Healthcare efficiency

Interesting post on "Healthcare Efficiency" (April 17) about preventing hospital acquired infections in the US. Love the last paragraph about healthcare workers resistance to the ideas behind Quality Improvement and change (? Change) in general.

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Survey results - September 17-24

8 surveys went out last week. Only 2 responses. Time for a change in plans...

Click here for survey results.

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RateMDs: Saint or Satan?

Physicians who know about RateMDs are rarely neutral about it. Physicians who don't know about RateMDs... well, watch out, docs!

RateMDs is an online information exchange where anyone can anonymously post comments about a (North American) physician. There are similar sites for rating lawyers, high school teachers, university profs, etc.

RateMDs sparked my online patient satisfaction survey. Here's why:


Physician rating sites have existed as long as there have been physicians. These sites used to be called coffee row, the backyard fence, and your cousin's friend who knows someone who knows someone. The information was there, but was informal and relatively inaccessible unless you were "connected". Now, the Internet makes everyone connected, and they're sharing information.

Browse through RateMDs (c'mon, you know you want to), and you'll see why some physicians are upset about being rated. There are some pretty frank comments. Some may be accurate and deserved. Others may be vindictive and slanderous. We have no way of knowing. Perhaps looking at the pattern of comments gives a reliable picture of each physician's demeanor. I'd like to think so, but comments and ratings for individual physicians vary quite widely in some cases. One person with a vendetta could leave multiple posts slagging the doc. A physician could salt his own page with glowing praise.

There are weaknesses with the RateMDs model, but the idea is here to stay. I think we should embrace the idea, improve the model and turn it to the benefit of our patients. After all, what physician doesn't want honest, frank feedback on his or her performance?

Ha, ha! Of course, I'm being facetious! I'm a lot more comfortable not hearing about my weaknesses and bad habits, and I'm sure many other physicians feel the same way. If I know my performance is substandard, the logical and professional response is: try to improve. And that means... Change! Before physicians decide to ask for feedback from our patients, we need to commit to making the changes that the responses suggest.

I want to solicit patients' opinions about my performance, but I also want to draw on their experience and insight to make constructive suggestions on how I can improve. To that end, I made my own post (April 17, 2007) on RateMDs encouraging people to comment on how I can improve my medical practice.

As you see on my RateMDs page, there haven't been many responses to that request. As such, I decided to start my own personal rating service. I'm requesting patients to take a web-based survey about their experience in my office. In the spirit of openness, I'll post a link to the survey responses on my blog.

How can you be sure that I haven't polished up or even completely faked the survey results? Right now, you can't. But, I welcome any suggestions on how I could set this up so I can't be accused of fabricating results. (At the moment, I feel I need to review the responses before posting them just in case a patient has included private personal or medical information that should not become public knowledge.)


Any suggestions?

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Survey results - September 10-14

Survey says...

10 surveys went out on last Tuesday and Wednesday. 3 responses back. Here's the link to see the results.

I was hoping for a 50% response. I'll try more surveys tomorrow and Thursday.

FYI: At question 3, if the patient answers that the appointment was made by the specialist (me) as a scheduled recall visit, then the survey skips question 4 about how long they had to wait for the appointment.

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1-800-How's my doctoring?

Am I doing my work well? Are my patients satisfied with the service I provide? I've been practicing urology for 15 years with no formal feedback on my performance. Like anyone, I appreciate a pat on the back or kind word for a job well done, but I'd also like to hear about the areas I can improve on.

My interest in surveying patients started with another project we have underway in my office. In our urology practice, my partners and I wanted to shorten our appointment waiting times. Click here to find out about our "Advanced Access" project. (The story starts at the bottom of the page.)

An important part of the Advanced Access project is getting feedback from our patients. We currently use the same survey that I'll be using here, but the results are pooled. That is, we don't record which physician got which responses. I want to measure my own personal results.

I also want to share my results and that's why I've started this blog. Once the first week's results are collected, I'll post a link to make them available to you.

Why share the results? I'll have more to say about this in future posts, but if you are familiar with RateMDs, you already have an idea of what the future holds for physicians regarding feedback on performance.

I'm a little nervous about how this is going to work. It's an experiment in openness and collaboration. I have no control over how my patients respond to the survey. If the results make me uncomfortable, my only recourse will be to decide not to share them. Let's see how brave I'll be.

It's also the first time I've used web-based software this extensively. The first week will be a test to see if everything works properly. If you have problems with the patient survey, please post a comment on this blog and I'll try to fix it.

Wish me luck!

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