
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.”
In 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 to which group the patient belonged. 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. Okay, 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 vaccines 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.”
I’m not sure playing this as satire is actually a good idea, since the data is actual, just inflated. With some actually very probable scenarios made up.
I have been in healthcare since 1970s. Patient satisfaction has nothing to do with quality care. It is directly related to how the patient/family is treated by the hospital staff and physicians. I have seen some physicians with the worst patient outcomes but with good bedside manner have rave reviews by the patients. And conversely I have seen physicians that are meticulous, with good outcomes and poor bedside manner have the worst reviews by patients. Whoever thought that there was a link between satisfaction and outcomes was totally misinformed and it’s unbelieveable that a 10 year study was completed based on that false premise. Also connecting patient satisfaction to physician pay is insane. Some patients have excellent doctors and excellent care but they are never happy. Connecting pay to patient outcomes may be reasonable. However it is my belief that physicians should be paid a salary, not dependent on ordering surgery, ordering tests, ordering medications, etc as our current healthcare system supports. Possibly give bonus based on positive outcomes. Just think of the wasted dollars spent over 10 years on a study based on a false premise.
Nicely stated Trina. I wish all would follow your description of how a patient wants to be treated. It really is a no brainer but seems to elude so many. I have worked in the medical field for 34 yrs. I never thought I would see the day when the almighty dollar$$ became more important than the patient. I am saddened by this. Best wishes to you, your patients are lucky to have you.
look under the word “GREED”
The last two paragraphs say it all!
Wow, fabulously written! Funny we were just talking about this last night at work…
Is there a reference for this article?
As satire this is interesting
how, exactly is this satirical?????
But isn’t quality Healthcare supposed to be like Burger King? “Have it your way!” Sounds like the best approach to me.
(Yes, that was sarcasm!)
It’s kinda sad when GomerBlog is this close to the truth. I see parents being allowed to refuse phlebotomy when that data is vital to their child’s care. They’re also demanding where an IV can, or cannot be placed. No longer is the best accessible vein the criteria for the site.
I don’t care if it says its satirical, it’s got to be real!
Dan Moullet
On behalf of all our our dead patients, we score their press gainey -all 5’s
We know it’s what they would have wanted.
Yes, this is supposed to be satire. But in fact in the last year actual data in real studies has shown this to be true.
I thought this was supposed to be a satire site. This is entirely plausible, even worth doing :-)
Lol!! Is this legit?! What a joke!
so true!!!