Fragments left inside patients from medical devices may injure or kill when the pieces shift on their own or are pulled by magnets in imaging machines, regulators at the Food and Drug Administration warned in a post on its Web site. About 1,000 incidents caused by medical device fragments are reported each year, involving more than 200 devices, the FDA said. The most common were catheter guide wires to the heart, followed by bone screws.
Instead of waiting for hours in an emergency room or landing in a nursing home, New Yorkers with government health coverage will soon have opportunity to avoid those costly treatment venues by going to their own family doctor. Gov. Eliot Spitzer proposed changing the way New York reimburses hospitals and doctors for services as part of overall changes aimed at making healthcare cheaper for taxpayers and better for patients.
The business of rating physician care is a tricky one and has resulted in strained relations between health plans and providers on more than one occasion.
The issue came to a head last fall in New York State when Attorney General Andrew M. Cuomo confronted the state's health plans about the science behind their ranking systems and the way they presented the findings to consumers. In the interest of fair play and transparency, Cuomo struck agreements with the major players in the New York insurance market to establish guidelines for ensuring the programs offered consumers a realistic picture of the care offered by the physicians and were not just a means for directing consumers to the lowest cost providers in the network.
These guidelines included requirements that plans not base rankings solely on costs and that they identify to what degree cost played a role in the rankings. Plans also have to disclose to consumers and physicians how the rankings are designed and to provide a process for challenging the ratings.
One of the plans that agreed to this new process was Empire Blue Cross and Blue Shield, an affiliate of Indianapolis-based WellPoint Inc. Now, however, WellPoint is building on the issue and is taking objectivity in the area of physician ratings a step further by removing itself entirely from the process.
WellPoint rolled out a new physician rating service in partnership with Zagat, the well-known publisher of consumer guides for restaurants, hotels and nightspots, that leaves the job of rating providers to the end consumer of care--the doctor's own patients. WellPoint is testing the system by making it available to 1.3 million members enrolled in its consumer-driven health plans in four markets--Los Angeles, Connecticut, Cincinnati and Dayton, Ohio. Later this spring, WellPoint will open the ratings system to all of its enrollees in these markets.
Physicians will be judged on a 30-point scale--just like restaurants and hotels have been for decades--in four categories: patient trust, communication, availability and practice setting. Patients will also be able to leave comments about their experience, which provides that peer-to-peer aspect that makes Zagat's restaurant and hotel reviews so popular.
While physician organizations are rightfully cautious about another new ranking system coming down the pike, I think this partnership could be good for the industry. It brings a respected name in the ratings business into the healthcare arena--one that's unencumbered by the baggage of past efforts to rate the patient care experience. It also offers consumers a ready forum to share their personal experiences--a forum that many are already comfortable participating in through the firm's other ratings services for restaurants and hotels.
But the unique dynamics of the physician/patient relationship have defied common sense interpretations in the past. Will consumers remove themselves from the role of patient and evaluate their physician truthfully and accurately? Will Zagat and WellPoint be able to police the forums in a way to prevent unfounded accusations, but still encourage open discussions on the issues? It's a new step, but one that needs to be taken.
Brad Cain is editor of California Healthfax and executive editor for managed care with HealthLeaders Media. He may be reached at bcain@healthleadersmedia.com.
Did you hear the one about the conservative talk show host who went into the hospital for hemorrhoid surgery?
Unfortunately, there's no punch-line--because it's no joke.
CNN's Glenn Beck almost unwittingly became the new national spokesperson for the healthcare crisis in the U.S. Perhaps the real crisis for the healthcare industry is that Beck's story of the ineffective, uncompassionate, and downright dimwitted healthcare workers he encountered during his hospital stay didn't seem to surprise anyone. It's not just this one hospital that has an image problem. Based on the response to the talk show host's story, which at its peak was the second most-downloaded video on YouTube, I'd say every hospital in the country has an image problem.
Beck was admitted to the hospital (which has not yet been named) after his doctor told him to go to the ER, get some pain medication, and get himself checked in for what was supposed to be a routine outpatient procedure. There were complications that extended his stay, but that's not what went wrong. What went wrong was that he encountered indifferent employees who wouldn't make eye contact with him. What went wrong is that he was scared that he was going to die and no one seemed to care. What went wrong was that his experience was so dark and terrifying that he thought about killing himself.
"Don't talk to me about healthcare," he says on the tape. "Don't talk to me about HMOs. Don't talk to me about anything else. Don't talk to me about how you need a new CAT scan. Don't talk to me about how you need a new facility. Talk to me about how you could have a hospital full of people that don't see people in pain."
Granted, the story is one man's account. And further it's the account of a man who was on some serious pain meds. But his story has resonated with the public because they can relate to it. Beck himself was caught off guard by how quickly the story spread. "I didn't realize why this was a story until recently, and that's because everyone knows that this is true," he said. "Everyone has gone through this."
Your hospital probably uses words like "compassionate" and "caring" in its marketing messages. Your nurses are wonderful, your doctors are brilliant. They don't just save lives, they restore hope, right?
But the public isn't buying it--that's clearly evidenced by the response to Beck's story: A collective shrug of the shoulders, a roll of the eyes, and a rhetorical "what did he expect?" In fact, some are glad that Beck didn't get the star treatment because, they say, the media knows how the average American experiences healthcare on a regular basis.
I know that some of you believe this doesn't apply to you. The only thing that matters is what the local market thinks about your hospital. The only opinions that impact your bottom line are those of your patients and the physicians who refer them. And what happened at that hospital could never happen at your hospital, because all of your nurses and doctors and staffers are compassionate and caring and wonderful and brilliant.
Are you sure?
I'm guessing that the CEO of that hospital never would have thought that one of his or her nurses would tell a patient with a fully distended bladder who is crying from the excruciating pain of hemorrhoids to have a seat. I'm guessing he or she would assume that any triage nurse would help the woman struggling to get her husband into the exam room, rather than tap his fingers impatiently while he waits for them to catch up.
Your good name--your reputation for saving lives and restoring hope--could be ruined tomorrow by one staffer who doesn't get it and a patient or family member with a video camera and a platform on which to post it. One admitting nurse who won't look a patient in the eye, one triage nurse who acts like he has better places to be, one shift nurse who acts like answering questions is an inconvenience is all it takes to undo everything you and/or the members of your staff who do love their jobs and care about their patients have worked for.
You could spend a lot of money to hire a consultant on marketing, branding, and internal communications and you'd probably end up with this same advice from one coincidentally famous patient who underwent hemorrhoid surgery and had a bad experience: "There was a woman who served meals to me every day, for five days," Beck said. "She would joke with me and talk. She made my stay more tolerable because she treated me like a human being ... She looked me in the eye. That's what has to be changed about healthcare. We have to stop looking at medicine as just a science and put the people back into it."
Interested in reading more about healthcare's image problem (and ways to fix it)? Consider the following:
Why Is The ED Such a Pain?: In January's HealthLeaders magazine cover story, Molly Rowe looks at the unique challenges of the ED, which, she notes, is "your hospital's window to the community."
Living up to your promises: Consultant Kristin Baird lists three things that hospitals can do to deliver on the promises of high-quality, compassionate care in those warm and engaging TV commercials and print ads.
From Foe to Friend: Corey Christman reports on how hospitals have responded to five common employee complaints.
Stuck at the Gate: Jim Molpus writes that when it comes to quality and customer service, hospitals should not emulate the airline industry.
Bringing a health system together under one branding initiative, for many, would be easier said than done. For University Health Systems of Eastern Carolina, a seven-hospital system in North Carolina, establishing a brand image meant focusing on family and drawing attention with a bit of color.
Though the goal was to bring the facilities together under one brand image, UHS's agency Jennings Co. in Chapel Hill, NC, set out to first find the points that differentiated UHS facilities from any others in the region. After speaking with leadership from UHS and the community, family and care were the primary concepts that emerged. "We want to treat every patient as if they were a family member. That's what really sets us apart," says Anissa Davenport, vice president of marketing and public relations for UHS.
With those concepts in mind, the next step was to create a unique brand personality for UHS. To do this, distinctive colors were chosen and combined with the imagery. The colors were then assigned to service lines within the campaign. For example, pinks and teals were used for the Women's Health line, and purples and reds were used for the cardiac lines.
"Graphically, the use of big blocks of warm and inviting color is a defining element of this campaign," says Dan Dunlop, president of Jennings Co. By using rounded corners for the various campaign pieces throughout the multi-integrated campaign and the use of the headline text across the entirety of the ad spaces, the ads are unique and eye catching.
Though the initiative is only half way through its run, early focus groups suggest the branding strategy has been effective. According to Davenport, "We'll do a comprehensive analysis at six and 12 months, but the feedback we've gotten has been great so far!"
Officials at Anna Jaques Hospital in Newburyport, MA, believe their efforts to reduce emergency room wait times will keep help the hospital from feeling much effect from an influx of pharmacy health clinics expected to pop up all over Massachusetts. The state recently approved plans for CVS pharmacy to create store based medical clinics, which will bring 100 to 120 clinics to Massachusetts.
Raising the most money really isn't the only measure of a great fundraiser--overcoming obstacles and still breaking new ground for the future is just as important to an organization's bottom line as today's dollar. To help prove this theory, editors of The NonProfit Times asked readers in to nominate great fundraisers.
Alex Bogusky is chief creative officer of Crispin Porter + Bogusky, a Miami- and Boulder, CO-based ad agency that has made a name for itself with its unique, irreverent style. Its portfolio includes TV spots like Volkswagen's "unpimp your ride" campaign as well as more unorthodox Internet campaigns. In this interview, Bogusky discusses how marketers can take a brand and make it famous.
When William Moore arrived as the new CEO at Atlanta Medical Center in September 2001, he found a hospital that had gone through an ownership change from a faith-based organization for the past 90 years to a for-profit, publicly traded company. The hospital was seeing declining numbers of patients in a competitive marketplace, and Moore was now the fourth CEO to lead the hospital in five years. The changes had created a credibility gap between the employees and leadership.
The San Mateo (CA) County Health Foundation says it will commit $1.9 million to improve facilities and expand availability of health care services at San Mateo Medical Center, which is its county's public hospital and clinic system.
