LOS ANGELES,
CA – “We have to halt
this study immediately!” was a warning issued by lead researcher,
Dr. Hans Willford from UCLA. “Long term mortality
rates are sky rocketing over our placebo groups.”
http://cdn.gomerblogllc.netdna-cdn.com/wp-content/uploads/2014/08/survey-300x180.jpgIn
an effort to decrease medical costs and to improve patient care, a
multicenter randomized study was launched nine years ago to
determine if satisfied patients led to an
actual improved quality of care, healthcare cost
savings, and increased life expectancy. Contrary
to popular beliefs from administrators and politicians, the results
were disastrous.
“This is not what we expected at all,” said Patrick Rhinno, CEO of
Prezz Ganey, a healthcare consulting firm. “I mean, we were
expecting this study
to help launch our patient
satisfaction computer programs into every
single hospital and medical
clinic in America. I’m sure the
study is flawed.”
The
PISS study, short for Patient Improvement Satisfaction Study, took
patients and divided them into two groups. The
placebo group would receive routine medical care while the second
group implemented patient satisfaction surveys and linked scores to
monetary reimbursement. Physicians were told
before treating patients which group the patient belonged
to. Physician and hospital reimbursement remained
normal in the placebo group, but in the survey group, physician
salary and hospital reimbursement were tied directly to patient
satisfaction scores from surveys.
Patients in the survey group demonstrated
a 238%
increase in mortality and
a 146%
increase in morbidity with
chronic medical conditions over the 10 year period.
“Patient satisfaction appears to be directly related to increased
mortality and morbidity,” said FDA spokesman Dr. Rachel
Barthow. “Counterintuitive to many other aspects
in life, satisfaction in medical care does not always equate to
improved care. As a matter of fact, it may be
detrimental to one’s health.”
Gomerblog’s medical correspondent, Dr. Bryan Thompson, gave
Gomerblog this analysis:
“The problem with linking reimbursement to patient satisfaction is
completely flawed from the start. Here’s an
example. A patient that weighs 340 pounds comes
into your clinic. We all know the healthiest
intervention for this patient is weight loss.
However, if a doctor mentions weight loss to the patient and they
get upset, guess what? Negative patient satisfaction survey, which
could mean decreased reimbursement. A doctor
looking for increased reimbursement will possibly tell the patient
that everything looks great and just keep doing what you are doing
in eating those cheeseburgers. Guess what,
excellent patient satisfaction survey.”
The
study also showed an 858%
increase in antibiotic prescriptions to patients with viral like
symptoms in the survey group. Those
patients developed
more antibiotic resistant infections
and C.
diff than over the placebo
group. ER physician, Dr. Rachel Kenners said, “If
we don’t give antibiotics to patients who come to the ER for their
runny nose and cough, than we are almost guaranteed a negative
survey. To get paid and to keep
our jobs, we have to prescribe antibiotics even
though they aren’t warranted.”
Cherry picking healthy patients and avoiding sicker patients was
clearly evident in the study. “One physician told
a dialysis patient that it was OK to skip a week
of dialysis so that the patient could head down to
Disneyland,” said an
undercover internal medicine physician.
He
had the patient fill out a glowing survey before
leaving the clinic. A week later when the patient
returned with chest pain and peaked
T waves, the physician forced
his junior partner to see the patient, so that he could see
teenager sports physicals. For the physicals he
just signed on the bottom line and had all
patients in and out in 5 minutes. He received
glowing satisfaction surveys from parents due to the quickness of
his exams, without ever laying a stethoscope on
them.
Dr.
Goop continued: “And, as one can
see another way to improve patient satisfaction is
to decrease patient wait times. Ok, so a doctor
who spends less time with
patients and less time thinking
about their medical problems will lead to decreased wait times.
Boom, excellent patient satisfaction scores!”
A
medical ward nurse was recently written up for bringing a diabetic
patient an ADA approved food tray, instead of the ham sandwich that
the patient wanted. “The patient’s blood sugar was in the
300s. I refused
to bring him a ham sandwich with chips and I
got slapped with a horrible survey!”
Anti-vaxxers pose a unique challenge during satisfaction surveys.
Essentially primary care providers have to tell
them that vaccines do cause Autism and they should not get
vacccines to even think of getting reimbursed fully.
Some hospitals have even resorted to a “Ask
for Dilaudid, Get Dilaudid” policy just to ensure possibly
breaking even in managing and treating drug seekers.
Cost analysis demonstrates that passing out
Dilaudid to everyone who asks for it brings in more money in the
long run even when you account for patients who die of respiratory
depression or other opioid induced complications.
A
family physician, wishing to remain anonymous had this to say:
“Doctors and nurses aren’t paid to be your friend
or to sugarcoat things. We are
here to give sound medical advice and to treat medical
problems. It’s what we were taught to
do. Yes, we want to be your
friend, we want to treat you if respect as long as you treat us
with respect, but we have to do the right thing for you
and sometimes that means telling
you things that you may not want to hear or do.”
“Thinking that doctors and
nurses will only do the right thing in medicine by
dangling dollar bills in front of us is actually a complete insult,
and the companies and governments imposing these
stipulations upon us need to redirect their actions towards their
own flaws and greed.”
加载中…
(2015-08-14 19:32:18) 
