The Annual Performance Review is Torment for All Parties

How do you know when you are doing a good job in your position in a medical office?  What areas do you need improvement? What challenges does the office administration hope you will tackle in the coming year? For a medical practice to function smoothly, every single person from the front desk to the office manager to the medical providers can benefit from feedback about his/her performance.

Yet, the annual performance review is dreaded by all parties.  Is there a way to make it better? These regular "report cards" are important to running a practice, but most office managers and physicians don't like being on either side of this event. I can share what doesn't work well, especially for employed physicians.

We've tried all sorts of review procedures.  In general, the front-desk staff and the nurses deal well with the review performed on their anniversary of hire month. In fact, these staff members look forward to receiving feedback and especially like learning how their pay is going to increase. If they are not getting a raise, they usually are well aware as the office manager doesn't delay having these difficult conversations.

Employed physicians are a totally different challenge.  We have tried many different formats for this feedback, but have yet to find one that works well.

In our first attempt at formalizing the annual review for employed physicians, we used a template. This form covered all the important aspects of a doctor's vital role in a medical practice. It consisted of multiple sections (such as documentation, patient feedback, nurse feedback, chart completion, continuing medical education and citizenship/leadership). Each section had a number of different questions filled out by the supervising physician and office manager. The first one we used was complex and confusing and proved too cumbersome, so we only had it for about 18 months and searched for something easier.

 The next one we tried was no better! It was based on the A to F grading scale and a "C"grade was average and meant "meeting our expectations". I would bet that it would come as no surprise that doctors are over-achievers that getting a B or C made them irritated and panicked. No matter how many times we tried to explain this rating system, it never went well unless the doctors got "A's" on a section and no one can greatly exceed expectations all the time in all areas.

Yet again, we searched for a better method to achieve this procedure!

We next tried having the supervising physicians and office manager complete a written evaluation, including the various areas in which doctors should be proficient.  We met with the physicians, had each one read the evaluation and if they had any responses or corrections, and asked them to respond in writing.  Sometimes months would go by before we got their response and even putting a two week time frame on getting their reply didn't help.

Next we tried asking the employed doctors to write up their own evaluation and we would add our critiques and then meet to discuss.  As you can imagine, this was even less useful to all parties.

Finally, we started sending them our written evaluation and let each doctor know that if they wanted to meet to discuss, they could simply ask for a face-to-face evaluation with us.

Do you have any good methods to give feedback to employed physicians? What has worked in your office? What has definitely not been a hit? Please leave your comments as we all could use some good ideas for this dreaded yet important annual review.