Posting patient satisfaction scores online is important for organizational transparency, but how might physicians react to potentially negative feedback? Vivian Lee, CEO of University of Utah Health Care, and Akram Boutros, President and CEO of The MetroHealth System, describe transparency efforts at their institutions.

Transparency was a gradual process at University of Utah Health Care. At first, patient satisfaction scores were only given privately to individual physicians, according to Lee. Best practices were then shared to help physicians improve, followed by the ability for University of Utah’s providers to view each other’s scores.

Before going public with provider scores, University of Utah held a number of town halls. There was “a fair amount of resistance” in the beginning, admits Lee. “I tried to remind people always that when you’re a consumer and you go to Amazon or Yelp or TripAdvisor or whatever, if you don’t read a few bad comments, you don’t even believe they’re real.” The town halls generated a lot of discussion, “but by the time we went live I think all but two of our physicians had at least a score of four out of five stars,” says Lee. “People had really improved a lot.”

Similarly, at MetroHealth, physicians with lower-than-expected scores did not want those scores made public. To change their minds, says Boutros, physicians with good results were encouraged to tell their colleagues, “I want my results out there,” and explain that you can’t only post the good scores and not the bad ones. In the first year of going public with patient satisfaction ratings, MetroHealth gave awards to about 60 or 70 employees with scores in the 90^th percentile. “This year, we gave 280 awards for people in the 90^th percentile,” says Boutros. “So as Vivian says, you have to approach it whichever way, but you’ve got to get over the hurdle of ‘this is going to be negative.’”

From the NEJM Catalyst event Leadership: Translating Challenge to Success at Mayo Clinic, June 2, 2016.