Rating Doctors May Be Hazardous to Your Health
What’s happening:
Press Ganey…has become a hated target of hospital physicians, outstripping even trial lawyers. Utter its name in an emergency room and you’ll likely unleash a cloud of four-letter words. Based in South Bend, Ind., Press Ganey is the nation’s leading provider of patient satisfaction surveys, the Yelp equivalent for hospitals and doctors, and a central component of health care reform. Over the past decade the government has fully embraced the “patient is always right” mode l — these surveys focus on areas like waiting times, pain management and communication skills — betting that increased customer satisfaction will improve the quality of care and reduce costs. There’s some evidence they have. An ObamaCare initiative adds extra teeth, to the tune of $850 million, reducing Medicare reimbursement fees for hospitals with less-than-stellar scores.
The downside:
The current system might just kill you. Many doctors, in order to get high ratings (and a higher salary), overprescribe and overtest, just to “satisfy” patients, who probably aren’t qualified to judge their care.
Source: Forbes.
Patient satisfaction surveys about such attributes as empathy, bedside manners and waiting time are legitimate ways to rate physicians’ customer service. However, I’m hesitant for Medicare to incorporate such measures into its payment schedules. Medicare cuts physician fees to below Medicaid levels and then penalizes doctors for not pandering to senior patients. This will serve no purpose other than to nudge doctors to form concierge practices even faster. A better way to encourage customer service would be to allow doctors to balance bill Medicare patients. Doctors whose customer service skills are not up to standards would find seniors less willing to pay them. This is not unlike how nice restaurants operate. You don’t tip your waiter if the service is bad. Likewise, you would not patronize a doctor who charges more than Medicare will pay if the service is bad.
This needs to go along the same vein as “Congress shall pass no law..”
Very interesting post.
Once again we have proof of how careless this system is of patients. Physicians’ priorities are all over the place, as usual they just seem to care more about their own pockets than the health of those they are supposed to care for. How are we, based on these facts, supposed to trust their professional advice?
Hayekian unintended consequences.
Normally I support the idea of ratings for goods and services – they allow for an increased flow of information to producers. However, unlike a simple restaurant rating, a doctor rating is adversely influenced by the patient’s state of mind upon arrival. There are very few people who truly enjoy waiting in an ER or at a doctor’s office. When these consumers finally see their care provider, they already feel agitated from their poor health – which is often compounded by egregious wait times.
In our consumer-driven society, we are spoiled by immediate gratification. When we wait for three hours to see a doctor, we expect to feel better. If we don’t immediately, we may accuse the doctor of “not doing enough”.
If we begin to rate doctors based on the frustrated rantings of ER patients, we will unnecessarily punish good doctors for being anything less than miracle workers.
“One emergency room with poor survey scores started offering Vicodin “goody bags” to discharged patients in order to improve their ratings”
Also,
“Press Ganey admits that survey sample sizes sometimes are too small and says a minimum of 30 responses for an ER is necessary to draw meaningful conclusions from its data. But William Sullivan, the Illinois ER doctor, says that Press Ganey reports monthly results to his hospital even when there are as few as eight to ten surveys. His department has ranked in the first percentile one month and in the 99th percentile two months later.”
The current down side:
“The current system might just kill you. Many doctors, in order to get high ratings (and a higher salary), overprescribe and overtest, just to ‘satisfy’ patients, who probably aren’t qualified to judge their care.”
One major concern I have with what it means for the all those patients who are addicted pain-killers and adderall. I mean now they can have a dangerous influence on health care. Doctors must do what is right, and sometimes patients aren’t in the best position to judge what is best healthy choice for them.
“Many doctors, in order to get high ratings (and a higher salary), overprescribe and overtest, just to “satisfy” patients, who probably aren’t qualified to judge their care.”
– Thats disturbing