Impact of isolated clinical performance feedback on clinical productivity of an academic surgical faculty.

Abstract

There is increasing financial pressure to maximize clinical productivity for academic physicians. We examined whether clinical performance feedback alone could contribute to improving the clinical productivity of surgeons in an academic department of surgery. We implemented a clinical performance feedback program in January 2003. We then compared clinical productivity in terms of relative value units (RVUs) of surgeons for 18 months before and 18 months after this intervention, using each surgeon as his or her own control. Regression was performed with dependent variable ln (monthly RVUs) and independent variables "calendar month," "pre/post" January 2003, and "surgeon." The coefficient on "pre/post" reflected average change in RVUs. We also surveyed faculty on their use of and attitudes toward this feedback. There was a 58% survey response. Ninety-two percent of responding faculty reported that they viewed and used the performance feedback, and that it affected their practice. Ninety-two percent believed the information accurately reflected their performance, 89% thought that the comparisons were useful, and 79% desired more feedback information, specifically, comparisons with external benchmarks. When RVU data were examined, the coefficient on change pre- and postintervention indicated a 7.4% increase in productivity (p < 0.001), or a 6.0% increase (p=0.003) after exclusion of outliers. Performance feedback was associated with a small (6.0%) but significant improvement in productivity in this academic surgical faculty group. Performance feedback can be useful and should be used in conjunction with other management tools for this population.