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Posts Tagged ‘medicine’

Delta Airlines in-flight magazine included a review of wine and business expert Gary Vaynerchuk’s book, The Thank You Economy.  The review said that customer service today is generally poor and that social media will make bad service a much bigger deal.  But it is a double-edged sword: companies can also use social media to give their customers a more personal experience.

This is all half-right when it comes to medical care.  Doctors are giving their patients great medical care day in, day out.  But it isn’t always perfect, and at times patients feel their care is lacking.  The Internet and social media can make mountains out of the negative experiences, ruining doctors’ online reputations.

The key is how to use the Internet to nip the problems in the bud, not by trying to “paper over” the problem with online reputation building services but by actually improving the quality of care and making the quality of care more transparent.

DrScore does both these things.  First, by giving doctors an easy, low cost way to get detailed feedback, DrScore gives doctors the information they need to do what they want to do, to give every patient a truly outstanding medical experience.  In addition, by making doctors’ overall scores transparent to the public, DrScore lets patients see a more representative picture of U.S. medical care.

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I recently returned from a trip to a national medical meeting at which I was invited to speak in a session titled, “Managing Your Online Reputation.”  The first guest speaker talked about personal experiences of being skewered online, and the second speaker talked about doctor rating sites in general and how those sites are a jungle of mean-spirited, libelous trashing of physicians.  Worse yet, the audience had come expecting that kind of discussion about online sites and desperately wanted to know what could be done to put an end to online doctor rating.

Now that’s my kind of audience!  I’m not someone who wants to preach to the choir.

My presentation went very well.  I started by explaining why I, a doctor, would start an online doctor rating site. I explained  the value of getting feedback from patients and described how that feedback has made me a better doctor. I also demonstrated how transparency actually helps improve doctors’ reputations in the community.

I think I won over most — if not all the doctors — to the idea that DrScore does online rating the right way and is a positive development for both patients and their doctors.  (At least I know I convinced those doctors who came up afterward to tell me what they thought of the talk.)  Some of the doctors who attended the session decided to sign up to use the DrScore.com patient satisfaction reporting service as a way to get feedback from their patients.

It is heartening to know that doctors can see the value in getting patient feedback and that at DrScore we’ve created an easyk inexpensive way for doctors to get that feedback as a tool to assist them in improving patient satisfaction.

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Joe and Terry Graedon interviewed me about my book Compartments on the People’s Pharmacy: Compartments and Communication.

Our interview was about how misperceptions can lead to communication difficulties that interfere with good health care. When people are operating within their own area of expertise, they may find it hard to understand what the big picture looks like from another person’s perspective. Whether the differences lie between doctor and patient or between different health care providers, the results can be unfair judgments and missed opportunities.

This  attitude can affect the way doctors interpret the results of placebo-controlled trials and how they feel about home remedies. We also discussed the pros and cons of e-mail communication between doctors and patients, and how to choose a good doctor.

Listen here and let me know what you think.

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One of the big efforts to improve the quality of medical care in the United States is the implementation of electronic health records. By putting our medical charts into electronic media, doctors will have more uniform access to our health histories, can be given ticklers for important screening tests, and can be told of potential drug interactions with medicines that were prescribed by other doctors, along with many other potential benefits. You can learn more about the advantages [and disadvantages] of electronic health records on my Getting Better Health Care radio program: “Will the electronic medical record revolutionize health care?.

These benefits may help improve patient satisfaction, too.

However, electronic health records have the potential to negatively impact patients’ medical experiences.  DrScore.com research has shown that the No. 1 factor that drives patients’ satisfaction with their doctors is the patient knowing he or she is seeing a friendly, caring doctor.  If patients find their doctors buried in a computer screen, punching buttons and typing, it could take away from the sense that the doctor is providing the patient personal attention.

There are some things doctors can do to manage the situation.

  • First, don’t put the computer on one side of the doctor’s chair and the patient on the other.  If you do place things that way, the doctor has to  turn their back to the patient to see the chart, and that is simply not good for patients’ impressions of their doctor.  I know, because that’s how things are arranged in my new office!
  • The other thing that doctors can do, especially if their office is like mine, is to acknowledge the problem to the patient. Tell the patient, “These new electronic health records are helpful in so many ways, but one thing I don’t like about them is that I have to turn my back to you to look at your chart.  I hope you will understand and don’t mind.”  Comments like these let patients clearly know that they are being seen by a physician that cares about them and about their feelings.  Letting patients in on one of these little secrets about medical office functioning also lets them feel like they are a part of the process. And they are part of the process — they are the very center of it.

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DrScore has shown time and again that doctors’ conventional wisdom about doctor rating — that only unhappy patients will rate their doctors online — is completely wrong.  The most common overall satisfaction score that patients give their doctors is a perfect 10.  The next most common score is 9.  Of doctors with 10 or more ratings, the average score is just over 9.3 out of 10.  And if a doctor wants to make the annual “America’s Most Loved Health Care Providers” in the United States, he or she will have to have a score well over 9.9 out of 10.

So. if so many people are so thoroughly happy with their doctors, why do we need online doctor rating at all?
First, the public wants to know (and doctors need the public to know) how well doctors are doing.  The newspaper is never going to publish a front page news story with a title like, “John Smith Sees Dr. Jones and Has a Wonderful Office Visit.”  No, if the newspaper publishes a front-page story about a doctor, It is most likely negative, leading people’s perceptions about quality of care to get quite warped.

Transparency is good for medicine.
Second, getting feedback from patients online is easy, efficient and helps doctors do what doctors want to do most: give patients great care. DrScore’s interactive survey makes it possible for doctors to get the detailed feedback they need — both positive and negative criticism —t o make their medical practice better from patients’ perspectives.

In all honesty, I don’t think Nordstrom’s or Disney would be happy with a score of just 9 out of 10, with one in 10 or one in 20 customers being distressed with their experience.  We in medicine can — and should — be aiming higher, trying to give all patients what they consider a perfect, caring medical experience.

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Two judges have ruled the massive new health care law unconstitutional.  Two other judges have ruled that the law is constitutional.  What does this mean?

Dr. Mark Hall, Professor of both Law and Social Sciences & Health Policy at Wake Forest University explains the implications of these rulings, their underlying basis in constitutional law and what happens next in a wonderful article in the New England Journal of Medicine.

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The FDA has announced a new program to help doctors check the approved indications and other information in drug “labels.”  These “labels” are the FDA-approved educational information sheets that drug companies package with medication. See information below:

Online Service Enables Physicians To Check FDA-Approved Medication Labeling Via EHRs.

Healthcare IT News (1/27, Merrill) reported that to “boost drug safety, a new online service has been launched that allows doctors to check the FDA -approved labeling for the most commonly prescribed drugs.” The service is part “of a new campaign” called “Know the Label,” which is being “launched in concert with the FDA’s efforts to provide up-to-date and complete prescribing information to physicians.” It is being delivered to all US physicians and providers “electronically via the websites of PDR Network, The Doctors Company and other liability carriers, via EHR systems. … ‘We congratulate The Doctors Company and PDR Network for finding a practical and novel way for physicians to access the full updated labeling through electronic means and have it available at the point of prescribing,'” said Janet Woodcock, MD, Director of FDA’s Center for Drug Evaluation and Research.

I doubt this new program to disseminate the label information is going to help patients much.  At least in my field, use of medication is based on  patients’ individual conditions and results of studies that go far beyond what’s in the FDA-approved “label.”  Medications are used for conditions other than FDA-approved uses.  Different doses are used.  Combinations that the FDA-approved label says are bad may often be exactly what a patient needs. I guess it won’t hurt to give doctors the information on FDA-approved medication labeling, unless it discourages doctors from giving patients needed treatments for unapproved conditions.

For best results, a doctor’s  good judgment is the best guide to treatment.

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