Assuming that quality patient care is at least partly related to the manner in which physicians deliver that care suggests a possible definition of a competent physician:
A competent physician possesses and demonstrates the special knowledge, skills, attitudes, and behaviors required to provide quality patient care.
There are several important aspects of physician competence that deserve special emphasis. First, physician competence is inherently peer-driven. Requirements and standards for competence found in training program accreditation, board certification and maintenance of certification, patient care practice guidelines, credentialing, licensing, and peer review are all developed and administered by special committees of physician peers. Second, physician competence is in part patient-determined. In the era of patient advocacy and patient-centered care, the assessment of a physician's competence is incomplete without considering the opinions of patients served by that physician (6
). Third, physician competence is constantly evolving. The basic knowledge, skills, attitudes, and behaviors for competence must of necessity change with new discoveries, technologies, health care system structures, and social mandates (7
). Fourth, physician competence is a continuous process. Partly because of the evolving nature of competence, physicians cannot maintain those abilities without ongoing attention to their knowledge and skills (8
). Fifth, physician competence is behavioral. Physicians must not only possess the knowledge, skills, and attitudes to provide quality care, but they must also demonstrate that competence when they evaluate and treat their own patients (9
). Finally, physician competence requires documentation. In a society that focuses increasing attention on accountability, physician training, board certification, and reputation for competency are being replaced by increasing demands for the on-going, objective documentation of acceptable performance (10