Wednesday, February 18, 2009

I like my doctor, but the tart was a little dry

This morning's New York Times has a nice opinion piece about publishing patient ratings of doctors. The editorial board likes it. I like it. Patients like it. Who doesn't like it?

Doctors with low ratings, I suppose. (Note, that could be me; I've never seen patient ratings of me or my clinic.)

Note that the questions used in the Zagat/WellPoint ratings (yes, Zagat) appear to be built, at least in part, around validated patient experience questions from Gordon Moore's research. From the NYT:

Who knows better than patients whether they have confidence in a doctor? Whether they like his or her bedside manner? Or find it easy or hard to make appointments? Or are dealt with on time or kept waiting for hours? Or find the staff helpful? These are the kinds of items covered in the Zagat/WellPoint survey, not anything to do with the quality of medical care provided.
These are similar to Moore's patient experience questions:
  1. I have one person I think of as my personal doctor or nurse
  2. It is very easy for me to get medical care when I need it
  3. Most of the time, when I visit my doctor’s office, it is well-organized, efficient, and does not waste my time
  4. The information given to me about health problems is very good
  5. I am confident that I can manage and control most of my health problems
  6. I feel able to give meaningful feedback to my doctor’s office about ways things could be improved
Wouldn't you feel like you were being well-served as a patient if you could answer yes (enthusiastically) to these questions?

As a physician, I have an obligation to provide the highest-quality medical advice, supported by science. I also have to be a good practicing colleage to other physicians and staff who need my work to be thorough, clear, and timely.

But I also have to keep in mind the perspective of my patients, what they want and need. Doing a good job for them also means responding to the issues surfaced in the Zagat/WellPoint and Moore patient experience items.

It doesn't mean patients will always agree with my recommendations, or that I'll agree with their assessments and requests, if science and common sense suggest otherwise. But the experience ought to be efficient, respectful, and thorough.

I'm glad someone is measuring. Maybe I could be, like, the Nobu of family doctors one day.