There are a few themes that permeate this blog – the impact of new technology on medical practice, evidence-based care, health care financing, and a patient-centered approach to care delivery. The recent dust-up over the release of surgeon-specific outcome data touches almost all of them.
ProPublica, a not-for-profit organization devoted to investigative “journalism in the public interest” got the ball rolling last week with the publication of their “surgeon scorecard.” They compiled 5 years of Medicare data (2009-2013) on 8 generally elective surgical procedures: Knee and hip replacement, laparoscopic cholecystectomy, lumbar spinal fusion (broken out by anterior and posterior approach), “complete” prostatectomy, TURP and cervical spinal fusion. For each one, they identified a list of principal diagnosis codes associated with a hospital re-admission within 30 days of the surgery that could reasonably be interpreted as complications of the index surgery. For example, if a patient had undergone knee replacement and was admitted within 30 days with a principal diagnosis of “infection due to prosthesis” then that “counted” as a complication of surgery. Details of the methodology were provided online. The complication rates were adjusted by patient age, gender, and a few other variables, and their user-friendly tool allows for easy look-up of complication rates by surgeon or hospital.
Continue reading Good Enough?
I recently wrote about the wonderfully inspirational documentary Rx: The Quiet Revolution, which tells the story of how four different groups are transforming health care for the better. Each group has some pretty amazing physicians who are committed to putting the patient at the center of the system, and they all have a lot to teach the rest of us about truly caring for patients as we “deliver care.” That got me thinking about physicians in our own Health System who are role-models for great care, and also about assuring that future physicians are just as caring and empathetic.
Well, as far as role-models go, it is hard to imagine a better group than the winners of this year’s Patients’ Choice Awards, given to those members of our Medical Group who achieved the highest scores on their patient experience surveys. They are:
Continue reading Great Doctors of Today and Tomorrow
I had the good fortune last week to see a screening of excerpts from an extraordinary documentary film that will be shown on PBS television stations in April. The film is called Rx: the quiet revolution and highlights four case studies. Each is an inspiring example of new models of health care delivery that are advancing the “triple aim” of better care for individuals, better health outcomes for communities, and lower costs. Our own remarkable Dr. Jennifer Mieres is the film’s executive producer.
The screening left me inspired and in awe of the great work being done by front line professionals all across the country. It also introduced me to a fabulous metaphor for the importance of engaging patients in their own care.
Continue reading There is Good News Out There