Patient satisfaction is all the rage.Medicare is beginning to tie patient satisfaction scores with hospital reimbursement, and doctors across the country are under pressure from administrative executives to raise patient satisfaction scores.High scores are even used by hospitals as a powerful marketing tool.But, in the end, are patient satisfaction scores hurting patients?I wrote about the issue previously, saying that
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How I approach ovarian cancer screening with patients
Ovarian cancer screening clearly touches a nerve.No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease is at an advanced stage. Tests to look for the disease, such as the transvaginal ultrasound or the CA-125 blood test, are not specific enough. That leads to false positive tests that necessitate more studies that may not ...
Why more primary care doctors are referring patients to specialists
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever before. In fact, the rate almost doubled in the 10-year period between 1999 and 2009.This drives up the cost of care, as specialist consults tend to be more expensive than primary care visits. Furthermore, specialists tend ...
Should Google censor anti-vaccine claims?
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google.Do a search for "autism" and "vaccines," for instance, and you'll be greeted with a wealth of information linking the two, despite the fact that any connection has been scientifically disproven.A fascinating piece in Slate asks whether search ...
Radiologists who cheat on their board exams: Who’s to blame?
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an exam to become board certified in radiology have cheated by memorizing test questions, creating sophisticated banks of what are known as 'recalls,' ... The recall exams are meticulously compiled by radiology residents, who write down the ...
Doctors: Don’t be ashamed about going bankrupt
Are doctors really going broke?According to this piece from CNN Money, some are: "Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. But some experts counter that doctors' lack of business acumen is also to blame."That's all entirely true.Pressure on reimbursement, combined with a lack ...
Place the frustration of cost uncertainty on health insurers
As we enter 2012, many patients will be changing to new insurance plans.And for a few, deductibles will be rising.One thing that's emphasized in the Affordable Care Act, however, is that preventive services would remain "free."However, consider this story of a man, who thought he wouldn't have to pay for his screening colonoscopy, instead was charged over $1,000 for ...
How much guidance do patients want with their medical decisions?
The following column was published on November 10, 2011 in Medical Economics.I recently saw two patients in my primary care clinic, each with new-onset hypertension.The first, a middle-aged executive, brought printouts from the Internet and already had researched the various treatment options for high blood pressure. During the visit, we discussed this information, and I gave my thoughts on ...
Show doctors the value when it comes to social media and EMRs
The common perception is that older doctors are more adverse to technology, especially when it comes to electronic medical records.Recent data, however, says that isn't true.According to a study cited in American Medical News, "physicians more than 10 years out of medical school and those with higher patient volumes were more likely than younger and less busy ...
Why a physician liaison is a short-term career choice
Times are tough for pharmaceutical reps, with many hospitals and physician offices banning their sales visits.But, there's hope for those out of a job. Consider the physician liaison.Faced with budget cutbacks, hospitals are becoming more aggressive growing their market share. They are not only buying physician practices, they want more doctors to admit, refer to and use their ...
Solving distracted doctoring from smartphones and tablets
Imagine that your neurosurgeon, during surgery, was talking on his cellphone using a headset.Unthinkable?Well, no. A recent article in the New York Times cites a case where a patient was left paralyzed and the neurosurgeon was sued, in part, for being distracted. He made 10 personal calls during the operation.The proliferation of portable electronic devices, smartphones, tablets, and ...
Bury bad doctor reviews with a strong physician social media presence
When I talk about online presence to physicians, the first question I'm often asked is, "How do I remove a negative physician rating?"The short answer is, you can't.American Medical News came out with an article outlining the various legal options physicians have whenever a patient rates them poorly on the web.Many of those options, including suing the ...
Why doctors need to be better negotiators
Pediatrician Rahul Parikh has a great piece in Salon, Why doctors can’t say no. You should go read it.In the piece, he cites a recent study showing that, in about 10 to 25% of cases, patients come into an office visit with an agenda, or something specific they request.It can be an antibiotic, x-ray or a scan, for ...
How patient satisfaction scores reward rich hospitals
Medicare is beginning to tie financial bonuses to hospital patient satisfaction scores.Although patient satisfaction is important, I've voiced concern in the past about giving hospitals a financial incentive to cater to patient surveys.In a previous USA Today column, I wrote, "already, more than 80% of doctors ... said patient pressure influenced their medical decisions. And in primary care, ...
The malpractice risk of high deductibles
As the cost of health insurance rises, patient deductibles are getting bigger.More doctors are reporting that patients are coming in less frequently for chronic care followups, skipping medication refills, or balking at the out of pocket costs for various tests.Sometimes, however, this can get physicians into trouble.I was reading through a copy of Massachusetts Medical Law Report, and saw ...
Doctors and patients cannot win when it comes to chronic pain
The following op-ed was published on September 18, 2011 in USA Today.A fellow physician recently shared a frustrating clinic visit with me, in which a patient had left by saying, "You doctors need to wake up and realize that patients (who are) in pain are in a no-win situation."The patient was absolutely right. This summer, the Institute of Medicine ...
The media’s role in educating patients about MRI overuse
Thankfully, there have been more news stories recently illustrating the overuse of tests.Specifically with cancer screening, the PSA test and mammograms have come under increasing scrutiny.I think this type of media attention is long overdue, as the public needs to be aware of the potential downsides of diagnostic tests.Now comes the MRI.A recent piece in the
The power of gut feeling in cancer screening
Cancer screening has always been an emotional topic.In recent years, both prostate and breast cancer screening have come under increasing scrutiny. Studies are beginning to question the benefits of early detection, and, in the case of prostate cancer screening, whether more harm is done than good.In fact, the USPSTF recently downgraded their prostate cancer screening recommendation.In a recent study ...
How new doctors will kill private practice
What are new medical graduates looking for in their first job?According to American Medical News, they're looking for jobs with the following criteria: "The most important items would be the ability to show a stable, growing practice and quality of life ... The stability would come from a practice that generates most of their collections from commercial insurance, ...
Prostate cancer screening requires patient input
Predictably, reactions to the USPSTF's prostate cancer screening guidelines are all over the map.Consider editorials from two national newspapers, the New York Times and USA Today.USA Today wants readers to ignore the recommendations: "Here's our suggestion for the 50-plus male: Get tested, then get smart. Information about prostate cancer and its treatment is readily available from the ...
