Patient Satisfaction Scores and Narcotics
We have written here before about the Candy Man, who got in trouble for handing out opioids like they were mints and how his patient satisfaction scores were great. Well, here is a story about a doctor who got hammered on her scores because she didn’t hand out narcotics but then also got less pay because of it:
“Kaiser’s management denied Dr. Alpert shareholder status at least in part on the basis of financial concerns that advancing Dr. Alpert would result in reduced revenues and that other physicians would follow her example and refuse to prescribe or provide medications that were not medically indicated, further reducing the profitability of Kaiser Permanente’s business operations in the northwest region and nationally,” the complaint alleges.
The way Kaiser used patient scores “systematically incentivized its physician employees (especially its urgent care physicians) to overprescribe opioids to vulnerable populations,” the complaint says. “Kaiser’s system penalized those physicians who refused to prescribe opioids where it was not medically indicated.”
I hope she wins this lawsuit. I also hope some administrators lose their jobs over this. The perverse use of patient satisfaction scores, when used without forethought, has always been a disgusting way to bonus doctors. Yes, we want doctors to care, to listen and to be human but this job can put you in the difficult situation of saying no now and then and those patients are the ones who will try to hurt you on these surveys.
When is the last time an administrator had a “physician satisfaction survey” about their job and their pay reflected it?
Yeah, I didn’t think so.
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I was recently on the staff of a hospital that received low ratings by a survey done by the county medical society. It reached the newspaper (only one is left). The hospital someone knew who the leaders were. Suddenly, several were listed as disruptive physicians and were removed from the staff. Their spots were then filled by doctors employed by the hospital system. The scores improved.
Actually when I worked in the wound care unit, and before I was let go because I was not making patients happy with narcotics and asking them to lose weight , I was told the hospital got Medicare bonuses based on satisfaction score (the diabolical Press Ganey who along with Perdue and Joint Commission and the pain scale were collaborators). The administrators got bonuses based on this, as non profit, means you bonus out all the leftover money to the administrators. I was told their bonus was dependent on the satisfaction score on Medicare patients. Thus the government is also to blame. I was pushed out since I refused to write for narcotics for chronic wounds knowing it would lead to addiction.
Now that physicians are employees, they can organize for collective bargaining.
Let’s show those “administrators” what the results of their actions will lead to.
Whenever I receive my own request to rate my physician/practice, I always write comments about how demeaning this is for physicians and then refuse to participate.
This is the most bizarre element of today’s medicine. I have an idea—we rate them when we leave their practice. What ever happened to voting with our feet? God but I loathe the nanny state.
They will settle. The doc will get a ton of money and walk away. Administrators will not lose their jobs because they are making money. Back to work for the status quo.