Emphasis should now be on peer mentoring, not profiling

A carefully tailored peer mentoring intervention improves self-efficiency, self-management skills, medicine adherence, and clinical outcomes, among other benefits for medical practitioners.


"Up until now, our doctors have been subjected to peer review, but the emphasis now should be on peer mentoring,” Prof Morgan Chetty, Independent Practitioners Association Foundation (IPAF) chair, insisted last week during the BHF Conference in Cape Town when noting that healthcare practice had been slow to integrate peer mentoring as a clinical intervention.

“We now have the benefit of new technology to support peer mentoring, new apps that are activating an untapped workforce to help some of healthcare’s deepest challenges, largely due to resource constraints,” he added.

Acknowledging that technology had been around for a while, Chetty made the point that earlier digital tools lacked the necessary protocols, processes and oversight to allow peer-to-peer support to predictably deliver outcomes.

The primary goal of physician mentoring should be to provide meaningful information on their clinical performance, processes to improve quality of care and outcomes, and to keep an eye on the cost of care.

“Success,” he said, “would be measured by evidence of improvement over time in structure, process, and outcome of care.”

Physician practice profiling, on the other hand, Chetty explained, was an epidemiological technique that focused on patterns of care rather than the individual occurrence of care.

The traditional use of claims data for these erstwhile peer review evaluations had several disadvantages, particularly as a quality improvement tool: “This method lacked specificity, lack of complete and current information,” he said, pointing out that new measurements included lab test results, correct medication information and, importantly, adjudication of coding.

“The main focus on profiling and peer mentoring”, Chetty concluded, “has to be on appropriate chronic disease screening, diagnosis and program enrolment as well as adherence to appropriate chronic care provision and clinical decision making.”

This, he reiterated, had to apply to medicine and treatment adherence, process measures, clinical outcome monitoring, and downstream utilisation practices.

Also important in this regard would be adherence to preventative care and, pertinent in particular to recent experiences, vaccination.

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