Comments on: Should patient satisfaction influence physician compensation? http://www.kevinmd.com/blog/2009/09/patient-satisfaction-influence-physician-compensation.html Wed, 15 Feb 2012 00:14:00 +0000 hourly 1 By: Jasonhttp://www.kevinmd.com/blog/2009/09/patient-satisfaction-influence-physician-compensation.html#comment-111786 Jason Sun, 13 Sep 2009 15:36:53 +0000 http://www.kevinmd.com/blog/?p=40002#comment-111786 I agree with Kim. I did an volunteer internship at a major urban hospital and the volunteers held a vital role in patient care. The number of patient techs often times could not handle the overflowing number of patients. But the volunteers were able to ease the stress the E.D. felt. Hospitals that are understaffed need to realize that they have a labor force willing and ready to work for near nothing. The hundreds of thousands of pre-medical and pre-health students who all need both a job, and experience in the hospital could fill the void in these understaffed E.R.s. My internship was unpaid, but it was invaluable in experience. The hospital benefited as well as the volunteer team helped ensure patients had someone to get the lesser important items for them as they waited. More emergency departments should take advantage of the undergraduate student population. The students would greatly benefit from the experience, and the hospital would plug the holes that exist in care. I agree with Kim. I did an volunteer internship at a major urban hospital and the volunteers held a vital role in patient care. The number of patient techs often times could not handle the overflowing number of patients. But the volunteers were able to ease the stress the E.D. felt. Hospitals that are understaffed need to realize that they have a labor force willing and ready to work for near nothing. The hundreds of thousands of pre-medical and pre-health students who all need both a job, and experience in the hospital could fill the void in these understaffed E.R.s. My internship was unpaid, but it was invaluable in experience. The hospital benefited as well as the volunteer team helped ensure patients had someone to get the lesser important items for them as they waited. More emergency departments should take advantage of the undergraduate student population. The students would greatly benefit from the experience, and the hospital would plug the holes that exist in care.

]]> By: Mikehttp://www.kevinmd.com/blog/2009/09/patient-satisfaction-influence-physician-compensation.html#comment-111522 Mike Thu, 10 Sep 2009 06:54:07 +0000 http://www.kevinmd.com/blog/?p=40002#comment-111522 Not only are only the "urgent" or "non-urgent" patients the ones that have their satisfaction scores counted, alot of the people in this group who use the ED as primary care. Many of these are "Self-Pay". So, theoretically, an ED's salary is lowered by patients who do not pay their bill and by patients not seen for emergencies which is what the ED doc is trained for. Where else in the world does this happen?Now there are some people who are go the extra mile to improve their "scores". And they are usually great MD's and very personable, and we can learn alot from them. But lowering salaries is not the right incentive. Not only are only the “urgent” or “non-urgent” patients the ones that have their satisfaction scores counted, alot of the people in this group who use the ED as primary care. Many of these are “Self-Pay”. So, theoretically, an ED’s salary is lowered by patients who do not pay their bill and by patients not seen for emergencies which is what the ED doc is trained for. Where else in the world does this happen?

Now there are some people who are go the extra mile to improve their “scores”. And they are usually great MD’s and very personable, and we can learn alot from them. But lowering salaries is not the right incentive.

]]> By: Doc Stonehttp://www.kevinmd.com/blog/2009/09/patient-satisfaction-influence-physician-compensation.html#comment-111514 Doc Stone Thu, 10 Sep 2009 00:18:03 +0000 http://www.kevinmd.com/blog/?p=40002#comment-111514 This just adds one more reason as to why physicians should be the dominate controling force in health care institutions--they are the ones held responsible for the entire process of care. This just adds one more reason as to why physicians should be the dominate controling force in health care institutions–they are the ones held responsible for the entire process of care.

]]> By: Rogue Medichttp://www.kevinmd.com/blog/2009/09/patient-satisfaction-influence-physician-compensation.html#comment-111511 Rogue Medic Wed, 09 Sep 2009 23:52:07 +0000 http://www.kevinmd.com/blog/?p=40002#comment-111511 Should we also base the reimbursement of middle school and high school teachers on the satisfaction of the students?If you are going to the ED for something that does not result in an admission, do you even belong in the ED? Maybe it would be better to assess the outcomes of patients by as objective measures as possible. Injury Severity Score, for trauma, for example.We are told that doctors with better bed side manners will be sued less often than others, regardless of the competence of the doctors. Do we need to come up with another way to reward something other than a doctor's ability to treat emergencies?Aren't we rewarding the wrong behaviors? Should we also base the reimbursement of middle school and high school teachers on the satisfaction of the students?

If you are going to the ED for something that does not result in an admission, do you even belong in the ED? Maybe it would be better to assess the outcomes of patients by as objective measures as possible. Injury Severity Score, for trauma, for example.

We are told that doctors with better bed side manners will be sued less often than others, regardless of the competence of the doctors. Do we need to come up with another way to reward something other than a doctor’s ability to treat emergencies?

Aren’t we rewarding the wrong behaviors?

]]> By: Doc99http://www.kevinmd.com/blog/2009/09/patient-satisfaction-influence-physician-compensation.html#comment-111510 Doc99 Wed, 09 Sep 2009 23:23:46 +0000 http://www.kevinmd.com/blog/?p=40002#comment-111510 "...But the MD attending the ER is rarely the cause of slow patient flow. "How about considering the number of patients and the severity of illnesses? Also, are we running a Hilton or a medical service? This "inmate running the asylum" is being carried a bit too far. Show me the connection between patient satisfaction scores and real measures of clinical outcomes. “…But the MD attending the ER is rarely the cause of slow patient flow. ”

How about considering the number of patients and the severity of illnesses? Also, are we running a Hilton or a medical service? This “inmate running the asylum” is being carried a bit too far. Show me the connection between patient satisfaction scores and real measures of clinical outcomes.

]]> By: hypnoidhttp://www.kevinmd.com/blog/2009/09/patient-satisfaction-influence-physician-compensation.html#comment-111499 hypnoid Wed, 09 Sep 2009 20:14:01 +0000 http://www.kevinmd.com/blog/?p=40002#comment-111499 I suspect the number one patient complaint in most ERs is the wait time. It's a valid area of concern and probably pretty reasonable as a quality of care measure. But the MD attending the ER is rarely the cause of slow patient flow. Might make sense to link the pay of the ER administration as a whole to such measures, but not the clinician! I suspect the number one patient complaint in most ERs is the wait time. It’s a valid area of concern and probably pretty reasonable as a quality of care measure. But the MD attending the ER is rarely the cause of slow patient flow. Might make sense to link the pay of the ER administration as a whole to such measures, but not the clinician!

]]> By: Kimhttp://www.kevinmd.com/blog/2009/09/patient-satisfaction-influence-physician-compensation.html#comment-111492 Kim Wed, 09 Sep 2009 17:39:03 +0000 http://www.kevinmd.com/blog/?p=40002#comment-111492 Shadowfax's piece made me realize the real benefit of volunteers in the ER: about the only things we *can* do are fetch blankets, cups of water, snacks, etc. and present a pleasant, caring face to patients. Having an extra set of hands to make up rooms helps a little bit with throughput, too. Shadowfax’s piece made me realize the real benefit of volunteers in the ER: about the only things we *can* do are fetch blankets, cups of water, snacks, etc. and present a pleasant, caring face to patients. Having an extra set of hands to make up rooms helps a little bit with throughput, too.

]]> By: irb123http://www.kevinmd.com/blog/2009/09/patient-satisfaction-influence-physician-compensation.html#comment-111478 irb123 Wed, 09 Sep 2009 12:36:43 +0000 http://www.kevinmd.com/blog/?p=40002#comment-111478 The press-ganey is better at showing overall trends with the whole emergency department, and is less useful as an individual physician barometer. It is a seriously flawed non-evidenced based rating system, as I have pointed out in my blog: http://drbrenner.blogspot.com/2009/08/my-own-private-press-ganey-hell.htmlEmergency physicians, in particular, treat emergencies as their primary concern. Yet the press-ganey only grades physicians on the "urgent" patients (e.g. patients that are discharged from the hospital). To even consider linking the PG to salary, you need to include the sicker, admitted patients as part of the source pool, since they took up the majority of the physician's time. The press-ganey is better at showing overall trends with the whole emergency department, and is less useful as an individual physician barometer. It is a seriously flawed non-evidenced based rating system, as I have pointed out in my blog: http://drbrenner.blogspot.com/2009/08/my-own-private-press-ganey-hell.html

Emergency physicians, in particular, treat emergencies as their primary concern. Yet the press-ganey only grades physicians on the “urgent” patients (e.g. patients that are discharged from the hospital). To even consider linking the PG to salary, you need to include the sicker, admitted patients as part of the source pool, since they took up the majority of the physician’s time.

]]> By: amyhttp://www.kevinmd.com/blog/2009/09/patient-satisfaction-influence-physician-compensation.html#comment-111477 amy Wed, 09 Sep 2009 12:13:33 +0000 http://www.kevinmd.com/blog/?p=40002#comment-111477 Compensation should not be dependent on patient satisfaction. Doctors cannot be held accountable for every facet of the patients experience yet the patient can take it out on the Dr out of frustration. The Dr may have done a great job taking care of the patient and following protocol yet, the patient didn't get the outcome they wanted so they are going to give the Dr low marks whether there is merit to do so or not. This is also a deterrent for Dr's to take on more complex cases that are not likely to have an optimum outcome. Compensation should not be dependent on patient satisfaction. Doctors cannot be held accountable for every facet of the patients experience yet the patient can take it out on the Dr out of frustration. The Dr may have done a great job taking care of the patient and following protocol yet, the patient didn’t get the outcome they wanted so they are going to give the Dr low marks whether there is merit to do so or not. This is also a deterrent for Dr’s to take on more complex cases that are not likely to have an optimum outcome.

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