Safety-Net Hospitals

A new study in the Archives of Internal Medicine show that the 25% of hospitals with the highest proportion of Medicaid patients score nearly 6 percentage points worse on measures of patient satisfaction compared with what is called non-safety-net hospitals.   Here a taste of some of the questions:

  •  “How often did doctors explain things in a way you could understand?”
  • “How often was your pain well-controlled?”

These metrics are putting these lower income hospitals at risk since they could get less pay from the government.   As if anyone wants more incentive to leave a very tough work environment, these hospitals will get paid less so they will pay their employees less or cut more and more of them. This will undoubtedly decrease these these patient satisfactions scores even more.   Do you see the vicious cycle that will occur?  And remember, patient satisfaction scores have not been proven to be worth a damn.  The insanity of this blows me away.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “Safety-Net Hospitals

  1. GHD
    August 8, 2012 at 7:29 pm

    That is not my experience. I worked in the private sector for 21 years and now with a state run charity hospital for 12 years. I cannot remember once being thanked when in private practice (anesthesiology). I would say daily I am thanked at the charity hospital. And our hospital (a real dump) is ranked in the 95th (or higher) percentile in patient satisfaction. I think that when patients know that we are caring for them at less than market rates they value us more. When they just stiffed me in private practice, they took it for granted that I had to treat them.

  2. August 8, 2012 at 1:16 pm

    Well, surely a bunch of unqualified “consultants” and managers can develop a snazzy system full of figures and charts to distinguish between the Good Ones and the Bad Ones, can’t they? And decide how to punish the Bad Ones financially?

    That’s what our society is doing with schools and teachers. Why not hospitals?

    • Pat
      August 8, 2012 at 6:16 pm

      Pat, great point! Now what do failing schools and a crumbling, manic health care system have in common? BOTH are deemed to provide a “right”, BOTH have continued to fail despite costs rising far faster than background inflation, BOTH are hollering for arbitrary pay-for-perfomrance standards, and both are rapidly becoming de facto branches of the federal government. We are doing for health care exactly what has been done for education, with similar results.

  3. August 7, 2012 at 9:25 am

    I work a lot at one of these very hospitals, very much on the margin,, and that is exactly what is happening. While there are individual variables specific to each facility, these inane survey questions are part of the funding with which we have to contend. A huge irony is that with enough dissatisfaction, our Medicaid population could complain themselves right out of a hospital altogether.

Comments are closed.