Professional practice assessment in ambulatory private rheumatology: a pilot evaluation of the medical file content for rheumatoid arthritis.

OBJECTIVE: Professional Practice Assessment (PPA) has become an obligation for all physicians in France, however its modalities remain unclear. The objective of this work was to evaluate the feasibility and accuracy of a PPA for private practice rheumatologists performed in the context of a network. METHODS: A list of items considered mandatory to collect during an outpatient visit for rheumatoid arthritis, was prepared by the network. Non hospital-based rheumatologists, members of the network then evaluated some of their patient files selected by chronological order over a one-month period of time using this list. These files were then assessed by another private rheumatologist, member of the group, randomly allocated, using the same list of items. RESULTS: Eighty percent of the private-practice doctors accepted to participate. The mean time to evaluate 15 patient files was 2 hours. Agreement between auto-evaluation and external evaluation for each file was good (agreement statistic, 0.75-1.0). Items mandatory to collect were collected in a high proportion of cases (84.6%). CONCLUSION: PPA can be performed in the context of a network, auto-evaluation is a valid method and when the list of items is decided on by the network, the data are collected satisfactorily.

Continuing medical education for rheumatologists in France. Results of a national survey.

OBJECTIVE: To determine how continuing medical education is rated and used by French rheumatologists. MATERIAL AND METHODS: All French rheumatologists (n = 2579) were sent a questionnaire in September 1998. Results were evaluated using the test for differences between two proportions, with the significance level set at 0.05. RESULTS: 46% of the questionnaires (n = 1197) were returned completed. Mean age of respondents was 45 +/- 8 years; 41.2% of respondents were in full-time office practice, 14.8% were in full-time hospital practice, and 32.7% divided their time between the office and hospital. Nineteen percent worked in the Paris area. Nearly all the respondents (99.6 to 100%) attended continuing education meetings. Respondents working in Paris were significantly (P < 0.05) more likely than those working elsewhere to attend national conventions (99.6% vs 88.4%), whereas a difference in the other direction was found for regional and local conventions. The mean score assigned by respondents to national, regional and local conventions was 60/100. Respondents in full-time hospital practice were more likely than other respondents to attend international conventions; they were the only subgroup that assigned a score greater than 50/100 to this resource. University classes were attended by 44.4% of respondents and obtained a mean score of 65/100. Rheumatology journals were used by 99.2% of respondents and obtained scores greater than 65/100 in all subgroups. Respondents in full-time hospital practice were more likely to read international rheumatology journals than the other subgroups; they were the only subgroup that assigned a score greater than 50/100 to this resource. CD ROMs, videocassettes, and the Internet were used by less than one-fourth of respondents and were assigned low scores. The proportion of respondents who participated in the provision of education ranged from 23.6% to 53.3%. Opinions on the usefulness of the various educational resources varied across type-of-practice subgroups. CONCLUSIONS: Most respondents attended meetings and used resources for independent learning. The findings from our study could be used to plan further investigations into the use of continuing medical education by French rheumatologists, particularly those who did not send back our questionnaire.