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Table 3 Physician action types

From: Model depicting aspects of audit and feedback that impact physicians’ acceptance of clinical performance feedback

Action Type

Definition

Examples of Actions Taken

Retroactive Acts

The physician revisited previously seen patients to correct an identified problem

Contact patients who did not come in for a scheduled office visit to reschedule the appointment.

Contact patients who were given an order for a test or procedure, but has not gotten the test/procedure, to remind them of the importance of the test.

Proactive Acts

The physician focused on future, rather than previously cared for patients

Contact patients who have an upcoming appointment to remind them of the appointment.

Physicians developing tools to track their patients and performance.

Providing patients with education and/or tools to better manage their disease (i.e. provide them with blood pressure equipment).

Defensive Acts

The physicians attempted to justify their specified level of performance. The defensive approach was often used when physicians felt there was an external locus of control (or factors outside their control such as non-compliant patients) that impacted their performance.

Provide management with an explanation as to why performance was low. 

This approach often required extensive research to identify and document the factors associated with low performance. 

Along with the explanation for low performance, many (4 of 12) physicians offered improvement suggestions.