WHAT DOES PHYSICIAN-FRIENDLY FEEDBACK LOOK LIKE?

There are hundreds, if not thousands of books written on how to give feedback. In my own readings, Radical Candor by Kim Scott and Thanks for the Feedback by Stone and Heen rank as two of the stronger efforts in this area. But many fewer books are written about the specific challenge of giving physicians feedback (data-driven or otherwise) on how they practice medicine. And based on Agathos’ experience to date, it appears that very few physicians get meaningful individual feedback after they leave medical school. (Elspeth speaks to that a bit in this brief video below.) 

As a solution provider of clinical data tools that offer physician feedback, we have a clear interest in ensuring the way we deliver feedback is as physician-friendly as possible.

Here is our look at the characteristics we feel make for the most physician-friendly feedback:

• Trustworthy
• User-friendly
• Respectful

Trustworthy

Trust is the core of any good relationship, and the bedrock into which new knowledge, insight, and change can take root. When it comes to the relationship between a healthcare organization and the physicians who deliver care, trust is something that has to be earned. In The Speed of Trust, Stephen Covey talks about regularly making deposits in the trust account, so that when the inevitable slip up happens, you have something from which they can draw.

When it comes to physician feedback, you can make deposits in the trust account by ensuring that any feedback is

• Clear and specific — Can the physician understand the specifics of this feedback?
• Attributed accurately to their practice — Was the physician in fact responsible for the actions and choices at hand? (This is surprisingly hard, and we have worked hard to perfect this. Here is a brief video about how Agathos handles attribution.) 
• Sensitive to context — Are you reminding the physician of best practices? Suggesting something other than known best practices? In between best practices? How can the physician trust that your feedback is grounded in evidence-based care? Specific to their patients?
• Tied to specific examples — Can physicians see recent and relevant examples of the actions and choices at hand, all to make the feedback more tangible, to allow them to reflect upon specific situations, and consider if there are patterns only they might recognize in between the many situations when actions were warranted?
• Free of financial motives — For feedback to be trustworthy, physicians want to know the number one goal behind the data is better care. Any financial motives will clutter the initiative, even though there are almost always financial benefits to improving patient experience and care.  

User-friendly

Most humans dread any interaction that would be set aside specifically for feedback. Think about performance reviews or when the boss sets up that vague meeting with no warning. Nobody is looking forward to that interaction, nor is that a convenient way to deliver or receive feedback. To be physician-friendly, the delivery of that feedback must be user-friendly:

• Timeliness — Is the data recent enough to recognize?
• Flexibility — Can physicians look at it when they have the time, ideally a time of their choosing, and not be forced to consider it while in the middle of a patient interaction?
• Ease — However the feedback is presented, is it obvious how physicians are doing, what they might consider changing or diving deeper into, and what insights they might share with others? Is it presented in such a manner that they do not have to think too hard?
• Speed — Can all the above take just minutes?

Nobody wants (or needs) long drawn out 1:1s between attendings and physician leaders. “Give me the data and let me figure it out.” At least as an initial step.

Respectful

So often the manner in which feedback is delivered can impact how that feedback is received. Personalities often interfere, and the recipient often questions the credibility or motives of the feedback giver, regardless of how sound the content may be. A respectful approach that is physician-friendly would be characterized as follows:

• Constructive and balanced — Respectful feedback is free of personality, data-driven, and about areas over which the physician has control.
• Actionable and goal-oriented — The physician can make direct changes to their work that would change the measurements on the particular pattern of practice, which in turn will have obvious impacts on outcomes.
• Assumes confidence in clinical judgment — Instead of explicitly telling physicians what to do, physician-friendly feedback simply provides relevant data and lets the physician decide whether any changes are warranted.
• Away from the point of care — To best offer a chance for reflection and self-directed learning, respectful feedback might best allow a physician to process feedback during a quiet moment of their choosing, thereby making receiving that feedback a more positive experience.
• Emphasis on collaboration and support — Knowing how peers are performing (by availability of unblinded peer comparison data) allows physicians to connect with peers to discuss differences in care approaches and find better ways forward for their facility. 
  
  

Owning the most physician-friendly approach to feedback

While we ultimately want to improve healthcare as measured by patient outcomes, Agathos’ approach is to focus change toward the hands of those who make some of our most weighty healthcare decisions: physicians. And to be successful here, it is imperative that we make the intervention with physicians as positive as possible. With that, we have over nine years, dozens of facilities, thousands of physicians worth of experience refining and improving how we deliver peer comparison data to physicians. Based on our regular feedback from physicians, while we are far from perfect, we know we are on the right track and — like the physicians we serve — getting better every day.

Want to see what physician-friendly, data-driven feedback might look like at your healthcare organization? Let’s talk.

If you are interested in a little more on our approach to putting physicians first, take a look at this brief video where Andrew explains more on that topic.