This is the second in a two-part series on providing constructive criticism to your hospitalist peers. Part 1 appeared in the March issue on p. 12.
Have concerns about a colleague’s work performance? Then you have two main options: You can bring it up in a formal peer review (if it’s a clinical issue) or you can approach the individual yourself.
“Medicine is an art and a science. Many problems relate to the art side—communications and relationships, primarily,” says Richard Rohr, MD, director, Hospitalist Service, Milford Hospital, Conn. “You may need to talk to a colleague about how they approach family members or how they communicate with patients. In this instance, you’d offer more of a coaching comment.”
While you may hesitate to point out another hospitalist’s problem areas, keep in mind that it is constructive criticism.
“Physicians love to run things past colleagues,” says Kenneth G. Simone, DO, founder and president of Hospitalist and Practice Solutions, Veazie, Maine, and a consultant to hospital medicine groups. “Informal feedback can provide an unbiased and objective perspective, as opposed to [a formal peer review].”
When to Offer Constructive Criticism
In some practices, or for some individuals, sharing constructive criticism with peers is part of the job. “Informal peer discussions should take place every day,” advises Dr. Rohr. “While handoffs pose a risk for losing vital information, they are also an opportunity to consider alternatives for diagnosis and treatment that may benefit patients greatly.”
If this seems like a natural thing to do within your hospital medicine group, follow Dr. Rohr’s advice: “These discussions should be frank but nonjudgmental. If someone has a problem discussing cases in this manner, then the group leader needs to get involved. If a life-threatening error is exposed, then the formal peer review system needs to be activated.”
Providing Peer Feedback
When there is no personal conflict, you may still consider offering constructive criticism if you feel it’s warranted. “I think [peer feedback] is extremely important—if it’s done correctly,” says Dr. Simone. “It provides a safe haven for discussion and can contribute to professional growth.”
According to Dr. Simone, appropriate topics to discuss regarding a colleague’s performance include logistical problems within the practice, such as a doctor who is chronically late for morning rounds; continuity issues, such as a physician who fails to provide detailed information when handing off patients; communication breakdowns, such as forgetting to check out the labs pending on a newly admitted unit-patient with chest pain; behavioral issues, such as a physician who’s verbally abusive to the nurses or disruptive at morning rounds; problems with work ethic, responsiveness, or availability, such as the doctor who never responds to his/her beeper (necessitating a call from nursing to an accommodating provider who’s always willing and available to help); and general team play.