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Hospice and Palliative Medicine Advisory Committee Meeting Summary | Fall 2024

January 23, 2025  |  Posted by ABIM  |  Specialty Board Meeting Summaries

Laura Dingfield, MD, MSEd, FAAHPM, Chair, Hospice and Palliative Medicine Advisory Committee

The Hospice and Palliative Medicine Advisory Committee—which meets twice a year and is responsible for oversight of policy and assessment in the specialty—held its fall meeting on November 22, 2024. The Advisory Committee reviewed updates on ABIM’s work in a number of key areas and discussed other pressing issues in the field. In addition, representatives from the American Academy of Hospice and Palliative Medicine (AAHPM) joined for a portion of the meeting*.

The following is a summary of the Advisory Committee’s fall meeting. For reports of prior meetings, visit the ABIM Blog.

Conversation with the Administrative Board President*

Contents:

A Note on the Advisory Committee’s Composition

The Advisory Committee comprises physician representatives of five American Board of Medical Specialties (ABMS) Member Boards (referred to as the “cosponsoring boards”) as well as two public members: one with a patient or caregiver background in the field and one with healthcare team member experience in the field. For more detailed information about the history and composition of the Advisory Committee, visit the ABIM Blog.

The Advisory Committee members are:

Conversation with the Administrative Board President*

Prior to the meeting, members and guests of the Hospice and Palliative Medicine Advisory Committee had the opportunity to view a recorded video update from Furman S. McDonald, MD, MPH, who assumed the role of President and Chief Executive Officer (CEO) of ABIM and ABIM Foundation on September 1, 2024. Dr. McDonald reflected on current transitions for ABIM as well as key topics for the Advisory Committee’s consideration and awareness:

  • A proposed pilot model for “exceptionally qualified” international medical graduates (IMGs) pursuing accredited subspecialty fellowship in the U.S. or Canada to become eligible for ABIM Board Certification: ABIM invited commentary from the diplomate community throughout September for the ABIM Council to consider before making a final decision early in 2025, and Dr. McDonald noted that this timing coincides fortuitously with—but is distinct from—similar initiatives for state medical board licensure. Learn more through a video and FAQs on the ABIM website.
  • ABIM’s progress in engaging more closely with early career physicians (diplomates who earned initial certification less than 10 years ago): a task force of ABIM Governance members is making plans to convene early career physicians, create a platform for their perspectives and provide opportunities for them to be more directly involved in ABIM.
  • The continued popularity of the Longitudinal Knowledge Assessment (LKA®), high rates of reported satisfaction and ongoing enhancements: on average across disciplines, 80% of eligible diplomates who choose an assessment continue to choose the LKA over the traditional, 10-year Maintenance of Certification (MOC) exam, and 70.7% of survey respondents agreed with the statement, “I am satisfied with my LKA experience so far.” Specific to hospice and palliative medicine, those numbers are higher: 85% of physicians who chose an assessment in 2024 chose the LKA, inclusive of diplomates of the cosponsoring boards, and 80.2% of survey respondents indicated satisfaction with their experience. Still, Dr. McDonald noted, ABIM continues to evolve and improve the assessment based on diplomate feedback.**
  • The removal of the requirement for ABIM diplomates to earn some MOC points every two years to be considered “Participating in MOC.” With the availability of more activities that earn ABIM diplomates MOC points (e.g., continuing medical education for MOC, UpToDate®, the LKA), the ABIM Council determined that the requirement was no longer needed and that its removal would benefit diplomates and make the program simpler.**

Members of the Advisory Committee asked Dr. McDonald to explain more about the IMG pilot program, specifically whether it would apply to physicians in specialties outside of ABIM, such as family medicine. Dr. McDonald explained that the pathway would be exclusive to ABIM and not applicable to physicians who completed international residency programs in other specialty areas. He added that other Boards have instituted program changes or enhancements in the past based on ABIM’s example, so it is possible that another Board could launch a similar program or have different eligibility pathways than ABIM offers.

**MOC program updates noted above apply to ABIM diplomates. Physicians maintaining certification with the other cosponsoring ABMS Member Boards should refer to their Board with questions or for more information about their program.

Diplomate Professional Profile*

In summer 2023, ABIM invited a pilot group of diplomates to complete the newly developed Diplomate Professional Profile (DPP), a questionnaire required of all ABIM diplomates that is built into the Physician Portal. The questionnaire relates to clinical work and practice patterns and serves to inform ABIM’s ongoing efforts to update assessment options and exam blueprints and develop policies for initial certification and MOC. Since last year, ABIM has continued to invite all remaining eligible diplomates on a rolling basis to complete the DPP. Diplomates receive a prompt to complete their professional profile when they sign in to their Portal.

Siddharta G. Reddy, MPH, Senior Research Associate at ABIM, reported to the Advisory Committee that 31% of diplomates overall had completed their DPP to date. He also reviewed profile questions specific to hospice and palliative medicine.

Dr. Dingfield inquired whether diplomates of the Qualifying Boards1 who maintain certification in hospice and palliative medicine through ABIM can complete the DPP. Staff explained that only physicians with initial certification in internal medicine receive the invitation to complete the DPP, and further development is needed to include others.

The group also discussed the connection between data ABIM collects and the blueprint. ABIM Approval Committees rely on profile data to ensure that assessments are relevant to physician practice, such as settings and practice type. They noted again that the DPP does not include data from diplomates of Qualifying Boards; rather, ABIM has other methods of collecting data from Qualifying Boards to guide assessment content development and is eager to work with those boards on other opportunities.

Julie Bruno, MSW, LCSW, Chief Learning Officer for AAHPM, added that AAHPM has gathered data through member surveys using a series of categories that will be reviewed in 2025. She noted that responses have indicated an increase in outpatient palliative care practice, including clinic and home-based settings.

Diversity, Equity and Inclusion (DEI) Initiatives at ABIM*

Natalie S. Plummer, Esq., Manager, DEI Programs at ABIM, Lorna Lynn MD, Administrator for the Equity Committee, and Pamela White, Senior Vice President, Communications, and Chief DEI Officer, reported on the work of the DEI team at ABIM and recent advances in ABIM’s DEI initiatives. These include:

  • ABIM’s work with participating medical society partners, which led to the formation of the Diversity, Equity and Inclusion Collaborative Network. The goal of the network is to share best practices, coordinate resources and create strategies to support and move diversity work forward as a community.
  • Improvements to the ABIM Physician Portal that now allow diplomates to more accurately self-identify their race/ethnicity and gender with an expanded list of options. This also aligns with ABIM’s efforts to increase diversity in its governance and eliminate bias in assessment questions. Since this effort began, ABIM has seen consistent growth in the number of its diplomates supplying information, with more than 77,000 updating their information. It should be noted that ABIM’s data represents only its own diplomates. Some of the cosponsoring ABMS Member Boards gather similar data but have not yet aggregated them with ABIM’s, while other Boards do not yet capture this information. Therefore, a complete representation of the demographics of hospice and palliative medicine presents an opportunity for further analysis. Ilanit Brook, MD, MSHS, Advisory Committee member, emphasized the importance of including an option to select an identity not listed or “Other” to avoid inadvertently excluding anyone.
  • A report led by Dr. Sara Ray, a medical historian from the University of Pennsylvania, to study the governance records of ABIM. The goal of this project was to determine whether ABIM’s practices within the context of the medical beliefs of the time caused harm to historically marginalized groups that might require restorative action and transparency. The team noted that they planned to share findings from this project with the Advisory Committee in 2025.

Ms. Bruno also spoke about AAHPM’s work in this area, sharing information about the Next Gen Scholars for Equity in HPM Program launched in 2023. The program fosters equity in palliative care and training by pairing scholars from underrepresented communities with mentors who work with them on career advancement opportunities.

Setting a Quality Agenda in the Discipline*

In 2021, ABMS—which comprises 24 medical certifying boards in the U.S., including ABIM and the other cosponsoring boards of the Advisory Committee—adopted new standards for continuing certification that include a requirement for Member Boards to work with stakeholders to facilitate the development of discipline-specific quality agendas. The Specialty Boards and Advisory Committees discussed this in their spring 2023 meetings.

A work group including Dr. Kistler from the Advisory Committee, Katherine Ast, Director, Quality and Research from AAHPM, and AAHPM Quality Committee chairs Eric Goodlev and Laura Gelfman have worked together to identify key themes for the quality agenda: equal access to high quality care, ensuring the inclusion of patient voices, relationships with other internal medicine specialties, and biopsychosocial support and counseling. The Advisory Committee discussed these points in greater detail along with challenges, particularly the difficulty of defining “seriously ill” populations, establishing metrics for care and improving interdisciplinary approaches to care. They agreed on the need for clear terminology to assist physicians from other specialties and proposed possibilities for exploring how to define that.

They also discussed gaps in current metrics of how patients feel seen and heard by their providers and what better metrics should look like. Several members raised points to consider, including how to balance quantitative and qualitative data, including multiple and diverse patient populations cared for by palliative care clinicians (not just the seriously ill).

Update from the American Academy of Hospice and Palliative Medicine*

Ms. Bruno shared news about AAHPM, including the announcement of Steve Smith, MS, CAE, FAAMSE, as Interim CEO and Executive Director. AAHPM is also seeking a new chief medical officer and expects to announce an appointment soon. Ms. Bruno provided an update on AAHPM’s strategic plan and progress on meeting its goals to advance the field, support professional success, build a vibrant community and ensure AAHPM is a strong organization.

Dr. Dingfield is part of an AAHPM working group partnering with the Accreditation Council for Graduate Medical Education (ACGME) on faculty development resources for graduate medical education (GME) and hospice and palliative medicine (HPM) educators. The working group is creating videos for faculty educators in GME to use to improve direct observation, assessment and feedback on communication skills. In addition, the working group is developing a faculty development course focused on assessment HPM educators which will be offered in collaboration with the ACGME in 2025.

Society representatives departed at this point in the meeting.

Recommending Candidates for the Advisory Committee to ABIM Council and the Cosponsoring Committee

Each year, ABIM (as the administrative board) initiates the process of recruiting candidates for open seats on the Advisory Committee. Each member serves a three-year term with the option for one renewal, and positions open on a rolling basis. ABIM posts all openings on its website and shares them with diplomates and other stakeholder groups. The ABIM Council has final approval of physician members representing ABIM; the other Member Boards have final approval for physician members representing them. The Hospice and Palliative Medicine Cosponsoring Committee, which oversees the Advisory Committee, has final selection of the public and interprofessional members. The Advisory Committee pays close attention to its own present and future composition, namely how practice setting and region, career stage, educational background (U.S., international), and race and ethnicity are represented among its members before selecting two candidates for each opening to recommend to Council, the cosponsoring Member Boards or the Cosponsoring Committee as the case may be.

In June, ABIM issued notice about two openings on the Hospice and Palliative Medicine Advisory Committee for terms beginning July 1, 2025: one for a hospice and palliative medicine physician in a non-university or community setting, and one for a public member with patient or caregiver perspective in hospice care. At the fall meeting, the Advisory Committee discussed the candidates they had interviewed and voted on two public member candidates to recommend to the Cosponsoring Committee. They deferred voting on candidates for the physician member until a later meeting.

ABIM will announce the final appointees for all positions in spring 2025 prior to the start of their terms.

New Proposal for ABIM’s Approved Quality Improvement (AQI) Program*

The AQI Program is the process through which ABIM recognizes externally developed quality improvement activities that physicians are doing in practice. It also allows diplomates to earn MOC points for activities that support their local improvement priorities. Approved activities grant 20 MOC points to physicians who meaningfully participate in the activity. Dr. Hays, representing ABA on the Advisory Committee, reviewed the following proposal for the program and provided his recommendation for approval:

  • “Leveraging EHR Tools to Identify Gaps in Medication,” sponsored by Mercy Health. The activity aims to address the need for improved management and treatment strategies for heart failure patients at Mercy Health. It relies on the introduction of smart phrases into clinical notes to help physicians quickly assess and adjust medications, identify treatment gaps and order medications. Outcome measures include percentage of providers using the new smart phrases, as well as various clinical endpoints relevant to management of heart failure.

After a brief discussion, the Hospice and Palliative Medicine Advisory Committee voted to approve the AQI proposal for MOC credit. Any ABIM diplomate in any discipline who is a participant will be eligible to receive credit for this activity.

ABIM welcomes proposals from sponsors that may include medical specialty societies, hospitals or departments within hospitals, medical groups, clinics or other health-related organizations that wish to approve a single activity. Organizations with a quality improvement activity to submit to ABIM for MOC credit recognition are encouraged to take the following steps: 

  1. Download the ABIM AQI Program Guide (PDF). 
  2. Download and complete the AQI Application (PDF). 
  3. Email completed applications to mocprograms@abim.org.

Learn More

The Hospice and Palliative Medicine Advisory Committee values the feedback and commentary of the entire medical community, including diplomates and society partners.

Are you a diplomate of ABIM and interested in getting involved?

Keep on top of the latest news from ABIM.

Do you have questions? Contact ABIM directly:

*Society representatives were present for discussion of this topic.

1 The Qualifying Boards for certification in hospice and palliative medicine are the American Board of Obstetrics and Gynecology (ABOG), the American Board of Physical Medicine and Rehabilitation (ABPMR), the American Board of Psychiatry and Neurology (ABPN), the American Board of Radiology (ABR), and the American Board of Surgery (ABS) and other ABMS surgical boards.

AAHPM, ABIM governance, Hospice, Hospice and Palliative Medicine, Hospice and palliative medicine advisory committee, Laura Dingfield, LKA, Palliative Care, Summary Report

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