“Data can’t change me!”
Many of the conversations grouped in this category were achieved using a gender lens of practice in the ED. Most of the responses generated in these discussions centered on the incongruence of values between genders. Gender inequity in clinical practice was not explicitly explored as part of this work, only reactions to data from each gender subgroup. Although many of the discussions center on gender themes, the logic used to discredit a data metric was seen across all subgroups of participating respondents.
Female respondents demonstrated a significant aversion to throughput metrics. Themes were based on sentiments of higher clinical scrutiny for female practitioners as well as reduced value placed on throughput measures.
“We are also way more cautious and way more scrutinized than our male colleagues are.” [P14] “I would say less women are driven so much by the money aspect of it than the guys are. So, the guys are usually much more driven by how many patients they see and what they bill etc.. And that is not entirely true for everybody but whereas women seem to be less drawn into it.” [P10]
Instead, female practitioners stated they placed more emphasis on metrics related to the quality of patient care than those related to throughput, an element otherwise seen as a positive attribute previously quoted as an enabling feature. The aspect of this feedback which is considered counterproductive is the outright rejection of a practice metric in favor of another, a logic which could be broadly applied throughout the range of metrics. This was also seen in a subset of academic clinicians, who stated that adherence to practice guidelines was more important than patient satisfaction, therefore minimizing the patient experience.
“So, probably, women value the quality of care delivered to the patients maybe or maybe they value more the spending time and communicating better with their patients then the just sheer volume of patients seen per shift… [M]aybe they value you know better care for patient care than volume. And that is a different way to look at things.” [P2]
Some clinicians viewed data exercises such as audit and feedback as attempts at practice standardization, leading to the belief that this would remove physician autonomy. The views expressed within this section of the manuscript raised important questions about our expectations of care and practice uniformity.
“…if it becomes that this is secretly a process to make sure that I act and behave like an automaton then it becomes a real problem because physicians are wired appropriately or perhaps inappropriately to really value that autonomy.” [P15]