Posts Tagged ‘doctor-patient relationship’

A simple solution — greater transparency for all.

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An e-mail arrived from a marketer offering to help market my medical practice.  The message talked about how the Internet can be good or bad, how doctor rating websites can negatively affect a practice, and how this marketer has solutions for how to put the Internet to better use.

I have a solution, and it’s really quite simple.  Doctors should be encouraging their patients to do online ratings.  Doctors are doing a great job for their patients.  What doctors need is transparency: We ought to encourage patients to do online ratings so that the public sees the great quality of care that doctors are providing.

On the DrScore.com rating site, the average score of a doctor with 20 or more ratings is 9.3 out of 10!  There’s no reason to want to hide that.

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Despite trying to stay healthy, I have a passion for fast food.  Just the other day, I ate out at both Panera Bread and Taco Bell.  I was struck that both companies asked me to complete a survey on my visit, with the request to visit online satisfaction survey sites printed automatically on the receipts.

These companies, like so many others, are collecting customer service feedback and probably act in some way on the results.  I imagine the parent corporations for these stores are committed to making sure there customers get a great experience—not just great food, but a great all around experience, too.

I may be biased, but I think medical care is more important than tacos.  I think attention to providing patient-centered medical services is more important than attention to providing good customer care with bagels and danish.

DrScore.com makes it just as easy and inexpensive for doctors to get patient feedback.  Just as Panera and Taco Bell print the request on the receipts, I look forward to the day when all patients get asked for feedback when they receive a bill or a return appointment card.

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I just recently got back from a trip to Japan, where I was invited to give a very well received presentation to dermatologists and other physicians there on the topic of patient satisfaction. There was tremendous interest in DrScore and in online physician ratings.

Despite cultural differences between the United States and Japan — and differences in the social structure in paying for health care — the fundamentals of patient-physician relationships are quite similar.  The Japanese physicians were intrigued by the DrScore research on factors that determine patients’ satisfaction with their care.

Perhaps the Japanese are very comfortable with Internet-based technologies, as there was no pushback from the physicians on the idea of making doctors’ patient satisfaction scores public.  They seemed to grasp the value to both patients and physicians in making representative scores public.

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Make sure you check out the Getting Better Health Care Radio Program on webtalkradio.net. My latest interview is with Dr. Nancy Oriol, founder of the award winning Family Van program in Boston. She tells us about the barriers to accessing our health care system and how reaching out to the community can help reduce those barriers.

Want to reduce your health care costs? Don’t miss my interview with Dr. Cynthia Koelker, author of 101 Ways to Save Money on Healthcare.   She tells us how we can save money on preventive care, including information on which screening tests we need and which we don’t.

The previous show with David Coates talks about the politics of making needed changes in our health care system.

Another show not to be missed is the interview with Dr. Sandra Kweder, Deputy Director of the Office of New Drugs in the FDA’s Center for Drug Evaluation and Research.  She explains what the FDA does to assure that marketed drug products are effective and safe.

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I received an e-mail invitation to attend a medical-legal seminar on reducing risks. I’m not sure what they are going to cover, but clearly, the No. 1 way to reduce medical legal risks is for doctors to give patients great quality medical care. Patients also need to perceive the quality of care is great. That is why obtaining feedback from a patient satisfaction survey service like DrScore is a necessary component to assessing and assuring patient satisfaction.

Great medical care is really a partnership. Patients can reduce their risk of being in the kind of situation that results in medico-legal liability by taking more responsibility for their own care. Patients should get a copy of their medical records, particularly the results of laboratory work that is done. That will help make certain nothing falls through the cracks in a system that has shown itself to have too many cracks.

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Doctor patient communication

The Archives of Internal Medicine reports that communication between doctors and patients isn’t always what it should be.  The study of 89 hospitalized patients found:

  • Of the 73% of patients who thought there was 1 main physician, only 18% could name the physician
  • Only 67% of the physicians thought patients knew their names
  • Only 57% of patients knew their diagnosis
  • Only 21% of physicians said they always provided explanations of some kind
  • 90% of patients getting a new medication said they were never told about any side effects

The researchers concluded that steps to improve patient-physician communication should be identified and implemented.  Boy, is that an understatement!

To start, perhaps doctors could leave each patient a business card with the doctor’s name on the card.  That would help patients know their doctors’ names.  Even better, have a line on the card where the diagnosis could be written.  I’d include the doctor’s cell phone and e-mail address to help enhance communication between the doctor and the patient and their family.  And perhaps the doctor ought to have a checklist of things to do so that whenever a new prescription is given, the patient is given a written explanation about the medication, including the potential side effects to look out for.

Of course it would help for every patient to be given the opportunity to give their doctor feedback through a system like www.DrScore.com to identify these kinds of problems and solutions to them ASAP.  A “Please give me feedback at http://www.DrScore.com” would be a nice addition to that business card.

We are so invested in improving medical care, with billions and billions of dollars going to the development of new treatments that may someday help someone.  Just a little common sense and some inexpensive solutions could be done right now to enhance the care that most patients receive.

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The AMA and 47 state medical societies authored a letter to insurers about the unreliability of “claims-based” doctor ratings. Claims-based studies use the billing information doctors send to insurers to assess the quality of the care that is delivered. The AMA letter cited studies by the RAND Corporation showing the limitations of these studies.

The AMA hasn’t offered a better way to assess the quality of care doctors provide. Measuring the quality of medical services that doctors provide is extremely complicated, especially because we want doctors to tailor treatments to each patients’ specific needs, preferences and desires.

One aspect of medical care that may be most easily measured is patient satisfaction. This is what we measure and report at DrScore.com.

Patients always know how satisfied they were with their experiences, and there’s growing recognition of the value of patient satisfaction measurement. Government reimbursement programs covering health care may soon require patient satisfaction measurement. The medical boards that certify physicians may require doctors to document and report results of patient satisfaction surveys, too.

This is good news for doctors. Doctors give patients great medical care, and open reporting of that quality is bound to help the public see what a good job physicians are doing.

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A story about a horrible killing in Oakland, Calif., caught my attention. The shooting of a young man by a security guard was captured on tape. The reaction of the community has been national news. This event also received National Public Radio (NPR) coverage in relation to state regulations on videotaping police.  Some states have made it a crime to videotape police in action.

One Web site is devoted to publishing such videotapes. The creator of the Web site was asked on the NPR program about how often the site shows videos in which the police are seen in a good light. He said that rarely happens, but he acknowledges the site isn’t designed to encourage the posting of videos that support the police side of the story. A caller to the program, the executive director of the Massachusetts Police Association was supportive of the public videotaping police officers, pointing out that most of the time such video would be supportive of police.

The police video issue shows the effects of selection bias, a very common problem. When a site like carlosmiller.com solicits video that shows police in a poor light, the site doesn’t provide a representative sample of what’s really going on. Front page news stories about doctors (or about anything else) are similarly biased toward bad events. Even doctor ratings sites can be biased, particularly those that call only for submissions of problems.

What people need is all representative information, good and bad, in order to make well-informed judgments. At DrScore, we encourage all patients to give their doctors feedback, and we encourage doctors to ask their patients — all their patients, the happy ones and, especially, the unhappy ones — to give feedback too.

Getting feedback that tells us how we can do a better job is, after all, a huge gift.

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Oy. The people running South Shore Hospital in Massachusetts must have had a bad day. On July 19, the hospital reported that back-up computer files containing personal, health and financial information on 800,000 people may have been lost.

Electronic record systems have been a boon to the U.S. economy and are poised to help improve medical care in many ways. There are promises of better health care, less error and lower cost. But, like everything else, it comes with potential problems too.  Dr. Dan Siegel explains more about it on the Getting Better Health Care radio program

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