The peer messengers tap into data about specific behaviors or clinical outcomes used by the university's Center for Patient and Professional Advocacy (CPPA). They schedule "confidential collegial visits" with identified physicians to share data about their standing, compared to local and national CPPA norms related to the complaints. Data is shared with targeted physicians in a 'respective, non-punitive, nonjudgmental, and nondirective fashion," Pichert wrote.
The peer messengers are "willing to intervene with colleagues over an extended period of time," Pichert says.
If anything, the peer messengers are told to avoid any tendency to be "fixers" of problems. If necessary, they initiate a process for additional hospital intervention if they don't make inroads in helping the physicians.
To improve physician clinical work and behavior, two elements are among the most important for success, Pichert says: hospital leadership and the doctors under review themselves.
"Overall success of an intervention process depends not only on peer willingness and skill to provide feedback but also on leaders who will hold others accountable," Pichert writes in the report.
Ultimately, Pichert told me, it is "self-regulation" among the physicians themselves that matters most.