Giving Patients More Ammunition


Patients do need the power to complain about bad doctors and, trust me, there are some bad doctors out there.  That being said, the other way for patients to get some retribution is to STOP seeing that doctor.   Word of mouth will spread, like any other business, and that doctor’s business goes under.   Right now, state boards allow patients to complain about ANYTHING and they have to investigate that complaint.  Many are a waste of time.  I was a victim of this recently when a patient complained that I didn’t give her an antibiotic for a virus.  Her strep test was neg and so was her culture.  Long story short, her complaint was dropped but not after a tremendous amount of angst, stress, evidence gathering and time on my part.  The state boards represent patients and not doctors.  Unfortunately, this has become an antagonistic situation with all the power going to the patients.   Val Jones MD just tipped me off to another system being set up that can easily be abused.

The Obama administration is creating a pilot program that will launch this fall, which is prototype patient reporting system through a contract with Rand Corp and the Agency for Healthcare Research and Quality (there is the bogus Quality term again).  It is called the Consumer Reporting System for Patient Safety and the project is designed to collect information from patients “about medical errors that resulted or nearly resulted in harm or injury” and can also secure reports from family members with the data supposedly being available for use by providers and health systems that wish to create or enhance their own local reporting systems.  Create?  Enhance? Yeah, f$cking right.   This is right from the Kentucky Health News article:

Here’s how the system will work: When a patient recognizes a medical error, an intake form will ask what happened, including questions about the details of the event and the health care provider(s). Providers and patient safety officers are expected to follow up with the patient, which AHRQ estimates would add 28 hours to the provider’s annual work load. The collected data will be analyzed to produce estimates about the patient safety events, which will be shared with health institutions.

Anyone else see a problem with this?  Only 28 more hours to the provider’s workload.  Is that per complaint?  And define a medical adverse event?  That is the key.  Just because you didn’t like the doctor because he didn’t give you antibiotics doesn’t mean it is an adverse medical event.  Just because a bad outcome happen doesn’t mean it is a medical adverse event.  Bad things in life do happen. People do die.  Trust me, this will be problematic because you are banking on patients to discern the definition when that definition is already confusing.

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] 

  3 comments for “Giving Patients More Ammunition

  1. Tad Hominem
    June 26, 2013 at 9:55 pm

    Hey, guys and gals ! welcome to the real world !this kind of system has existed for attorneys for years (yeah, I know, no sympathy here). Even non-clients can file a complaint with the grievance committee, which must investigate and the attorney must respond.
    The solution is to have some type of screening process in which the review board weeds out the obvious BS “complaints” without requiring the time and effort of a response (see antibiotic for virus above). But good luck getting that in an era of “consumer empowerment”. Or maybe a refundable fee to file the complaint. If the complaint is found valid or at least “colorable” the fee gets refunded. If dismissed the fee goes to the doctor. yeah, like that will happen.

  2. Luis
    June 26, 2013 at 12:35 pm

    Doug–can you steer me to the hilarious piece from a few months ago about “Quality, quality, and more quality”, and how repeating the term ad nauseum and defining it however one wants to makes our lives miserable?


  3. David Devonis
    June 26, 2013 at 11:49 am

    To recognize an error in baseball, you have to be aware of the rules of the game. Not every fan is able to recognize errors–that’s why there are umps and scorers with specialized knowledge to make official decisions. What’s happening here is that patients are being promoted from fans to scorers of medical practice without having the depth of knowledge necessary to make good calls. Either that, or expectation is that every patient should be, themselves, a medical doctor. Sounds like a surrealist play plot.

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