The 360-degree review is valuable but has some problems
Physicians should be getting a lot more feedback about their behavior than they are actually getting, according to Milton Hammerly, MD, chief medical officer at QualChoice Health Insurance in Little Rock, Ark.
“After residency, you get very little feedback on your work,” said Dr. Hammerly, who used to work for a hospital system. “Annual reviews for physicians focus almost exclusively on outcomes, productivity, and quality metrics, but not on people skills, what is called ‘emotional intelligence.’ ”
Dr. Hammerly said he saw the consequence of this lack of education when he was vice president for medical affairs at the hospital system. He was constantly dealing with physicians who exhibited serious disruptive behavior and had to be disciplined. “If only they had gotten a little help earlier on,” he noted.
Dr. Hammerly said that 360-degree evaluations, which are common in corporations but rarely used for physicians, could benefit the profession. He discovered the 360-degree evaluation when it was used for him at QualChoice, and he has been a fan ever since.
The approach involves collecting evaluations of you from your boss, your peers, and from people who work for you. That is, from 360 degrees around you. These people are asked to rate your strengths and weaknesses in a variety of competencies. In this way, you get feedback from all of your work relationships, not just from your boss.
Ideally, the evaluators are anonymous, and the subject works with a facilitator to process the information. But 360-degree evaluations can be done in all kinds of ways.
Critics of the 360-degree evaluations say the usual anonymity of evaluators allows them to be too harsh. Also, evaluators may be too subjective: What they say about you says more about their own perspective than anything about you.
But many people think 360-degree evaluations are at least going in the right direction, because they focus on people skills rather than just meeting metrics.
Robert Centor, MD, an internist in Birmingham, Ala., and a member of the performance measures committee of the American College of Physicians, said the best way to improve performance is to have conversations about your work with colleagues on the department level. “For example, 20 doctors could meet to discuss a certain issue, such as the need for more vaccinations. That doesn’t have to get rewarded with a bonus payment.”
Dr. Pearl said that “doctors need feedback from their colleagues. Without feedback, how else do you get better? You can only improve if you can know how you’re performing, compared to others.”
A version of this article originally appeared on Medscape.com.
