'Internal Competitiveness' of Docs Spurs Improvement

Medscape's Nick Mulcahy quotes Amol Navathe, MD, PhD, in an article about interventions that can change clinician behavior.

"'Getting physicians to change their prevalent practices and work flow is always hard,' he told Medscape Medical News, 'because there are so many competing demands.'

In an essay in Harvard Business Review last year, Navathe and two coauthors point out that in 2008, Utah Health started collecting patient feedback and sharing it with physicians (it also revealed how individual doctors compared with anonymous peers). By 2012, the presence of websites such Healthgrades prompted Utah Health to start publicly posting patient feedback and scores for its individual physicians on its website. Notably, scores for 25% of their physicians exceeded the 99th percentile compared to peers nationwide, points out Navathe, suggesting that this intervention spurred excellence.

Some circumstances are better suited for data comparisons of doctors, Navathe believes.

'Peer comparisons are likely most useful when applied to clinical decisions with clear choices and when performance metrics have been accepted by physicians,' he and a coauthor wrote in a 2016 essay in JAMA."