(September 7, 2010 - Insidermedicine)

Patient characteristics, such as age and mother tongue, have a substantial impact on how they rate the clinical performance of their primary care physicians, according to research published in the Journal of the American Medical Association.

Here are some recommendations for performing an evaluation of your practice, published in 1998 in Family Practice Management:

•    When initiating a performance evaluation process, establish a baseline and then collaboratively define individual performance standards with staff

•    Self-evaluations should be balanced by measurable data about productivity and the effectiveness of the physician-patient encounter.

•    Measurements of patient satisfaction, outcomes, and quality indicators serve as useful proxies to direct observation of physician-patient encounters

Researchers out of Harvard University and Massachusetts General Hospital analyzed the physician clinical performance scores provided by 125,303 adults who visited any of nine hospital-affiliated practices or four community health centers between 2003 and 2005. The investigators looked at the relationship between patient characteristics and the composite physician clinical performance scores they provided.

Patients were more likely to give primary physicians better scores if they were older, had a higher number of comorbidities, or made more frequent primary care practice visits. Primary care physicians received higher scores if they had fewer patients who were minorities, non-English speakers, Medicaid recipients, or uninsured. After controlling for practice site and visit frequency, adjustment of patient characteristics changed physician scores to such a degree that 36% would be reclassified into different quality tertiles.

Today’s research highlights the need to take into account patient characteristics when using physician performance scores to make decisions, such as which physicians to reward or promote.