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Download a PDF of the Current Issue 2015 Volume 12 Number 3 July- September

Florida Cares & C.A.P.

Eileen Handberg, Ph.D.

In 1997, the University Of Florida College of Medicine, developed an assessment center for physicians and physician assistants to aid hospitals and regulatory boards in the assessment of professional competency. This program ran successfully but closed in 2003 when it lost one of its Medical Directors. In response to university concerns about all aspects of patient safety, and the demand for the service, UF CARES, at the direction of Dr. Douglas Barrett, Vice President for Health Affairs, was reestablished as Florida CARES & C.A.P. The new program reflects a change from a single university-based program to a collaborative model that involves five academic facilities: the University of Florida (Gainesville and Jacksonville campuses), the University of Miami, the University of South Florida, and Nova Southeastern University. The program also includes a Competency Advancement Program (C.A.P.). The change to a multi-centered program will allow evaluation of all specialties and more geographically centered testing and training, when appropriate. The program will initially limit its scope to those covered by the Board of Medicine and Board of Osteopathy (M.D.s, P.A.s, and D.O.s) and expects to expand to other health care practitioners, such as registered nurses and advanced practice nurses, in the future. Referrals to the program are for the purpose of assisting organizations, such as the Board of Medicine and hospital credentialing committees, in making decisions regarding whether a physician demonstrates the abilities and attributes to practice medicine in a safe and competent manner. Some common circumstances where a Florida CARES referral may be of value is when a physician is:

1. Returning to practice after treatment for chemical dependency.

2. Returning to practice after an extended leave of absence.

3. Diagnosed with a physical or mental illness that could affect his or her ability to practice medicine.

4. The subject of a patient care malpractice complaint before either of the boards when the knowledge or judgment of the physician is in question.

Referral to Florida CARES & C.A.P. begins with the completion of an application that details the circumstances underlying the present concerns (e.g., administrative complaint, investigative summary, or transcripts from board meetings). The application details the physician’s education, postgraduate training, and includes a listing of the physician’s last 100 patients. The application is reviewed and selected additional complete medical records are obtained for the purpose of developing a practitioner-specific and specialty-specific assessment. The assessment generally requires two days onsite at the testing facility and includes psychological testing, written examinations, standardized patients, case reviews with experts from the client’s specialty, and simulator-based testing, as indicated. The cost of the assessment is $8,500, but can be higher depending on the scope of the assessment. Assessments can also include reverse site visits to the practitioner’s practice location. Costs of the assessments are the responsibility of the applicant. The evaluation provides a detailed description of the deficiencies, as well as recommendations for remediation and upon completion, is provided to the referring agency. Evaluation findings usually fall into one of the following categories:

1. No deficiencies

2. Minor deficiencies

3. Moderate or specific deficiencies

4. Widespread significant deficiencies

5. Global deficiencies

6. Catastrophic deficiencies

Florida CARES & C.A.P. is under the medical direction of Nikolaus Gravenstein, MD, Professor and Chair, Department of Anesthesiology, College of Medicine, University of Florida. Program directors are Eileen Handberg, PhD, Assistant Professor, Cardiovascular Medicine, College of Medicine, University of Florida, and D. Lynn Glass, BSN, JD, LHRM, Associate Director of Risk Management and Loss Prevention, University of Florida Self-Insurance Program. Florida CARES & C.A.P. Medical Directors: University of Florida (Gainesville) Nikolaus Gravenstein, MD University of Florida (Jacksonville) Joseph J. Tepas, III, MD University of Miami Paul Barach, MD Nova Southeastern University James Howell, MD, MPH University of South Florida Jay Wolfson, Dr. PH, JD Program contact and addresses: Florida CARES & C.A.P. Box 100254 Gainesville, FL 32610-0254 e-mail: FloridaCaresAndCAP@anest.ufl.edu Phone: 352-846-3292 Fax: 352-392-6805 Administrative assistant: Rachel Lepanto