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Posts Tagged ‘patient empowerment’

Here is the latest press release from DrScore.com …

DrScore.com’s Four Friendly New Year’s Resolutions to Improve
Your Health and Patient Satisfaction

These resolutions for doctor visits are easy to keep!

WINSTON-SALEM, N.C. (December 28, 2010 ) — Eat five servings of fruits and vegetables daily, exercise longer, lose weight … it’s time to make those annual New Year’s Resolutions. This year, the patient satisfaction and online doctor rating website DrScore.com suggests a few resolutions to improve your health and patient satisfaction — and these resolutions are easy to keep!

 

“One way to improve your health is to have a better relationship with your physician or health care provider,” said patient satisfaction expert Steve Feldman, M.D., founder of DrScore. “We want patients to make resolutions to empower them so they can be better advocates for their own health and well-being.”

 

Resolution No. 1: Bring a list to doctors’ appointments. Having a written list of all your medications, your past illnesses, your current problems and your questions with you every appointment provides vital information the doctor needs and helps you remember the questions you need answered. “By listing your problems, concerns and questions, you will be better prepared for your visit with the doctor, and the visit will go much more smoothly,” said Dr. Feldman. “Don’t be afraid to ask any questions. Doctors appreciate patients who have organized their information and have done their research.”

 

Resolution No. 2: Speak up. If you are unsure about a situation, speak up and ask about it. “Doctors and medical office staff should be keeping you informed about what is going to happen during the office visit, what tests are being run, etc.,” Dr. Feldman said. “If you feel like you don’t understand something, are unsure about what is happening or are upset about how you are being treated, speak up and try to address the situation in a positive, non-threatening way.”

 

Resolution No. 3: Get written instructions. At the end of the visit, make sure you have written instructions on medications and treatment plans, and find out how and when you will get results from any tests. “The end of the visit is a critical time where the doctor writes prescriptions, gives you the best advice on how to take care of yourself or treat your illness, and talks about test follow-up,” Dr. Feldman said. “The details of medical care are common knowledge for the doctor, but it may be new information for you. Ask for your treatment plan in writing so you don’t forget anything.  Missed test results can also cause problems, so make sure you are proactive in finding out how the office will get the results to you.”

 

Resolution No. 4: Give your doctor feedback. Take the time to let your doctor know how the visit went either by telling him or her, communicating to the office staff, writing a letter or participating in an anonymous patient satisfaction survey at DrScore.com. “Don’t ever be afraid to give your doctor advice on how to be a better doctor,” said Dr. Feldman. “When you give your doctor feedback — whether it is positive or negative — you are giving them a gift. And then your doctor will know what New Year’s resolutions he or she needs to make to be a better doctor!”

For more information on patient satisfaction and improving your visit to the doctor, check out “Great Medical Care: The Handbook for Making Your Visit to the Doctor Better,”, written by Dr. Feldman. Or, visit the DrScore Blog, Thoughts on Patient Satisfaction.

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The Financial Times reported on September 30, 2010, that England will try to revise drug prices to get them in alignment with their value for patients. That sounds good, but can governments and regulators really make good decisions about this?

In a socialist world where government takes responsibility for providing medical care, government has to decide what it will and won’t pay, and what it will and won’t cover.  Another approach is for patients to decide how much to pay by deciding how much a drug treatment is worth to them.  That system seems to work well in the rest of the economy.

So many of us have come to rely on others — insurers or the government — to make our health care decisions for us.  I’m not saying whether that’s good or bad, just that it is.  If we want to control the cost of health care, we’re either going to have to let insurers or the government make those decisions for us, or we’re going to have to change to a system in which we make those decisions for ourselves.  But to do that, we have to be responsible for paying for our health care.  I discuss this in more detail in my Primer on Health Care Reform, available for free by clicking here.

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One of the issues with online doctor rating sites is that it is very much a one-sided affair.  In other businesses, if a customer made a complaint online, the business would be able to respond.  Not so on doctor ratings sites.  The patient privacy rules in the HIPAA legislation  preclude physicians from even acknowledging someone is their patient, so physicians have no ability to respond if they feel there is an inaccurate post about the care they offer.

This seems unfair to many physicians, and I do agree.  Fortunately, the vast, vast majority of patients are very, very happy with their doctors and their care.

The unlevel playing field problem is exacerbated by the possibility that someone with a personal grudge against a physician could purposefully try to harm the physician’s reputation.  It could be a competitor, an angry former spouse or a patient who felt vindictive for some reason.  While one advantage of an anonymous online feedback system is that it lets patients feel they can give fully open and honest feedback without risk of reprisal, anonymous systems have the potential for abuse, too.

Perhaps there could be a rules change that would let a physician respond if a patient opens the door to a discussion of the care they received. But I find that possibility to be unlikely, especially given all the benefits of strong rules about patients’ privacy.  Some physicians may consider other avenues, like those offered by Medical Justice.

But there is another approach, which  is to do what DrScore does: Don’t post open comments at all.

And actually, I think the best solution is to just get every patient to rate his or her doctor online.  That way, even if one patient does say something bad, the public can see what other patients think in order to determine if the negative comment was an outlier or was really representative of what the doctor was like.

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When I went on my recent trip to Japan, I flew United Airlines.  The meeting sponsors paid to have me fly in business class.  It was a great experience.  I could tell how the staff and the company were committed to giving me great care.
Just before the flight ended, a representative from United came over to me and surveyed me on my experience with the flight.  He was very polite, but at the time, despite my love of giving feedback, I just wanted to watch the on-flight entertainment system.  I think they would do well to offer an online feedback system like DrScore so that I could give my feedback at a time that was most convenient for me.

Sometimes I hear physician colleagues say that patient ratings aren’t a good way to assess the quality of health care.  They have a point, but they are also missing the boat.  I have no idea how to fly an airplane, much less all the other technical aspects of how airplanes and airlines work, just as most patients probably don’t know much about the technical aspects of medical care.  But I do know and I can comment on whether my experience on my trip was good or bad.

Patients know whether they have received a good medical experience.

Safe, on-time air travel is like making the right diagnosis and giving the right treatment.  It’s a critical foundation for great service, but it isn’t the end of great service.  A caring experience is essential, too.

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In his blog on patient protection, malpractice attorney Patrick Malone questions the idea of “defensive medicine.” He writes, “if there’s any chance the test may help the patient by revealing a treatable problem, then the test was necessary and doesn’t fall into the category of insurance fraud or defensive medicine.”

This isn’t quite true. Every test also comes with risks. A test might have a chance of revealing a treatable problem, but the risk of the test might exceed the potential benefit. For example, we could get a chest X-ray to look for cancer or a CAT scan of the head to look for brain injury, but the risk of the radiation may well exceed the potential benefit of the test. The right answer in such situations may be to avoid the test. But if a doctor doesn’t order the test, he or she runs the risk of missing the rare treatable problem and being sued.

The right answer to this may lie in a less paternalistic medical system. The doctor ought to educate the patient about the benefits and risk of the test, then let the patient decide if they want to take the risk of the test or the risk of missing the rare problem. Empowering the patient is usually the right answer, whether it comes to health care costs or avoiding malpractice issues.

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