There is a lot of talk these days about patient satisfaction. For several years, hospitals have been mandated by CMS to survey their discharged patients about their experiences. The results have been publicly reported and payments are tied to performance. This approach, including the use of a federally mandated standard questionnaire and the linking of payment by CMS to scores, is also planned for physician practices. These policies, which are being adopted by private insurers as well as government payers, have been credited with forcing hospitals and doctors to be more attentive to “customer service.”
It is hard to argue against the need for better service, and for better attention to patients’ comfort, and these programs seem to be working (registration required). But a couple of things about this whole approach leave me feeling more sad than inspired.
Continue reading Patient Satisfaction
A recent study in the New England Journal of Medicine (N Engl J Med 2013;368:1713-22) has been getting a lot of press lately, and not because it reported on a new blockbuster drug. Rather, it reported the results of an unusual – and unintended – experiment about the utility of Medicaid.
A little background: one of the cornerstones of the affordable care act (aka “Obamacare”) is the expansion of Medicaid eligibility to include more low-income individuals. Since Medicaid is a state-run program partially financed with federal funds (as opposed to the “fully federal” Medicare program), eligibility has traditionally varied widely by state with much more generous eligibility and coverage in states like New York (read “blue states”) than say, Alabama. Continue reading The Oregon Medicaid Experiment: A Success or Failure?
It is undeniable that today doctors are bombarded with information as never before. We have all seen the graphs plotting the exponential growth in the number of published randomized controlled trials, or of new practice guidelines, or of websites devoted to medical news. Each of us is feeling pressed, if not occasionally overwhelmed, by the volume of new material of every sort, and the constant competition for our attention and “eyeballs.” Surely there has to be a better reason to start a blog than sharing new information.
Fortunately, there is. Continue reading Introducing “Auscultation” – A Blog for Physicians