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Writing in USA Today, Dr. Kevin Pho, author of the KevinMD.com blog, described how he thinks online doctor rating can be made better.  His first suggestion is for doctors to encourage patients to do online ratings.  I could not agree more.  By getting more data on doctors into the public realm, patients will get a more accurate picture of how well doctors are doing.  Patients will also be giving doctors the feedback doctors need to give patients the best possible care.

Dr. Pho’s second suggestion is to prohibit anonymous ratings.  Here, I have to disagree with the good doctor.  Letting patients make their comments anonymously gives patients the freedom to give honest—both positive and negative—feedback without concern for reprisal.  Doctors need honest feedback, and the relationship between patients and doctors can be so intimidating for patients that they may not feel comfortable giving open feedback if it isn’t anonymous.

I appreciate Dr. Pho’s concerns about the downside of anonymity.  There are benefits and risks.  Given what we’ve actually seen from ratings on DrScore, the benefits far outweigh the risks.  Despite Dr. Pho’s concerns about the potential for ratings to be manipulated by patients with a grudge, the average score of doctors with 10 or more ratings is well over 9 out of 10.

Let’s encourage all patients to rate their doctors.  Any grudge will be drowned out by having more representative sampling.

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In 1999, the Institute of Medicine reported big risks in American hospitals.  Since then, there have been dedicated efforts to reduce those risks. Are things getting better? A recent New England Journal of Medicine article says no. You can more about the study with its author, Dr. Christopher Landrigan, on Getting Better Health Care.

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The FDA approved a new drug, ipilimumab, for patients with metastatic melanoma.  Advanced melanoma is a terrible condition for which there is little in the way of effective treatment.  Ipilimumab clearly improves outcomes of this horrible disease with improvement in median survival from 6 months to 10 in patients with advanced melanomas.

While the 6 month to 10 month median improvement is nothing to sneeze at, it isn’t a very high cure rate.  And the cost of the drug: over $100,000 for a course of treatment.  Is it worth it?

If I had advanced melanoma and a 3rd party way paying the cost of my medical care, I would say it was worth it.  If I were paying myself?  I’m not so sure.  The high, high cost for drugs that provide marginal benefits is illustrative of the main problem with have with U.S. health care.  Health care reform efforts that don’t address this central problem are going to solve our crisis.  To learn more, visit http://www.drscore.com/downloads/Health_Care_Primer.pdf.

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Satisfying patients is not just about making the right diagnosis and prescribing the right treatment.  Patients need to know they are seeing a friendly, caring, professional physician.  But how do patients know?  It’s complicated.

Patients’ perceptions are affected by all sorts of variables.  Researchers reporting in the Archives of Dermatology looked at what kind of dress patients expect from their physicians.   It’s a moving target, changing with our culture.  Ties and white coats—traditional doctor attire—aren’t uniformly recognized as needed any more.  Some patients, especially kids, can do without them.

Still, physicians will do well to wear dress that communicates to patients the doctor’s professional, caring approach to patient care.

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From Massachusetts’ plans to revamp medical spending to the Republican controlled U.S. House plans to change Medicare spending, there are efforts to move from a health care system that pays for services to one that pays for quality services.  To learn more about practical ways to improve health care delivery by changing incentives, listen to Dr. Mark Fendrick, Co-Director of the University of Michigan Center for Value-Based Insurance Design, talk about how value-based insurance can incentivize patients to seek out better health care at lower cost on Getting Better Health Care.

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More doctors are choosing to practice “concierge medicine”.  What is concierge medicine?  Concierge doctors care for a limited number of patients who agree to pay an annual fee in return for better access to the physician and more time at doctor visits.  On the one hand, this is great for the patients who can afford it and want better service; on the other hand, there is concern this will take away from patients who can’t afford better service.

For now, concierge medicine isn’t very common, though it is growing fast.  As insurers pay doctors less, more doctors may choose to offer concierge services to patients.  Whether this is good or bad depends on the eye of the beholder, but it is a natural and expected result of a medical care system that has a third party paying for care.

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There’s uniform agreement something needs to be done about the rising cost of U.S. health care. The issue has become an acute problem, even for military effectiveness. That’s right. American military leaders testified to Congress about how high health care costs are gobbling up the military budget and threatening military readiness. To learn more, listed to military budget expert Todd Harrison, Senior Fellow for Defense Budget Studies at the Center for Strategic and Budgetary Assessments on Getting Better Health Care.

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February — the month of Valentine’s Day and love. In the next week, we will be releasing who is America’s Most Loved Doctor, a doctor who had a significant number of ratings, along with the highest average rating, during 2010.

Last year’s America’s Most Loved Doctor was Thomas Selznick, DO, a family practitioner in Livonia, Michigan, with Livonia Family Physicians. His overall score was a 9.96 out of 10, and patient after patient described how ‘caring’ he was, how he takes time with the patient, listens and doesn’t hurry.

Who will be this year’s most loved doctor? I’ll give you a hint — it’s a doctor from the south this year, and it’s not a family practitioner.

Do you have a favorite doctor that you would like to see as America’s Most Loved Doctor for 2011? The way to do it is to provide feedback about your doctor through a DrScore.com survey. Rate your doctor and encourage other patients to rate him or her, too!

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Melanoscan — the new medical technology for detecting skin cancer.

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In a discussion on improving patients’ satisfaction, a colleague expressed concern that a uniform for nursing staff would be an indication that nurses are on the bottom rung of the staff ladder.  It is unfortunate that anyone working in a medical office would feel that way.  When it comes to providing patients a great medical experience, every staff member is critically important.

It’s kind of like a football team.  On the offense, who is on the bottom rung?  It’s not one of the “skilled position” players, the quarterback, running back or receivers.  It’s not the linemen either.  There is no bottom rung on a team.  While the quarterback may be the leader, the work of everyone on the team is critically important to winning.  Winning at patient satisfaction is altogether similar.

Physicians are the quarterbacks of patient satisfaction teams.  The physician can’t do everything, but like a great quarterback, the physician has a huge impact on the outcome of the “game.”  If the physician fully communicates his or her caring nature, patients are generally very appreciative.  By guiding the entire office staff team, by assuring that everyone on that team is devoted, skilled and empowered in giving patients great care, physicians can help assure the highest level of patient satisfaction.

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