Chris Jennings and Congressman Paul Ryan confer before their 14 March 2010 session at the ACC10 meeting
This morning, Kevin Pho, MD has published on op-ed on a commonly-used tool to determine "quality medicine" from the patient's perspective: patient satisfaction surveys. Like pay-for-performance, this seems like a great idea. One might even logically conclude that doctor's pay should be tied to both pay-for performance measures and patient satisfaction.
But Kevin and Edwin Leap, MD (whose article is referenced in Kevin's piece) point out their concerns with this approach:
Quality health care sometimes means saying "no" to patients, denying them habit-forming pain medications that can feed an underlying, destructive drug addiction, or refusing to order unneeded CT scans that can facilitate harmful radiation exposure.While it's helpful to receive feedback from patients' experiences in the office to improve the quality of the patient's experience and the all-important "brand loyalty" of large health systems in an increasingly competetive health care marketplace, tying the tallied results of these surveys to physician's salaries is a flawed concept.
But Edwin Leap, a physician and columnist, notes that doctors "are constantly under the microscope to give patients what they want, since 'giving people what they want' has been tragically (and falsely) equated with good medicine."
Satisfaction scores give patients a needed voice to express their concerns, which can help medical professionals improve their patient relations. But it's a mistake to use patient satisfaction as a doctor's financial carrot.