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The Kubler-Ross model, physician distress, and performance reporting
Marc C Smaldone1, Robert G Uzzo
1Division of Urologic Oncology, Department of Surgery, Fox Chase Cancer Center-Temple University Health System, 333 Cottman Avenue, Pennsylvania, PA 19111, USA. marc.smaldone@fccc.edu
Nature Reviews. Urology
|April 24, 2013
Summary
Physician performance reporting aims to improve healthcare quality. Applying the five stages of grief model may explain physician resistance to these new quality-reporting mechanisms.
Area of Science:
- Healthcare policy
- Medical quality improvement
- Physician behavior
Background:
- Physician performance reporting is key to healthcare reform, promoting transparency and accountability.
- Regional variations in practice and suboptimal evidence-based care necessitate quality improvement.
- Physicians have resisted public outcomes reporting despite evidence of practice variation.
Approach:
- The Kubler-Ross five stages of grief model (denial, anger, bargaining, depression, acceptance) offers a framework to understand physician reluctance.
- This model, originally developed for terminally ill patients, provides insight into emotional responses to change.
- Analyzing physician resistance through this psychological lens can inform implementation strategies.
Key Points:
- Physician resistance to quality reporting may stem from emotional responses analogous to grief stages.
- Understanding these stages can help healthcare systems address concerns and facilitate adoption.
- Physician-led initiatives are crucial for successful quality improvement in medicine.
Conclusions:
- The five stages of grief model provides a novel perspective on physician resistance to performance reporting.
- Addressing physician emotions is vital for the successful implementation of quality-reporting mechanisms.
- Further exploration of this framework in urology and other specialties is warranted.
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