Characteristics of ratings of physician competence by professional associates.

Although the evaluation of medical students and residents frequently includes the use of global ratings scales as measures of clinical competence, few studies have investigated the use of global ratings in evaluating the performance of practicing physicians, or the psychometric properties of these ratings. In this article, the characteristics of ratings of physician competence by professional associates are described, using practicing internists as the subjects for the study. Ratings of nine aspects of clinical competence for 210 internists were obtained from four physician associates with whom patient care had been shared. The results suggest that ratings of physicians' clinical competence by professional associates are both reliable and potentially useful in identifying physicians with low performance. Studies are needed to clarify further the psychometric properties of peer ratings, and to determine factors that affect these ratings.