How can you help physicians value evaluations?

En Chile, la percepción de cierta soberbia entre algunos médicos locales podría afectar la calidad de la atención. Se señala una falta de empatía que impacta la relación médico-paciente. En contraste, los médicos extranjeros a menudo se destacan por su mayor sensibilidad y conexión emocional con los enfermos. Esta diferencia podría deberse a experiencias diversas y enfoques culturales variados. No obstante, es esencial evitar generalizaciones y fomentar una cultura médica que promueva la humildad y la empatía, independientemente de la procedencia de los profesionales de la salud.

Understanding the physician's perspective involves recognizing their goals, challenges, and expectations within their demanding profession. Acknowledge their preferred feedback style, strengths, and areas for improvement. Demonstrating empathy fosters rapport and trust, enabling a more personalized and effective evaluation aligned with their needs.

The best way to do this is to understand what physicians gain through the evaluation and how they can benefit. One way is through a "direct benefit", meaning there is associated financial compensation for doing well, or just as powerful, there is additional free time in the form of reduced tasks (no prior auth or "gold carding" for example) or more vacation earned. In addition there are indirect benefits, such as scoring well on a patient survey that can drive more patients toward the practice, or higher quality scores, which elevates the practice when measured against peers. Both direct and indirect benefits drive a physician to do better, so long as they understand the metrics used by the group evaluating them and scoring is transparent

Demonstrate knowledge of their situation and challenges. Remember personal details. Provide evaluations that are unique to them. Show that you are aware of and value the contribution and effort that they have been making over time at your institution. Especially highlight the improvements they may have made from their last evaluation or improvements that they were part of making at the institution or clinic.

Before you give feedback or conduct an evaluation, try to understand the physician's perspective. What are their goals, challenges, and expectations? How do they prefer to receive feedback? What are their strengths and areas for improvement? By showing empathy and respect, you can build rapport and trust with the physician, and tailor your evaluation to their needs and preferences.

When I think of providing evidence & examples for physicians, it’s more on the Quality and Payment side. There’s still many Physicians that doesn’t understand how being Proactive in their patient’s Health can not only improve quality if care but it’ll also help their practice bring in more money through value based opportunities. There will always be sick patients but make a change in those that can avoid serious illnesses and improve your rating and bottom line.

When evaluating a physician, substantiate feedback with concrete evidence and examples, steering clear of vague or subjective statements. Utilize data, observations, and patient feedback to illustrate points objectively. For instance, highlight specific instances such as communication lapses with patients, fostering a constructive dialogue on improvement strategies rather than making general assertions.

It is imperative that you understand what and why you are trying to criticize and improve. It is easy to criticize but it is very hard to offer constructive productive self esteem building criticism ! Many times we were taught on following orders or doing things one way or the highway ! However if you have evidence based medicine and balance with a good medical foundation and listen to your patient and peers and ancillary staff you can minimize not eliminate errors of judgement and develop a better working in progress diagnosis and plan to a difficult case thinking always of your patient and your own limitations

In my experience as a CMO, I encountered many physicians who have not participated in a performance evaluation before. It is important that the purpose, process, measures, and questions asked are openly shared before the review. Evaluators should include a group of peers and co-workers who have direct observation of the physician's activities for specific feedback. During the review, provide the physician's scorecard with examples that support their rating. When providing feedback, share that all persons have "blind spots". The "gift" provided through the survey process is to identify those opportunities. Share the mean rating score of their peers for comparison and develop a tactical action plan for performance improvement.

Effective evaluation in a medical setting aims to foster growth rather than pass judgment. Recognizing a physician's strengths is vital, highlighting their positive impact on patient care and teamwork. Constructive feedback, coupled with actionable suggestions, can guide improvements. For instance, encouraging punctuality by emphasizing its role in respecting patients, colleagues, and ultimately enhancing overall healthcare quality. The focus is on continuous learning and enhancement, ensuring both the physician and patients benefit from a collaborative commitment to excellence.

Promoting a collaborative evaluation process fosters mutual understanding and motivation. Actively seeking input from physicians regarding their performance cultivates a sense of involvement and value. Encouraging them to reflect on achievements and areas for improvement enhances self-awareness. A two-way dialogue allows for the exchange of ideas and solutions, transforming the evaluation into a constructive partnership. Acknowledging their efforts reinforces a positive atmosphere, motivating physicians to actively contribute to creating an action plan for ongoing improvement. This inclusive approach not only refines performance but also strengthens professional relationships, contributing to a more resilient and motivated healthcare team.

Sustaining the impact of evaluation necessitates an ongoing commitment.Regular check-ins enable monitoring of progress and offer opportunities for continuous feedback. Celebrating successes serves not only as positive reinforcement but also underscores the connection between individual performance and broader organizational objectives. Demonstrating a readiness to provide resources and assistance in the face of challenges reinforces a collaborative environment, emphasizing that improvement is a shared endeavor. By showcasing the direct link between a physician's growth and positive patient outcomes, a culture of continuous learning is nurtured, reinforcing the enduring value of the evaluation process within the healthcare setting.

Most physicians are harder on themselves than any manager or administrator ever will be. Acknowledging an individual physician’s unique strengths and contributions to the practice will go a long way towards fostering trust and teamwork. As a group, physicians are highly educated, self-motivated, and self-sacrificing. Working with, not against, physicians to develop and set goals and milestones is far more respectful and meaningful than simply parroting the latest corporate-speak and checking a series of predetermined boxes.

Admittedly I am not a physician, but have worked with them my entire professional career. When feedback and evaluations are focused heavily on the negative or needs improvement, I’ve seen many physicians slowly start to either tune out during these sessions or avoid them altogether. Make sure to point out those areas where they excel, show massive improvement, or continue to be the standard for the organization.

Perhaps the notion of an "evaluation" is one to be challenged. Most physicians are being evaluated continuously. Quality, productivity, patient satisfaction, engagement, and many other metrics flow freely and often. Is it really necessary to have an "evaluation". Instead how about a reflective conversation regarding all of the metrics that already exist, aligned with a conversation with the physician on what matters to them, their purpose or "why" and how to integrate the expectations implied in all the metrics (inspect what you expect) with who they are. Could be quite transformative!

In fostering a culture where physicians value evaluations, it is essential to establish a transparent evaluation process. This process should clearly outline the frequency of evaluations, the sources of information, and the manner in which the evaluation results will be communicated to the physicians. The process should be applied uniformly across all physicians within the organization. Moreover, evaluations and communication should not be reserved solely for instances of problems. Rather, they should be part of an ongoing process, emphasizing continuous improvement and open dialogue.

After 45 years in surgical practice, i want to share the retrovision as we change in out goals, but not in our principles. When is the right time yo look away and further take the commintement for to retire of the clínical practice? We’ve lost patients, coleagues, friends and siblings, even our wife or husband. Do we have mire to share? Rethink it please. With.best regards