L’évaluation des pratiques professionnelles dans les pays francophones : l’expérience belge

Evaluation of professional practice in medicine falls in the framework of a wider evaluation of the quality of care and the return on the financial and human resources used by the Social Security. In Belgium, this action began in 1993. It involves accreditation of physicians, and this is now based on three principal criteria: medical practice criteria (especially the minimal threshold of patients contacts), continuing medical education (learning activities with accumulation of a minimum number of credit points), and an evaluation of medical practice (participation in meetings with a local medical evaluation group). This accreditation is not obligatory, but it is encouraged by non-negligible financial incentives for accredited physicians (increased consultation fees, and an annual contractual indemnity). On the other hand, the physicians who are responsible for the organization of the accreditation decisions carry out their responsibility without being paid, which together with the administrative workload makes the system rather slow.