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Making It All Public

Cheryl Clark, for HealthLeaders Media, May 13, 2014
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This article appears in the May 2014 issue of HealthLeaders magazine.

The public should get to read what patients think about the quality of care they receive from their doctors, leaders of the University of Utah Health Care in Salt Lake City believe. It's important for the organization's transparency, and serves as a tool that pushes doctors to improve their care.

That's why the four-hospital, 597-bed system not only solicits reviews from their patients with comments about doctors' performance, it also has posted nearly 20,000 patient comments on those physicians' Web pages. It has deleted only those comments that are libelous, profane, or violate patient privacy, about 3%.

Some 14 months after the program began, comments that include scathing rebukes and complaints as well as praise are viewable for 376 of the 450 physicians whose patients were surveyed, and for whom there have been at least 30 comments apiece. Every week, another 250 comments are posted. Here are some examples:

  • "One of the finest doctors I have ever dealt with … thorough in her examinations and is very careful to explain …" wrote one patient about a nephrologist.
  • This doctor "is the bomb! Very professional, gives you a clear understanding of what is going on, and what is to come," a patient wrote about a gynecologic surgeon.
  • And about an orthopedic surgeon, "Horrible patient care." And, "Worst physician I'd ever seen. He did not seem to have any interest … I felt like I was a number."

Posted comments describe wait times that were too long, visits that were too short, physicians who had poor bedside manner or came across as insulting, and treatments that didn't help or made matters worse. All are all on display, posted just beneath a one- to five-star scorecard that rates doctors on each of nine questions.

From Salt Lake City to Cleveland and Boston to Miami, hospitals are baring their data souls, showing the best and the worst about their quality of care. Instead of touting promotions and platitudes, their websites are now tools for education and transparency, and leaders say quality of care has only gone up as a result.

Thomas Miller, MD, chief medical officer for University of Utah Hospitals & Clinics, says the physician scorecard effort was a high-level policy decision. It emphasized that the website is now a tool for disclosure of quality through "truth in reporting."

The effort, admittedly easier because of the system's closed staff model, evolved after several physicians angrily complained about commercial, proprietary review sites in which a few anonymous people had written what the physicians considered to be some hateful and unjustified remarks.

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