Eyeworld

73 OPHTHALMOLOGY BUSINESS August 2015 performance and behavior of the least of your providers. The time is now to develop a process for fair, continuous provider improvement. What should a provider review cover? Any job review process, and the associated documents or written instruments, should allow you to address the specific behaviors, per- formance and outcomes you want to encourage, as well as provide a way to cite any performance gaps. There are 2 basic kinds of perfor- mance reviews: "review light" and "review right." The first is a traditional, shallow, brief, top-down, one-sided approach. The supervising authority, respon- sible for the worker's work product, fills out a performance evaluation scoring the usual topics (timeliness, accuracy, teamwork, etc.) and then delivers the message in a few min- utes to his or her subordinate. The worker signs a copy and gets back to the floor until the next review, next year. This approach to reviews is not appropriate for the least of your staff, much less providers. A deeper type of review is more appropriate for all staff in your practice, and particularly so for providers, who represent the most expensive resource in the company. Deeper reviews have the following characteristics: • They take time: A well-crafted provider review for one doctor may take a few hours to prepare and an hour or more to deliver and discuss. • They use facts and data, not just feelings and impressions—not, "We think that some of your patients think you rush them through an exam," but, "We polled 25 patients at random from the last 4 weeks and 15 told us they felt rushed." • They go well beyond the review- er's feelings to poll the impres- sions of a provider's patients, staff, and peers (and the provider himself) in a so-called peer-to-peer or 360-degree approach. • They come to formal, written conclusions about any needed corrective or improvement ac- tions, with formal deadlines and an agreed process for helping the reviewee improve. Who should perform a doctor's review? How often? Up to about 8 or 10 providers, it's a reasonable obligation of the job for your practice's managing partner or president to be tasked with at least annual provider reviews. It's perfect- ly OK for this task to be delegated to another senior officer of the prac- tice, or an officer combined with a neutral outside consultant or a semi-retired emeritus doctor with no ax to grind. In larger practices we typically find the provider review continued on page 74

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