Listening to Feedback, Increasing Surgeons' Pay

Team-based feedback has the potential to improve surgeons' relationships with coworkers and patients. The clinical implication: using such feedback to improve less-than-optimal behaviors could increase practice reimbursement under the "pay-for-professionalism" system.

Many employers are using feedback from 360-degree surveys—combined with coaching—to improve employee performance. The 360 degree evaluation model incorporates feedback information from a circle of stakeholders including subordinates, peers, customers and also an employee self-assessment. Now, 360-degree assessment is moving into the surgical suite. Studies show that such assessment can improve physician team performance and quality of patient care. Two tools are validated for this purpose:

  • The Physicians Universal Leadership-Teamwork Skills Education (PULSE) 360 allows colleagues and coworkers to assess a physician’s leadership, teamwork, and clinical practice style.
  • The Clinician & Group-Consumer Assessment of Healthcare Providers and System (CG-CAHPS) is a US Department of Health and Human Services patient feedback tool employed to benchmark quality in health care. Soon, Medicare will use this tool to tie physician performance to compensation.

A new study examined PULSE 360-degree survey results to determine if they could predict patient satisfaction/experience ratings as reported in CG-CAHPS. The authors postulated that a relationship between these two forms of feedback could help physicians reinforce their strengths and identify and work on their limitations.

The authors analyzed data retrospectively using CG-CAHPS patient and Quality PULSE 360. They looked at two factors: (1) insight impact score and (2) leadership-teamwork index.

The Quality PULSE 360 insight impact score correlated with patient satisfaction, patient recommendation, patient rating of surgeon respect, and patient impression of clarity of the surgeon counseling. The leadership-teamwork index also correlated with patient rating of the surgeon’s behavior (ie, his or her respect toward patients) and patients’ impression of the clarity of the counseling the surgeon provided.

The authors indicate that feedback from work team members may provide helpful information into how patients perceive a surgeon’s behavior. Their insights and observations are usually congruent with patients’. Team-based feedback has the potential to improve surgeons’ relationships with coworkers and patients. The clinical implication: using such feedback to improve less-than-optimal behaviors could increase practice reimbursement under the “pay-for-professionalism” system. This study appears in the October 2014 issue of Clinical Orthopaedics and Related Research.