan, Janet P. Tate, Shih-Yieh Ho, and Rebecca S. Lipner
Arch Intern Med. 2009;169(4):418.
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