Performance assessment. Family physicians in Montreal meet the mark!

OBJECTIVE

To assess the clinical performance of a representative non-volunteer sample of family physicians in metropolitan Montreal, Que.

DESIGN

Assessment of clinical performance was based on inspection visits to offices, peer review of medical records, and chart-stimulated recall interviews. The procedure was the one usually followed by the Professional Inspection Committee of the Collège des médecins du Québec.

SETTING

Family physicians' practices in metropolitan Montreal.

PARTICIPANTS

One hundred randomly selected family physicians.

INTERVENTIONS

For each physician, 30 randomly chosen patient charts with data on three to five previous visits were reviewed using explicit criteria and a standard scale using global scores from 1 to 5 (unacceptable to excellent).

MAIN OUTCOME MEASURES

Scores were assigned for office practices; record keeping; number of continuing medical education (CME) activities; and quality of clinical performance assessed in terms of investigation plan, diagnostic accuracy, treatment plan, and relevance of care.

RESULTS

Overall performance was judged to be good to excellent for 98% of physicians in their private practices; for 90% of physicians concerning CME activities; for 94% of physicians concerning their clinical performance in terms of quality of care; and for 75% of physicians as to record keeping. There was a link between record keeping and quality of care as well as between the number of CME activities and quality of care.

CONCLUSION

The overall clinical performance of family physicians in the greater Montreal region is excellent.