Internal Medicine Competencies DRAFT

  1. Practice patient-centered and relationship-based care.
    • Engage patients, caregivers, families, and communities in effective self-management health and well-being strategies.
    • Exhibit respect for diverse interpretations of health, disease, and illness based upon other cultural and/or health system beliefs, models, and practices.
    • Demonstrate critical self-examination of personal biases and beliefs to promote patient-centered care.
  2. Obtain a comprehensive health history which includes mind-body-spirit, nutrition, and the use of conventional, complementary and integrative therapies and disciplines.
    • Acquire accurate and relevant history from the patient utilizing a biopsychosocial model that effectively customizes and prioritizes physical, nutritional, lifestyle, social, emotional, spiritual, cultural, environmental, and behavioral aspects of health and well-being in a hypothesis driven fashion.
    • Seek and obtain appropriate, verified, and prioritized data from secondary sources (e.g., family, records, pharmacy).
    • Obtain relevant historical subtleties that inform and prioritize both differential diagnoses and diagnostic plans, including sensitive, complicated, and detailed information that may not often be volunteered by the patient such as use of complementary and conventional therapies.
    • Demonstrate gathering subtle and reliable information from the patient.
  3. Collaborate with individuals and families to develop a personalized plan of care to promote health and well-being which incorporates integrative approaches including lifestyle counseling and the use of mind-body strategies.
    • Partner effectively with patients, caregivers, families, and communities to develop personalized care plans for health promotion and disease prevention and treatment that include evidence-based screening and management strategies utilizing conventional and complementary approaches.
    • Demonstrate proficient communication to support initiation and maintenance of lifestyle modification.
  4. Demonstrate skills in utilizing the evidence as it pertains to integrative healthcare.
    • Acquire the best evidence with regards to integrative healthcare with a focus on the intersections between health, disease, and the catalysts of: feelings, stress, nutrition, physical activity, social support, spirituality, sleep, and environment by:
      • Accessing reputable print and/or online medical information resources to answer clinical questions and library resources to support decision making.
      • Effectively and efficiently searching NLM database for original clinical research articles.
      • Effectively and efficiently searching evidence-based summary medical information resources.
      • Appraising the quality of medical information resources and select among them based on the characteristics of the clinical question at the point of care.
      • Evaluating critically the strengths and limitations of evidence-based medicine as it applies to conventional and complementary approaches and its translation into patient care.
  5. Demonstrate knowledge about the major conventional, complementary and integrative health professions.
    • Describe roles and national and state standards of a variety of integrative health care professionals as related to training, licensing, credentialing, and reimbursement.
  6. Facilitate behavior change in individuals, families and communities.
    • Collaboratively explore readiness to change, implement patient-centered shared decision making, and employ the lexicon of integrative medicine approaches and disciplines: coaching techniques, motivational interviewing, active listening, appreciative inquiry—to facilitate a culturally competent patient-physician communication climate and sustain successful adoption of interventions that support health and wellbeing in individuals, families, and communities.
  7. Work effectively as a member of an interprofessional team.
    • Respect and discuss the roles of the variety of integrative medicine health care professionals.
    • Discuss the legal implications and appropriate documentation necessary for interprofessional efforts.
    • Collaborate as an interprofessional team to ensure quality care at the patient, family, community, and health system level.
    • Participate in interprofessional medical education to enhance interprofessional practice, team performance, and quality of care.
  8. Engage in personal behaviors and self-care practices that promote optimal health and wellbeing.
    • Demonstrate personal behaviors and self-care practices that reflect commitment to optimal health and well-being.
    • Serve as a role model for commitment to personal health.
  9. Incorporate integrative healthcare into community settings and into the healthcare system at large.
    • Partner with communities to identify culturally competent, population-based interventions that facilitate access to integrative approaches.
    • Coordinate integrative care in a cost-effective manner across the healthcare continuum.
    • Demonstrate the effective use of technology to improve the quality and safety of team-based integrative health interventions delivered to patients, families, and communities.
    • Provide leadership and education to the public, the profession, and the policy makers regarding integrative medicine's evolving evidence base.
  10. Incorporate ethical standards of practice into all interactions with individuals, organizations and communities.[1]
    • Professional education: maintain competency in the practice of their primary specialty such that it conforms to the standards and expectations of peer organizations, specialty groups and licensing requirements.
    • Continuing Medical Education: participate in and track records of CME in the multitude and ever changing fields of interest to integrative health professionals.
    • Professional conduct: eschew illegal activity and unethical practice related to patients, employees, peers and associates.
    • Professional responsibilities: maintain a cooperative attitude in patient relationships based on a mutual decision as to what is best for the patient.
    • Professional confidentiality: Within any legal requirements, safeguard confidentiality of patient information and records, affirming the rights of patients to obtain their records for their own purposes.
    • Community standards: abide by prevailing community standards and law in regard to business practices. Advertising will be honest and factual. Unethical sharing of fees and conflicts of interest will be avoided.
    • Principles of practice: commit to enhancing knowledge, competence and expertise in integrative medicine to the greatest benefit of patients.

[1] Adopted from AM Board of Integrative / Holistic Medicine

Competency Development

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