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Ask the expert: How often should the medical staff provide physicians feedback?

Hospitalist Leadership Connection, January 4, 2011

Because hospital quality programs traditionally focus on negative feedback, physicians don’t look forward to receiving it more often than absolutely necessary. Your organization will undermine its efforts to create a culture of continuous performance improvement if it only provides infrequent feedback that highlights only negative aspects of a physician’s performance.

To promote a culture of continuous performance improvement, physicians should expect regular, periodic feedback. This feedback should include appreciation for what the physician is doing well and what opportunities there are for improvement. Further, physicians who join your medical staff or group should be told up front to expect regular feedback regarding their behavior and clinical performance.

The frequency of this feedback varies depending on the data. For example, determining how often to provide aggregated, rate-based data (such as patient satisfaction rates or patient complaint rates) depends on whether the data change is based significantly on the physician’s patient volume. If a physician saw only 12 patients and had four disruptive incidents in one year, his or her disruption rate would be 30%. If a physician had four disruptive incidents but saw 1,200 patients, his or her rate would be 0.3%. If your facility is accredited by The Joint Commission, behavior data should be included in the physician’s ongoing professional practice evaluation (OPPE) report, which the medical staff should produce every six to nine months. The OPPE report should be included in the physician’s reappointment file in compliance with The Joint Commission’s standards and the Centers for Medicare & Medicaid Services’ requirements. Even if your facility is not accredited by The Joint Commission, this is still a best practice. The bottom line is that your organization should provide feedback to physicians more frequently than every two years if it wants to make feedback, appreciation, and self improvement part of its physician culture. Your best bet is to provide performance feedback culled from inpatient data to physicians either quarterly or every six months.

The above excerpt is adapted from the new book, A Practical Guide to Managing Disruptive and Impaired Physicians, by R. Dean White, DDS, MS, and Jonathan H. Burroughs, MD, MBA, FACPE, CMSL, published by HCPro, Inc.

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