Video: 7007 US Physicians Weigh In on US Board Certification

From January through March 2018, a voluntary Internet-based survey of US physicians and surgeons was conducted by Practicing Physicians of America concerning ABMS Board Certification. 7007 completed surveys were available for analysis. Here is a brief video summary of many of the survey's findings as promised:



-Wes

Reference: pdf file of PPA Physician survey questions that formed the basis of this report.

US Board Certification Survey Results to Be Presented at the June AMA Meeting

The largest independent voluntary survey of US physicians on the topic of US Board Certification (and continuous certification) will be presented at the 2018 Annual Meeting of the AMA House of Delegates at the Hyatt Regency Chicago on June 11, 2018, at 9 AM. The social media-promoted national survey was conducted by Practicing Physicians of America and explores the topics of value, cost, burnout, research methods, physician awareness of conflicts of interest, and the negative consequences physicians have experienced from the process. Physicians from all 50 states and nearly all US territories and subspecialties responded.

Pennsylvania Medical Society is hosting the event and I will be presenting. Given your busy schedules, I look forward to meeting all three of you who can make it.

-Wes

It's Your Chance to Help Out

If you've got a minute, shoot on over to Shrink Rap's blog to take part in their Attitudes Towards Psychiatry survey. They're looking to get as many peoples' opinions as possible.

Thanks-

-Wes

The Incidence of Self-Reported US Heart Attacks by Age

As told by Gallup survey:

Click image to enlarge

-Wes

Do Patient Satisfaction Surveys Guarantee Quality Medicine?

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.

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.

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.

-Wes

Evaluation Time

This week several evaluation requests from insurers appeared in my mailbox at work. One from UnitedHealthcare and the other from Blue Cross and Blue Shield of Illinois (BCBSIL). No doubt there will be others.

Most doctors I know ignore these surveys. I, for one, have never filled one out. Usually such notices are relegated to the circular file. Maybe a few physicians are brave enought to turf them over to their already overburdened office managers who could care less about such a survey, scribble a response if required, and move on. But no doubt a few well-meaning individuals complete these - and probably say relatively nice things like "my patients never complain" or "my hospital seems pretty good at what they do." More likely they complete them without ANY data before them, like how many of their patients have been denied payment and how long reimbursement rates for services rendered actually took. And even after the survey is completed (and, if lucky, mailed) we are left to wonder, what's riding on these rarely-completed surveys? So I spent a minute looking at them.

UnitedHealthcare wanted me to sign on to a computer with this survey address: http://www.msisurvey.com/H07162a. They gave me a tip about this address:

TIP: Do not enter the survey web address into a search engine or search function on your browser, as it will not find the survey Web site. Use only the Address or Location line located at the top of your web browser window.

Thanks to web-crawlers, I added it in this little tip into my blog to be SURE to correct this problem. I wonder why they want to keep their UNITEDHEALTHCARE SURVEY so secretive in this era of "consumer empowerment" in healthcare? By the way, the server was down when I tried to log in this morning stating:

The system is unavailable at this time, please try again after 6am EST. We appologize for the inconvenience and appreciate your patience.

That was at 7 am CST (8 am EST) today - maybe because the computer clocks are screwed up due to ending Daylight Savings Time today - but I digress.

Here's a sample of the letter from Blue Cross Blue Shield of Illinois:

"The BCBSIL Quality Improvement Plans require measurement of physician satisfaction with procedures for utilization management, referrals (if applicable), appeals, claim payment, continuity and coordination of care, and various services including BCBSIL services and hospital information."

I'm not good at business double-speak. What is "utilization management?" And since when do insurers perform "referrals" or assure "continuity and coordination of care" for a patient? Is it just me or do insurers now think they are "care providers?"

And the cover letter from BCBSIL says something else:

The Hospital Information section, found on the last page of the Satisfaction Surveys, is important to BCBSIL, as results (will be) analyzed for the BCBSIL Annual Hospital Profile. We strongly encourage you to provide feedback on your primary hospital. Responses are only analyzed and presented at the aggregate level. Therefore, all the individual responses are kept strictly confidential.

The questions for the hospital survey include things like scoring the overall quality of the hospital, timeliness of imaging reports, adequacy of the number of nurses, quality of discharge plans, etc. Wow. Not only do I get to care for patients, but I can be Zagat for hospitals, too!

Or am I being asked to be a mole? Are such "hospital quality" questions really because they care about improving quality in hospitals? Or is there another motivation like: "We want to use your less-than-perfect aggregate responses against your hospital during negotiations with them." At least this would be honest and make more sense why these data are so "important." They are, after all, interested most in their bottom line as a business.

But let's not be quite so negative. No doubt the insurers take the three or four responses (not the real number, mind you, but certainly a minority of the total surveys distributed), and show their leadership and stockholders their beneficience in all things insurable. Surely they raise self-congratulatory data up their PR flagpole and to Congress and CMS as justification of their existence.

All from three or four survey responses.

Ah, the beauty (and shame) of healthcare bureaucracy...

-Wes