Archive April 2017 XVIII, No. 4

Ideas That Work: Keep Score to Raise GI Docs' Performance

gastroenterologists PEER PRESSURE Just like the rest of us, gastroenterologists are competitive.

Keep Score to Raise GI Docs' Performance

At our GI center, we're big fans of peer feedback. That's why we monitor and compare our docs' adenoma detection rates and withdrawal times, ranked from first to last, for our physicians to see.

As you can see in the table, we've removed the names of the 21 doctors in our group and instead assigned each one a number and ranked them according to their ADR performance from the preceding year — MD1, MD2, MD3 and so on down the line. We're all at least a little competitive, so no one wants to be closer to the bottom than the top, and no one wants to be last on the list. This kind of peer pressure motivates. It reminds us to take our time, and it raises the level of the team as a whole.

We've been measuring our ADR — along with other colonoscopy metrics, like perforation rates and cecal intubation rates — for almost a decade. Our collective ADR for 2009 was 36.6% in males and 22.1% in females. By 2015, those numbers climbed to 53% in males and 37.2% in females. Compare those with the national averages of 30% in males and 20% in females.

Although we have excellent ADR compared to the too-low national standards, the weaker ADRs in our group are strongly associated with poor adherence to the "6-minute withdrawal rule."

Reed B. Hogan II, MD
GI Associates & Endoscopy Center
Flowood, Miss.
reed.hogan@gi.md

Adenoma Detection Rates & Withdrawal Times

Physician
Adenoma detection rate (male)
Withdrawal time (male)
MD2
79%
99%
MD1
77%
100%
MD3
70%
100%
MD5
65%
99%
MD7
61%
98%
MD11
60%
91%
MD6
59%
89%
MD9
58%
77%
MD16
56%
100%
MD8
51%
95%
MD15
51%
67%
MD13
49%
91%
MD18
48%
74%
MD12
47%
88%
MD10
47%
93%
MD14
47%
96%
MD4
45%
53%
MD19
44%
53%
MD17
43%
59%
MD20
39%
66%
MD21
32%
85%
GI Associates average
53%
79%
National average
30%
100%

* 6-minute minimum withdrawal time

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