May 9th, 2011 by DrWes in Health Policy, Research
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Quality measures. Patient satisfaction surveys. With our new health care reform law, these “performance measures” are the new black in health care.
Hospitals are currently spending, conservatively, tens of millions of dollars to bolster these “performance measures” in hopes of securing a refund of a mere 1% of payments that CMS will soon withhold from them in the name of “assuring” quality improvement.
But what if, nationwide, there wasn’t a big difference in these measures between hospitals? What happens then? Might payments then be made on political grounds?
Performance measures have been collected for some time now in anticipation of this new payment initiative by the government, so data exist to evaluate. In fact, Kaiser Health News was nice enough to aggregate the findings from our government’s Hospital Compare website for my review.
So I calculated the mean, median and standard deviation of the results of all of this data collected across 50 states and 2 territories and found very little difference in measures collected between states: Read more »
*This blog post was originally published at Dr. Wes*
May 9th, 2011 by Edwin Leap, M.D. in Opinion, True Stories
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Years ago I had a conversation with a surgeon at our facility. He was unhappy that a seriously injured trauma patient came to our facility after a MVC. ‘These patients shouldn’t come here Ed, they should go to a trauma center!’
Fair enough; we aren’t a trauma center. Not a Level I, not a Level II or III; not even a level 0.5! But we are the only hospital in a large rural county, and the closest, largest facility for portions of a few other counties nearby. The nearest hospital with neurosurgery and thoracic surgery is at least 30 minutes further away.
The problem is, torn blood vessels, crushed spleens, collapsed lungs, swollen brains don’t look at the clock, and cars aren’t designed to wreck only near trauma centers, any more than assailants shoot and stab people only within proximity of appropriate care. (It rather defeats the purpose of attempted murder, you know. )
Recently, my partner had the same conversation with the same surgeon. The patient had been shot twice and was hypotensive. ‘These patients shouldn’t come here!’ We understand, the conditions may not be ideal and trauma is, to be quite honest, fraught with medical and legal peril. Read more »
*This blog post was originally published at edwinleap.com*
May 8th, 2011 by Bryan Vartabedian, M.D. in Opinion
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Doctors are preoccupied with consumer review sites and the potential for bad press. Often the first impulse is to put the law on your side. Consider, for example, Dr. Kimberly Henry, cosmetic surgeon who last year initiated legal action against at least 12 reviewers from sites such as Yelp.com and DoctorScorecard.com.
While she may feel some sense of satisfaction in her quest for justice, I’m guessing many read the reviews to see what the fuss is all about.
Actions like these reflect a fundamental misunderstanding of modern reputation management. Physicians who react against patient dialog should understand the Streisand Effect. The Streisand Effect is an online phenomenon in which the attempt to remove or hide information is met with the unintended consequence of greater attention.
Instead of a prohibitive, reactive position against patient comments, doctors should consider a preemptive, proactive approach to dialog. Andy Sernovitz had it right when he suggested, ‘the solution to pollution is dilution.’ Work for good ink. It’s hard to get worked up about 10 poor reviews when you have 350 great reviews.
When physicians take action against patient reviews or even work to prevent reviews they raise a glaring red flag. We’re unlikely to win the battle against public dialog.
*This blog post was originally published at 33 Charts*
May 8th, 2011 by Elaine Schattner, M.D. in True Stories
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Last week I had some blood tests taken before a doctor’s appointment. I went to a commercial lab facility, one of several dozen centers for collecting specimens have opened up in otherwise-unrented Manhattan office spaces lately.
I have to say I really like getting my blood work done at this place, if and when I need blood tests. And it’s gotten better over the past few years.
First, pretty much all they do in the lab center is draw blood and collect other samples based on a doctor’s orders. So the people who work there are practiced at phlebotomy, because it’s what they do most of the time. The guy who drew my blood last week did the same a year or two ago, and he was good at it back then. He used a butterfly needle and I didn’t feel a thing.
Second, they seem organized and careful about matching specimens to patients. The man who drew my blood didn’t just confirm my name and date of birth, but he had me sign a form, upon my inspecting the labels that he immediately applied to the tubes of blood he drew from my right arm, that those were indeed my samples and that I was the patient named Elaine Schattner with that date of birth and other particulars. Read more »
*This blog post was originally published at Medical Lessons*
May 8th, 2011 by KerriSparling in True Stories
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So on Sunday night, I finished singing BSparl her bedtime song and leaned in to tuck her into her crib. But because she was giggling and reaching for me, I leaned in to give her an extra hug.
NEVER GO IN FOR THE EXTRA HUG.
Or at least that’s what someone should have whispered in my ear.
Because when I leaned it, she happened to reach up at the same time and her thumb met my eye with such force that it knocked me to my knees. Apparently, her thumb nail scraped off a section of my cornea (or, as my eye doctor said, “You know when you eat string cheese and you pull a section of the cheese off?” Thanks, Dr. S. I will never, ever eat string cheese again. Ever.) and severely damaged my eye. Read more »
*This blog post was originally published at Six Until Me.*
