New Jersey hospitals may soon be required to make public more detailed information on medical errors. A state Senate committee will meet to discuss a bill that requires the New Jersey Department of Health and Senior Services to publish how often certain errors occur at each hospital. Healthcare facilities already report preventable medical mistakes to the state and federal governments, but New Jersey only publishes the number of errors statewide, not the data for individual hospitals, as the bill would require.
When you're planning a vacation and thinking of trying some pricey restaurant with a celebrity chef's name on the door while you're there, do you hop online to find some consumer reviews first? I do. Sure, you have to keep such reviews in perspective—no matter how good a restaurant might be, someone's not going to like it—but as long as most people offer a positive assessment, I figure the place must serve some decent grub. While I'm at it, I might search for reviews of my hotel, too. Or that museum I want to visit. Consumer reviews might have their limitations, but they also have their value, if you know how to use them.
At least when it comes to finding a golf course or a place to eat pancakes. But what about finding a physician? The health insurer WellPoint's deal with Zagat to have WellPoint members rate their doctors online has garnered a fair amount of press, but in case you need a primer: The reviews include WellPoint members' ratings of their physicians in four categories—trust, communication, availability, and cost. As with other Zagat guides, patients' ratings are summarized and displayed numerically; also included is the percentage of patients who recommend the doctor as well as contact information. A physician's ratings aren't posted until he or she has been rated by at least 10 people.
Now, a sizable number of physicians have been asking patients to offer online feedback in a variety of ways for some time. A sizable number of physicians also hate the idea, of course—at least in a casual form like this that seemingly likens finding good medical care to finding a good nightclub. The central theme of those who object is that while patients might report that they "like" doctors for any number of reasons, they simply aren't qualified to judge the quality of care—or as Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, put it in a New York Times piece I read, "There is no correlation between a doctor being an inept danger to the patient and his popularity."
I agree. Just because a physician is nice or friendly or accessible or whatever other generic adjective you want to apply doesn't mean he or she is actually, you know, good. WellPoint and Zagat contend the ratings are about patient experience, not care quality. Fair enough, but I'm not sure Joe Consumer reading reviews in search of a doctor will make that distinction.
If I knew that consumers would, in fact, make that distinction, then I actually think such ratings could have value—as long as the rating categories make sense. Communication, yes. Trust, maybe. Availability? I guess some docs make a stronger effort than others to squeeze in one more patient or return phone calls in a timely manner, but I don't know that a physician should get demerits for having tons of patients and thus being "unavailable." And cost? Physicians determine the cost of medical care? I didn't know that.
Smart remarks aside, this kind of feedback certainly has its place. At some companies, for instance, subordinates rate their supervisors. On college campuses, students rate their professors. Patients' observations on, say, the amount of time spent in the waiting room or a nurse's bedside manner do have value—particularly if multiple patients offer similar viewpoints and a genuine trend emerges. But to me, that value is limited. Talk to me about outcomes data or infection rates—then I'll pick my provider.
Jay Moore is managing editor for HealthLeaders magazine. He can be reached at jmoore@healthleadersmedia.com.
Note: You can sign up to receive HealthLeaders Media QualityLeaders, a free weekly e-newsletter that reports on the top quality issues facing healthcare leaders.
The American Academy of Emergency Medicine is questioning the reorganization plans for the emergency room at the University of Chicago Medical Center. The Academy says the U. of C. is not including its own emergency-room physicians in the planning, and said the U. of C. should "re-evaluate its triage and screening examination policies." The University's initiative is aimed at clearing its ER of patients with non-urgent injuries and illnesses by redirecting them to community hospitals and clinics. The American College of Emergency Physicians has already called for a Congressional investigation into the initiative and whether it violates federal "patient dumping" laws.
Nadya Suleman told TV host "Dr. Phil" McGraw that she fears Kaiser Permanente Medical Center may not release her octuplets to her until she proves she can care for them. In an interview with the Los Angeles Times, McGraw said Suleman called him and was distressed after talking to Kaiser officials. Suleman has taped two episodes of McGraw's show. Suleman, a single mother who already had six children before giving birth to octuplets Jan. 26, lives with her mother in a three-bedroom house that is in pre-foreclosure. Suleman has no job and relies on government assistance.
When President Obama included money in his economic stimulus plan to help people identify the most cost-effective medical care, he set off one of the sharpest, and most unexpected, political fights of his young administration. The "comparative-effectiveness" issue was supposed to help lay the groundwork for the broader reform effort. But it became a lightning rod for conservative commentators who labeled it a step toward socialized medicine.
Officials in Louisville, KY, are looking at a new screening system for 911 calls as a way to reduce overcrowding in emergency rooms and limit ambulance runs. Hundreds of ambulances are sent out each year in the city to respond to ailments that might not require one, officials said. Many of them go to 911 operators either because the patients making the calls have limited health insurance or they have no doctor or one who is unavailable. If the system is enacted, 911 calls deemed low priority would be rerouted to a registered nurse, who would determine what care is needed.