Fitting Feedback

Am I doing a good job? Do I make a difference? Everybody -- from the file clerk to the senior physician -- wants and deserves feedback on how well they're performing.

As a leader in your practice, you might think about the language of feedback in terms of the bottom line: patient visits, revenue, expenses, and net. While money is one motivator of work satisfaction, research shows that the majority of working adults come to work for the psychosocial and spiritual reward.

There are also "softer" considerations to framing performance feedback, like thoroughness in setting up an exam room, a caring attitude when answering a patient's questions, and well thought-out patient flow systems.

In any case, everyone wants to be of service and they'd like some input, please, about how they're doing. Giving feedback is difficult for everybody. Some of us shy away from any conversation where we might sound confrontational for fear of a backlash. Or perhaps you're of the school that people should just do their jobs and not expect applause for it.

The truth is, without feedback, we can't improve and grow; and with frequent positive acknowledgment for jobs done well, we grow by leaps. Here are my suggestions for making performance feedback more satisfying for the recipient and less daunting for the giver.

Be specific

Rather than telling your nurse or staff member, "You're doing a great job," take a minute to articulate the specific behavior that made a difference or was aligned with your organization's mission. Here are some examples:

• "The extra time you took with Mrs. Jones to explain the procedure was very reassuring to her and her family." 
• "Your analysis of our patient satisfaction data was thorough and straightforward. This will help us focus our efforts."

Be timely

Instead of waiting for a staff meeting or a quarterly or annual performance review, offer your feedback as soon as possible after you observe behavior you appreciate -- or that you want improved. It only takes a minute to do it in person (with sincerity and enthusiasm) or in written form (highly prized by the recipient). One caveat: Don't give negative feedback via e-mail; always offer constructive comments face to face and, preferably, in private.

'What generally works best'

There will be times when you observe your staff doing things "the wrong way," or not to your preference. While verbally beating somebody with a stick might work to correct behavior, your results will ultimately be better if you frame it in terms of what works best for you or the organization. Here are some examples:

• "When I do an upper endoscopy, what generally works best for me is to have the patient set up in this position, with the instrument tray and scope set up over here."
• "When a patient calls in at the end of the day, what the group decided will generally work best for us is for the doctor on call to take the patient, rather than the patient's primary physician."

In the absence of feedback, people naturally assume the worst about their performance. Give your staff the gift of frequent acknowledgment for the specific things they do well every day -- even the mundane tasks that are part of their job description. Doing so regularly will not only measurably improve their performance, but also promote strong morale and a more fulfilling workplace.

Francine R. Gaillour, MD, MBA, FACPE, is president of The Gaillour Group, an executive coaching resource for physicians who want to develop their potential as leaders, entrepreneurs, and business professionals. Her transition into business management came after 10 years of practicing in internal medicine. She can be reached at francine@physicianleadership.com, (888)562-7289, www.physicianleadership.com, or at editor@physicianspractice.com. 

This article originally appeared in the March 2005 issue of Physicians Practice.