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Measuring Patient Satisfaction: A Bridge Between Patient And Physician Perceptions Of Care

May 9th, 2014

Patient satisfaction is at the core of patient centered medicine. Improved patient satisfaction not only leads to an enhanced patient experience—something every sick or injured patient deserves—it is also associated with improved treatment outcomes. In 2008, researchers demonstrated that improved patient satisfaction was correlated with higher quality hospital care “for all…conditions measured.” More recent work has begun to identify exactly how this correlation works. For example, higher patient satisfaction has been associated with reduced readmission rates. Furthermore, improved patient satisfaction has even been correlated with reduced inpatient mortality, “suggesting that patients are good discriminators of the type of care they receive.”

Despite the correlation between higher patient satisfaction rates and improved outcomes, measurement of patient satisfaction remains controversial among many health care providers. Physicians, in particular, often chafe when organizations, such as The Commonwealth Fund through their site WhyNotTheBest, or the Centers for Medicare and Medicaid Services though their Physician Compare website, begin to publicly report doctors’ patient satisfaction data. Additionally, employed physicians often fret when patient satisfaction is included in their reimbursement metrics.

Certainly there are instances in which sound medicine may lead to a lower rate of patient satisfaction; infrequently, satisfaction can correlate, not with high quality care, but with the fulfillment of patients’ a priori wishes for their treatment. A good example of this problem is the difficulty in refusing to fill narcotics prescriptions and steering a patient toward alternative pain relief modalities when the physician has good evidence that a patient has a problem with narcotics abuse. While the doctor in this example is practicing good medicine, it is highly unlikely that the patient will leave the office anything other than deeply disappointed.

Despite these relatively rare cases, many studies show a deep chasm between how patients and doctors view medical care, and thus demonstrate the need to measure patient satisfaction rates. Patients and their doctors can view the same episodes of care quite differently so, without patient satisfaction measures, we are left with an incomplete or even misleading picture of patient care.

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Do Medicare And Medicaid Payment Rates Really Threaten Physicians with Bankruptcy?

October 2nd, 2012

Physicians for years now have claimed that their practices lose money when treating Medicare or Medicaid patients. Doctors use these assertions to portray themselves as yearning to offer treatment to the elderly or indigent but unable to do so due to economic realities. The specter of bankruptcy is often invoked. Recent studies suggest that physicians may not fully participate in treating the newly insured Medicaid patients resulting from the Affordable Care Act.

The reasons physicians typically give for such refusals revolve around the notion that accepting new Medicaid or Medicare patients would bankrupt their practices. Rarely, if ever, are such assertions questioned in the general press. Doctors regularly employ this argument to forestall any reductions in physician reimbursement.

Are such claims justified, or are they used as a smokescreen when refusing care to some individuals for reasons other than economic survival? The answer to this question depends on the specialty of the physician.

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Patient-Centered Care: What It Means And How To Get There

January 24th, 2012

At a recent symposium concerning both saving money and improving patient care, Health Affairs Editor-in Chief Susan Dentzer stated, “It is well established now that one can in fact improve the quality of health care and reduce the costs at the same time.”  This is exactly the principle behind the growing movement toward patient-centered care.  […]

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Physician Payment Reform: An Opportunity To Bolster Primary Care

September 7th, 2011

With the Budget Control Act of 2011 now signed into law, health care lobbyists are preparing to fight any changes to federal programs that affect their constituents.  One particular concern for physicians is the scheduled 30 percent cut to Medicare reimbursement mandated by the Sustainable Growth Rate (SGR) formula. Any attempt to waive these cuts will need […]

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A Call For Physicians To Contribute To Solutions, Not Costs

July 29th, 2011

 It’s time for America’s physicians, particularly its highly paid procedural specialists, to make a choice.  Are we primarily businessmen with a keen eye on the financial bottom line, or are we above all professionals, well versed in the healing arts and dedicated to our patients’ care, regardless of their circumstances?  America’s medical system is breaking […]

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