Time to IVT Treatment and Functional Outcomes in Acute Ischemic Stroke—Reply
Johannes Kaesmacher, Fabiano Cavalcante, Urs Fischer
Abstract
the large and growing body of evidence that patients of physicians who demonstrate more medical knowledge have better prognoses on a host of important outcomes. 2 In doing so, we were addressing the "patient outcomes issue" often raised in conversations about certification and maintenance of certification.We also agree with Stern and Hafferty that there is a strong foundation of fundamental educational science undergirding certification and maintenance of certification, which was not addressed in our article due to Viewpoint word length constraints.In particular, the authors point out that there are blind spots with self-assessment, and the inaccuracies associated with it are well known. 3 The ABIM's Longitudinal Knowledge Assessment is an external assessment based on sound educational principles 4 ; it was designed to assess medical knowledge and judgment while identifying these blind spots and providing real-time feedback to help physicians improve over a 5-year period.We agree with Stern and Hafferty that individual memory is prone to decay over time, as demonstrated by the aptly named and well-studied "forgetting curves."Additionally, medical knowledge is evolving at such a rapid pace that the doubling time is now measured in days. 5 To keep pace, the ABIM continually updates its content.It requires substantial infrastructure and expertise to construct relevant and meaningful assessments across the expanse of medical knowledge in a discipline such as internal medicine and its many subspecialties.We concur with Stern and Hafferty that professional selfregulation is worth protecting and we are grateful for continued physician engagement in the process.At a time when physician practice is increasingly constrained and limited by the action of state legislatures in areas ranging from reproductive rights and gender-affirming care to what constitutes unprofessional behavior, it is critical to have a robust set of physician institutions to recognize appropriate clinical practice.To that end, one of the ways the ABIM protects the integrity of our profession and the credential it represents is by enforcing its policies against false information and unprofessional and unethical practices. 6Doing so protects the value of the credential held by more than a quarter of a million internists and subspecialists and helps to recognize their hard-earned expertise.As the ABIM continues to innovate, simplify, and make maintenance of certification assessments more relevant, it benefits from physician critiques to improve programs and relies on help from the medical community to amplify important messages with the goal of improving the health of the communities we serve.