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Doctors Look to Patients for Care Checkup | |
By LISA SINGHANIA MANCHESTER, N.H. - Dr. Rich Friedman may have a medical degree, but only his patients can give him the kind of checkup he needs to practice good medicine. "When I see patients, in my mind I am doing something positive ... I'm offering them advice that should help them," said Friedman, an internist. "But I don't know if they feel the same way." A new survey may help Friedman get that checkup. The New Hampshire Hospital Association, in conjunction with the Picker Institute in Boston, is asking patients at 20 New Hampshire hospitals to evaluate the quality of the medical treatment they receive inside and outside the hospital. The concept behind the Patient-Centered Care Project is that patient satisfaction is the best measure of medical care. The study asks patients about their interactions with general physicians, specialists, hospital personnel and, in some cases, rehabilitative therapy specialists. "This isn't about whether the food was good or the parking was easy," says Rachel Rowe, the project's director. "This is about what was your experience with your physician or nurse ... did you understand what was explained to you, did you feel your pain was controlled?" The project is unusual because it follows patients for a year after their treatment. Patients are asked to fill out surveys one month, three months and 12 months after their hospital stay. Rowe said the emphasis on what happens after patients leave the hospital is important because hospital stays getting shorter, not longer. "Things are being done at home that 10 or 15 years ago were being done in the hospital," Rowe said. "There are more homecare services provided and more discharge instructions need to be provided to patients." Since January, patients who are being treated for a hip replacement or acute myocardial infarction - a heart attack - have been asked to evaluate their care. About 1,000 patients have signed up so far. The project's goal is 2,000. Friedman says that even when doctors give patients the best medical advice, a poor bedside manner can create unhappy patients. If a patient perceives he's getting poor care, it won't matter how high-quality it is. "I may know this is a good way of treating a heart attack, but my patient may not know that without me answering their questions," Friedman says. The project has been popular with patients, says Ann Copson, a registered nurse, who recruits survey participants at Southern New Hampshire Regional Medical Center in Nashua. She says most of the almost 80 patients who have agreed to the survey want to help others, but they also benefit from the self-awareness the survey requires. "A lot of them as they start answering these questions, it's making them realize how bad their condition is," she says. "It's making them look at their surgery in a way they might not have before." Patient confidentiality rules prevent the group from releasing the names of any patients participating in the survey. The state's small size also makes New Hampshire an ideal laboratory for this type of survey. The relatively small number of patients makes it possible for the survey to get a more complete sampling. "We will do every heart attack for a year, every hip replacement," Friedman says. "In New York, you couldn't do that." Medical professionals are hoping to reap big benefits from the study, too, by focusing on how patients benefit - or don't - from care. Francis Fullam, who conducts similar surveys at the University of Chicago Hospitals, says the Patient-Centered Care project is a "sterling" example of the way health care professionals are trying to listen to patients. "It's trying to deal with two very common, important medical problems by looking at very specific patient populations," he says. "It's also very important in that they've established a degree of cooperation of hospitals which historically hasn't happened." Starting next January, the project will also look at maternity patients. Between 6,000 and 8,000 new mothers at 26 hospitals will be surveyed about the care they receive. Rowe says the survey will be especially relevant given a law passed by the Legislature last year that gives doctors and new mothers a greater say in determining the length of hospital stays. "I think legislators were making decisions based upon anecdotal information," she says. "This will focus on not just a mother's perception of a hospital, but prenatal education, breast-feeding practices ... it will really cover the spectrum." Copyright 1996 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. | |