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Patients again rate the doctors
Communication good, but test results missing |
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By Elizabeth Cooney TELEGRAM & GAZETTE STAFF
ecooney@telegram.com
WORCESTER, Mass., July 10, 2008 — Primary care physicians scored high on communicating well and showing respect for their patients, a state survey being released today shows, but they could do a better job notifying patients of test results, quarterbacking their care by specialists and reminding them about preventive care.
The second patient-experience survey conducted by Massachusetts Health Quality Partners shows generally high satisfaction with doctors, but it also picked up variations among the 400 adult and pediatric practices whose patients it polled. About 51,000 adult patients and 20,000 parents of pediatric patients answered questions not only about their personal doctors but also about dealing with office staff, getting appointments, and being seen by providers other than their own personal physicians. The survey, conducted last fall for the Watertown-based nonprofit coalition of doctors, patients, health insurers and hospitals follows another report in the spring on how well doctors’ care matched national guidelines for screening and managing more than two dozen diseases.
Practices with at least three doctors, not individual doctors, are graded by location on the group’s Web site ( www.mhqp.org), which can be searched by ZIP code, group name, practice name or doctor’s name. The effort is designed to guide patients as they choose a doctor and to help doctors see where they stand at a time when public reporting of health outcomes and consumer rankings are mushrooming, from Medicare’s Hospital Compare site to Angie’s List.
Patient perceptions matter, according to Barbra G. Rabson, executive director.
“If patients have a bad experience, they are less likely to trust their physician and less likely to follow medical advice,” she said, citing research from the Institute of Medicine.
Across the board, pediatricians performed better than their adult practice peers, with 96 percent of parents pleased with how well their children’s doctors communicated. Adult practices weren’t far behind, at 93 percent. Almost 90 percent of pediatric patients got reminders of immunizations, lead screenings, or eye exams, but fewer adult patients — 80 percent — were notified of preventive care such as flu shots or screening tests, the respondents said.
As for test results, 70 percent of all patients said someone from the doctor’s office let them know what happened in a timely fashion. And 60 percent said the doctor was up to speed on the care they got from specialists.
There were variations within large groups, such as Fallon Clinic, the Central Massachusetts Independent Physician Association or UMass Memorial’s practices at its medical center or in the community. As was true across the region and the state, most did well. Some locations earned four stars across the board, meaning the practices did better than at least 85 percent of the offices in this survey, while a small number got only one star on some of the seven measures, which means they did worse than 85 percent of offices.
“We did respectably, but not as well as we wanted to,” said Dr. Robin Richman, Fallon Clinic’s chief medical officer. “We truly do believe by doing better in these areas that we will indeed be able to improve the care and health of our patients.”
The assessment was similar at the Central Massachusetts Independent Physician Association, even though 60 percent of its members were not part of the poll. As solo practitioners or two-physician offices, they fell below the survey’s three-doctor threshold. Most of the practices that were evaluated made a strong showing.
“Any data from an independent source is definitely valuable,” said Dr. George Abraham, CMIPA medical director. “I think each practice should review that data saying, ‘What is the level of service I provide?’ It’s a chance to improve.”
When it came to other health care providers substituting for a patient’s own physician, satisfaction scores fell throughout the state. Overall, 83 percent of patients said their own doctor always gave clear explanations, but only 56 percent of patients said other doctors or nurses in the practice always did so. In a similar vein, almost three-quarters of patients said their own doctors always spent enough time with them, but just over half thought other practitioners met that standard.
Discontent about other members of the practice is an important signal, Ms. Rabson of MHQP said.
“We all want 24/7 care from our doctors and we all want our doctors to treat us as if we were the only patient they have,” she said. “Given the primary care shortage, I think we need to recognize that primary care is a team sport. It needs to be delivered as a team.”
Dr. Bruce S. Auerbach, president of the Massachusetts Medical Society, praised the MHQP effort, which was funded by Fallon Community Health Plan, Blue Cross and Blue Shield of Massachusetts, Harvard Pilgrim Health Care and Health New England. He also suggested why physicians will pay attention to the survey, which he called validated and credible.
“I think physicians inherently are competitive creatures, so when they see that they perform less well, perhaps, than their peers, they find out why and strive to improve their service,” he said.
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