Thursday, August 03, 2006
Doctors work hard to keep on top of medical news
Medical knowledge changes rapidly. Physicians learn a tremendous amount of information in medical school. They get to memorize the anatomy of the entire body. They get to understand how body metabolism works. They get to review how body cells look under a microscope. Physicians then complete an internship and residency. During this period they spend many hours taking care of patients. They learn by doing. When a resident graduates, he/she knows all of the up-to-date medical practices. However, after completion of residency training, keeping up with medical knowledge falls squarely on the shoulders of the physician. There are many ways of doing this. The most formal training is in the form of courses. Some of these courses are standardized. The American Heart Association offers the Advanced Cardiac Life Support (ACLS) course. This course concentrates on handling patients with acute heart problems. They also offer a course titled Pediatric Advanced Life Support (PALS). This concentrates on handling children with life threatening problems. The American College of Surgeons offers the Advanced Trauma Life Support Course (ATLS). This concentrates on handling acute trauma. Every physician who takes these courses learns the same thing. It is standardized throughout the country. I taught ACLS for 17 years. I have been an ATLS instructor for 23 years. I have been a PALS instructor for about six years. Teaching is an excellent way to learn the material. Other courses are formal courses. However, they have a group of instructors that teach what they think is important. As you read this, I will be away at one such course. The American Academy of Pediatrics conducts a 37-hour course in Developmental and Behavioral Pediatrics every other year. Since I am board certified in developmental and behavioral pediatrics, I have taken this course each time it has been offered. This allows me to stay current on new developments in my field.

The problem with formal courses is that they are very expensive. The tuition for the courses is usually about $1,000. There are travel costs. There is also the cost of lost revenue. A physician who is away at a course cannot be in the office seeing patients. Therefore, physicians cannot attend courses like this very often. For most of us, we attend one course per year. Each of these courses comes with what is known as Category 1 Continuing Medical Education (CME) credit. The state of Delaware requires its licensed physicians to obtain 20 Category 1 credits per year. That number is consistent with attending one course per year. The developmental course will earn me 37 credit hours. However, there are other ways of obtaining Category 1 credit. They include reading articles and submitting a quiz answer sheet. I do this annually for a risk management course run by the Armed Forces Institute of Pathology. It offers 5 credits. There are also online courses. These too present information and allow credit to be earned. The same is true for lecture series in local hospitals. These usually earn 1 or 2 credit hours at a time. There are also less formal ways of learning. This may be in the form of reading medical journals. This may be in the form of reading medical textbooks. This may be in the form of speaking with colleagues. This may be in the form of attending a non-Category 1-credit talk. Some information is provided via drug company representatives. This may occur in one-on-one conversations. It may occur in drug company sponsored lectures. The bottom line that it is up to each physician to make sure his/her knowledge remains current. There are multiple opportunities for that to happen. What is important is not how physicians do it. It is important that they indeed get it done. The good news is that physicians as a group are pretty compulsive about making sure their knowledge level is where it needs to be to meet the needs of their patients.