Providing Performance Feedback to Individual Physicians

There is increasing interest in and capability to assess the performance of individual physicians. However, because such activities are relatively new and often proprietary, lessons learned in applied settings frequently remain unknown to others. This report summarizes findings from the published literature and interviews with 12 key informants who were asked questions about their physician-level reporting activities. Regarding content, report sponsors should be honest and direct about the purpose; peer comparisons, actionable feedback, and achievable benchmarks are compelling. Regarding format, there is no definitive guidance; experience to date suggests that reports should be designed to provide a readily understandable snapshot of performance (e.g., rank-ordering results so high and low scores are obvious). There are many options for the report medium: printed hard copies; electronic static copies; and flexible web versions. Although web formats allow users to tailor information, many physicians do not have convenient web access or are not accustomed to using this medium. Thus, care should be taken to meet the needs of the intended audience. In terms of the reporting process, physicians should be involved early and often in development and implementation, and allowed to question data and make changes if errors are uncovered. Importantly, the passive provision of information alone is not sufficient to bring about behavior change. Multi-faceted approaches are more effective, such as interactive educational sessions, coupled with the use of local opinion leaders, and/or feedback reports. Many questions remain about how best to provide performance information to individual physicians; more research is needed.