Forbes: Why Rating Your Doctor is Bad for Your Health

Operation how to downsize medicareKai Falkenberg recently wrote an interesting article entitled: “Why Rating Your Doctor is Bad for Your Health.”  It doesn’t take a genius to know that the American healthcare system is fundamentally and extremely flawed.  Americans pay far more for the same healthcare in comparison to other industrialized nations.  In the article, Falkenberg writes that because of recent ObamaCare provisions, health care providers are forced to place a greater importance to survey results.

Doctors are over-prescribing medicines and exams so as to satisfy their patient’s anxieties.  They are now more concerned with their survey scores than the fact that each unnecessary test and medication only further burdens healthcare costs.  Press Garney is the Yelp of the medical field. 

Over the past decade the government has fully embraced the “patient is always right” model–these surveys focus on areas like waiting times, pain management and communication skills–betting that increased customer satisfaction will improve the quality of care and reduce costs. There’s some evidence they have. An ObamaCare initiative adds extra teeth, to the tune of $850 million, reducing Medicare reimbursement fees for hospitals with less-than-stellar scores.

Many people are hypochondriacs.  They always think something is wrong with them.  That’s why if they aren’t given a prescription to fight a cold they think they aren’t being provided with adequate healthcare.  One of the problems with these surveys is the low number of patients that fill them out.  In one case 7 patients responded.  The survey system thought that proved to be “statistically significantly” (which it is not even close to being).

Additionally, between 5-7% of a doctor’s salary is based on these scores.  I found this paragraph particularly troubling:

In a recent online survey of 700-plus emergency room doctors by Emergency Physicians Monthly, 59% admitted they increased the number of tests they performed because of patient satisfaction surveys. The South Carolina Medical Association asked its members whether they’d ever ordered a test they felt was inappropriate because of such pressures, and 55% of 131 respondents said yes. Nearly half said they’d improperly prescribed antibiotics and narcotic pain medication in direct response to patient satisfaction surveys.

medical cartoonOne emergency room with poor survey scores started offering Vicodingoody bags” to discharged patients in order to improve their ratings. And doctors face the reality that uncomfortable discussions on behavioral topics–say, smoking or obesity–come with the risk of a pay cut. “The challenge is how do we discuss this with the patient so the patient doesn’t leave unhappy,” addiction specialist Dr. Aleksandra Zgierska recently told the AMA’s American Medical News. “Saying yes is easy.”

Overtreatment accounted for $226 billion in 2011.  That helped raise insurance rates.  Unfortunately, this will only get worse.

ObamaCare’s “pay-for-performance” program is providing yet another boost. Starting last October, hospitals that perform poorly on quality measures forfeit 1% of their Medicare payments, a number that doubles by 2017, putting some $2 billion at risk. Thirty percent of that determination will be based on the hospital rankings from mandated patient surveys. That means, in some cases, hospitals are throwing money at things like new elevators and valet parking. It means doctors will be under yet more pressure to give their customers what they want.

When I get sick I try to use the least amount of products as possible.  I don’t like taking unnecessary exams.  The problem is that I’m in the minority.

What should we do to BEGIN fixing this problem? 

I say begin because there are many things that must be done.


Twitter: @adrakontaidis & @talkrealdebate


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About adrakontaidis

A conservative who doesn't pander to the GOP.

4 responses to “Forbes: Why Rating Your Doctor is Bad for Your Health”

  1. JF Owen says :

    The problem isn’t doctors, surveys or Obamacare (Forbes also recently published this: The problem is patients who have forgotten how to accept responsibility for their own health and lives.

    I freely admit that I’m much chunkier than I was when I was thirty or forty. I also understand the ramifications of that and accept that doctors don’t have a bag of magic fairy dust that they can sprinkle on my head to make the ills associated with that extra weight go away. My knees hurt and my back hurts more than it would if I lost forty pounds.

    So, when I go to the doctor for my yearly pin cushion and probe exam and he tells me I’m too fat, I smile and tell him he’s too ugly. What I don’t do is get angry because he told me the truth. When he tells me that I can reduce the pain in my knees by walking regularly and taking an Aleve twice a day, I don’t beg him for Hydrocodone. When I tell him it seems like I’m passing more gas than usual and he suggests that I cut back on the Mountain Dew, I don’t counter by asking him to do a colonoscopy to make sure.

    We’re becoming a nation of whiners and it seems like the curve is accelerating. Maybe that’s a natural consequence of being a generally prosperous nation. If that’s so, then there probably isn’t anything close to a quick fix.

    As a side note, I’m not sure how much credence I place in the survey questions the doctors answered either. They’re human too and a lot of them aren’t enamored with the Affordable Health Care Act. That might just color their answers a bit..

    Thought provoking post! It got my juices flowing for the day, but then talking about healthcare usually does.

  2. reasoningpolitics says :

    Over Christmas I had a long conversation with the chief of staff of a hospital. His concerns over costs and unnecessary procedures exactly match yours. Patient satisfaction is irrelevant. Patients usually do not understand that “doing nothing” sometimes is far better than doing something. Every procedure has costs and side affects. If surveys are what matters doctors should just give everyone a sugar pill and send them on their way.

    Objective quality of care is what matters. Paying for outcomes isn’t a bad idea, as long as outcomes are objectively measured. Surveys are stupid because we as patients are stupid.

    Good post.

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