The latest issue of Family Practice Medicine has an article on patient satisfaction scores.
I remember my first patient satisfaction score VIVIDLY.
I am in my first family medicine job in Alamosa, Colorado. I receive a 21 page handout with multiple graphs about my patient satisfaction scores. I am horrified because I score 30% overall. I am more horrified by the score than the information that I will not receive the bonus.
I go to my PA (physician's assistant). He too has scored 30%. We are clearly complete failures as medical providers.
Then I go to my partner who has been there for over 20 years.
She snorts. "Look at the number of patients."
"What?" I say. I look.
My score is based on interviews with three patients. Yes, you read that correctly. THREE PEOPLE.
And I have 21 pages of graphs in color based on three people.
I am annoyed and creative. I talk to the Physicians Assistant and we plan. I call the CFO.
"My PA and I think we should resign."
"What? Why?"
"We scored 30% on the patient satisfaction. We have never scored that low on anything in our lives before. We are failures as medical people. We are going to go work for the post office."
"NO! It's not that important! It is only three patients! You are not failures!"
"Three patients?" I ask.
"Yes, just three."
"And you based a bonus on three patients? And sent me 21 pages of colored graphs based on three patients?"
"Um..."
"I think we should discuss the bonus further...."
I did not get the bonus. It was a total set up and I am not sure that ANYONE got that bonus. Much of the maximum "earning potential" advertised was impossible for any one person to get. You would have to work around the clock. They got out of paying us by having multiple bonuses that each required a lot of extra work.... They were experts in cheating the employed physicians. That became pretty clear and I was 5th senior physician out of 15 in two years, because ten physicians got right out of there. I lasted three years, barely. I knew I would not last when an excellent partner refused her second year of $50,000 in federal rural underserved loan repayment to quit AND stayed in the Valley working in the emergency room. I called the CEO: "Doesn't this get your attention?"
"She just didn't fit in."
"Yes, well, I don't think anyone will." I asked my senior partner how she stayed. "You pick your turf and you guard it!" said my partner. I thought, you know, I hope that medicine is not that grim everywhere.
Unfortunately I think that it IS that grim and getting grimmer. Remember that in the end, it is we the people who vote who control the US medical system. If we vote to privatize Medicare, we will destroy it. Right now 1 in 5 doctors and 1 in 4 nurses want to leave medicine. Covid-19 has accelerated the destruction of the US medical non-system, as my fellow Mad as Hell Doctor calls it. We need Medicare for all, a shut down of US health insurance companies, and to have money going to healthcare rather than to paying employees $100,000 or more per year to try to get prior authorizations from over 500 different insurance companies all with different rules, multiple insurance plans and different computer websites. Right now I have specialists in four different local systems. The only person who has read everyone's clinic notes is ME because it is nearly impossible to get them to communicate with each other. Two of them use the EPIC electronic medical record but consider the patient information "proprietary" and I have to call to get them to release the notes to each other. Is this something that we think helps people's health? I don't think so. I have trouble with the system in spite of being a physician and I HATE going to my local healthcare organization. Vote the system down and tell your congresspeople that you too want Medicare For All and single payer.
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