Great Press Ganey Score

Everyone in medicine is talking about patient satisfaction scores – I have posted about them several times. I believe they are inherently flawed – although over the long term – (ie at least a year) they will tend to stablise and are SOMEWHAT reflective of what sort of provider you are (at least as patients perceive you). However, individual scores or comments are utterly useless by themselves and they are all over the place no matter if you are the nicest guy on earth (or if you “stare” at patients like Dr Scalpel evidently does….).

About a year or so ago one of my colleagues got one of the funniest Press-Ganey reports. In the space where comments are written (the guy had given the doc all “1’s” out of 5 for everything), appeared:

“After I saw Dr P****, I was more fucked up than before I got to the ER”.

Meanwhile Dr P had very good scores on average – which led me to believe – no Percocet Rx?????

ERPA

July 1, 2008 at 12:18 pm

I find the more percocet you give the better the press ganey scores are. Treat the pain or give the patient the thought you will treat it. Tell them if your still having pain, “I can give you more if you need it, let me know.”

Find out the medical problem?? I am not sure that is the most important thing with some people, as they already know the problem but want to hear it from someone else.
IE)I heard one patient- (in his late 20’s) taking to a doctor about his chronic dizziness. She said to him “you have seen 3 neurologist at 3 specialty centers, ENT, your primary care doctor, what do you think I can offer you here in the ER? I am pretty sure we are not going to figure this out here in the ER today” His response was that the CT angiogram of the brain is the gold standard of care because he figures a portion of his brain is not getting blood supply causing his problem. This pt has had MRI/MRA of the brain, multiple cts, etc. I am not sure why he came to the ER but to hear that he has chronic dizziness/vertigo from someone else or get the CT angiogram of the brain which isn’t done in the ER. No one can make him feel better.

Some people are drug seekers.

The problem with the press ganey score is people who receive and fill out the form is random. You can receive it in the mail and fill it out or not. I am sure the angry people, disatisfied customer will always complain through these. Happy patients can fill out or not, but their thought process may be everything was great, so I don’t have to fill it out to complain.

I had a patient who complained that I told him the trueth about his medical condition. I should have been more sensative about his problem. The patient was in the ER for urine retention. He said I thought my bladder was going to explode. I went and quickly put a catheter in and relieved his pain. I told him your bladder won’t explode but it can damage your kidneys so we have to check some blood work etc. I got the press ganey reply back and it was a negative comment, the patient was angry about the fact that I said that he was wrong about bladder explosion and about the kidney damage that could occur.

You can’t read peoples mind in the ER so you can always get bad score, but that is expected, and if you receive mostly good ones, it will not matter at the end of the year- or so they say.

The real problem with the scores is that employers want to pay you or give you bonus based on the random scores.

Drama Mama

July 1, 2008 at 6:28 pm

Okay- I’m on a roll-
I gave you another shout out on the D Pond today!
I know I am increasing your readership for sure!
I accept pay pal, checks and cash money!