What if the average patient (person) knew what healthcare insiders, providers and expert patients know?
Take the process of looking for a new personal physician. Conventional wisdom tells people that when looking for a new physician they need to consider things like specialty, board certification, years in practice, and geographic proximity. Online services like Health Grades allow you to see and compare the satisfaction scores for prospective physician candidates.
But industry insiders know different. Consider those patient satisfaction scores for physicians. In reality, “one can assume that the quality of care is actually worse than surveys of patient satisfaction would seem to show,” according to a 1991 lecture by Avedis Donabedian, M.D.:
“Often patients are, in fact, overly patient; they put up with unnecessary discomforts and grant their doctors the benefit of every doubt, until deficiencies in care are too manifest to be overlooked.”
Given the constant drumbeat about the lack of care coordination and medical errors, it would seem that some people (patients) are beginning to reach the breaking point alluded to by Dr. Donabedian. The empowered among us are starting to compare physicians (and the hospitals that employ them) to a higher standard — a higher standard that reflects the nature and quality of the medical services physicians actually provide. Empowered patients today are “being taught to be less patient, more critical, and more assertive.”
In Donbedian’s own words, “patients are justified…in suspecting that the practitioner who has been cursory, inattentive, uninformative, or even rude has not marshaled the full potential of technical skills on their behalf. “
So how might an empowered healthcare consumer go about finding a new doctor these days? For starters, here’s a list of evidence-based questions I would be inclined to ask:
- How would you describe your communication style?
- How do you inform patients of lab test results?
- How long after you get your lab results before I can expect to be notified?
- What percent of your adult patients have had their recommended preventive screenings?
- What percent of your patients are non-compliant with respect to taking their medications or otherwise following treatment recommendations?
- If I need to hospitalized, who would my doctor be? You or some hospitalist?
- What safeguards do you have in place to prevent communication hand-off errors should I be hospitalized or seen in the ER?
- How do you feel about my bringing a friend or spouse to my visit?
- Do you encourage patients to ask you about health information they have found on the Internet?
- For patients needing additional information, do you have a list of recommend websites you can give me?
- Will I get a written post visit report summarizing what occurred at each office visit, including medication and self care instructions?
So if you are a self-satisfied hospital administrator patting yourself on the back because of your high patient satisfaction scores (with your physician-owned practices) watch out. There are hospitals and physicians across town that “get” what empowered health consumers want, and one day soon they are probably going to eat your lunch.
REFERENCE: Donabedian, A., “Quality assurance in health care: consumers’ role.” The Lichfield Lecture. Quality in Health Care 1992;1:247-251.
*This blog post was originally published at Mind The Gap*