title: The Kubler-Ross model, physician distress, and performance reporting.
abstract: Physician performance reporting has been proposed as an essential component of health-care reform, with the aim of improving quality by providing transparency and accountability. Despite strong evidence demonstrating regional variation in practice patterns and lack of evidence-based care, public outcomes reporting has been met with resistance from medical professionals. Application of the Kubler-Ross 'five stages of grief' model--a conceptual framework consisting of a series of emotional stages (denial, anger, bargaining, depression, and acceptance) inspired by work with terminally ill patients--could provide some insight into why physicians are reluctant to accept emerging quality-reporting mechanisms. Physician-led quality-improvement initiatives are vital to contemporary health-care reform efforts and applications in urology, as well as other medical disciplines, are currently being explored.
authors.affiliation: Division 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
authors.forename: Marc C
authors.initials: MC
authors.lastname: Smaldone
authors.forename: Robert G
authors.initials: RG
authors.lastname: Uzzo
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004650:Employee Performance Appraisal / Q000592:standards*; D006117:Grief; D018166:Health Care Reform / Q000592:standards*; D006801:Humans; D010820:Physicians / Q000523:psychology* / Q000592:standards*