First things first: last week’s poll results showed that the majority of individuals were wary of using physician “Pay For Performance” as a strategy towards increasing AV fistula placement rates. Proponents of this strategy (see editorial by Hakim and Himmelfarb in a 2009 KI article) would argue that linking AV fistula placement to some type of financial reward (or linking lack of AV fistula placement to some type of financial penalty, depending on your viewpoint) is the surest way to increase the AV fistula rate in the overall dialysis population. Potential arguments against using a physician “Pay For Performance” strategy would include penalizing doctors who take care of patients with a lower success of achieving working AV fistulas and encouraging the placement of unnecessary AV fistulas, to name a few.
So I took the boards yesterday, and I’m eager to hear what others thought of the exam. Fair? Frustrating? Piece of cake? My own view: it’s a hard exam, and not only because it requires 8 hours of concentration–like many of these ABIM exams, there are often 2-3 answers which seem like they could be right; the challenge comes in selecting the “Best Answer” according to whomever wrote the question. Ever wonder how they come up with the questions? Here is the ABIM’s stated policy on how all their exams are developed. This week’s RFN Poll of the Week is Boards related.