I refer you to this excellent column by Bradley Flansbaum at The Hospital Leader. He notes:
We continue to hear about patient satisfaction. Quality measures may be valid under study conditions, but if used improperly or applied in a dysfunctional environment, they help no one. However, we hew to their power, and the data sometimes compel us to work the score, not the patient.
Why do the tests feel wide of the mark? Colleagues I speak with sense the results of the physician evaluations have small meaning; place little faith in their veracity; and would not judge another physician based on the results.
This is no nihilist commentary. Read on to see where he takes this.
We continue to hear about patient satisfaction. Quality measures may be valid under study conditions, but if used improperly or applied in a dysfunctional environment, they help no one. However, we hew to their power, and the data sometimes compel us to work the score, not the patient.
Why do the tests feel wide of the mark? Colleagues I speak with sense the results of the physician evaluations have small meaning; place little faith in their veracity; and would not judge another physician based on the results.
This is no nihilist commentary. Read on to see where he takes this.
3 comments:
It would be very surprising if multiple iterations do not improve the product of quality measurements, and it is encouraging to see that the profession itself is undertaking the task. That is where it should have been in the first place. Far more productive than simply railing against what is.
nonlocal MD
We really need to follow the lead of the hospitality industry and talk about patient engagement instead. Whereas satisfaction is commonly measured, engaged patients are loyal and more efficient users of a health systems's resources. They take a more active role in their health care decisions and have better outcomes across the board.
Satisfaction is important, as physicians and healthcare providers we are in a service industry. Unfortunately sometime we must engage patients with difficult information that they may not want to hear: "I'm sorry you can't have more IV dilauded, you are a known drug abuser and addict who has themselves admitted expressely for the purpose of getting a 3-day, IV opium joyride," or, I'm sorry a cure is not possible in this case but there are other treatments available," or "No, you cannot smoke on the premises," or "No, the diagnosis you've read about on the internet is not correct in this case, you're wife clearly has a large, left hemispheric stroke as demonstrated by CT angiography and MRI."
So we are also parental figures, in a sense: more knowledgeable, more experienced, medically,ethically and legally responsible for their health in most case whether or not they acknowledge our expertise or authority.
The customer is not always right in medicine. There is give and take here.
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