Putting the bottom of the list at the top

This is the time of year when lists rule — from Santa's naughty and nice list to the incessant best-of-the-year lists.

The U.S. Centers for Medicare & Medicaid Services (CMS) added some new items to their growing list — how well patients fared after knee or hip replacement surgery at hospitals nationwide. The ratings are based on the rate of major complications and readmissions within 30 days for hip and knee replacement patients.

The list is not the story. How the lists are being presented in the media is.

NPR's health news blog, Shots, ran a piece titled "Medicare Names Best And Worst Hospitals For Joint Replacements" along with a list — of the nine worst offenders on the list.

Kaiser Health News played it straighter with a table that lists all 192 hospitals that were either better or worse than average.

In the past, most media would focus on the top performing hospitals and expose situational examples from those that were lacking. Now the focus is on the bottom, looking up.

Ratings are important, but they are only part of the equation patients must examine when they are seeking elective surgery. Your best bet is always to do research and ask around, especially of people who are familiar with the hospital, surgeon and care team at the facility you are considering.

For health care PR folks, you always need to be ready to show how you are constantly improving on quality and experience. Because even if you are at the top of the list, there is always room for improvement.


Tackling the high cost of health care (with Tedy Bruschi)

Tedy Bruschi knows a few things about tackling. Now he's hoping to help Shields MRI tackle the high cost of health care.

If there were any doubt that the health care cost battle is being taken to the public, just watch the 30-second TV spot currently running from Shields Health Care Group featuring their pitchman Bruschi, the former and much beloved New England Patriots linebacker.

It's a well-written and very direct ad that touches on some critical points in the health care cost debate.

I'm Tedy Bruschi. Tackling a professional football player is not easy.  But tackling the high cost of health care, now that's easy.
Just go where I go — Shields MRI. 
The Shields family gives you a quality MRI at a sensible price. In fact, they could save you up to $1,000 or more. 
So get out there and take on those high medical costs. It's easier than taking on a really big fullback. Trust me."

A key phrase is "sensible price" followed by a very specific dollar figure — "up to $1,000 or more" — almost like a Geico ad.

In fact, Shields backs it up on its website with a chart comparing its cost for an MRI ($563) to the state average ($693) as well as the average for an MRI at community hospitals ($743) and teaching hospitals ($1,153). The page has a link to an MRI cost savings calculator and tips about how to "talk cost with the doctor."

Of course Bruschi has the last word in the ad:

"Why overpay for an MRI? Choose to go where I go — Shields MRI."

It would be great to see how Shields measures the ad and whether people do really exercise choice in selecting high-cost services, such as imaging. 

As patients become more cost-conscious consumers, especially as more people are enrolled in plans with high deductibles and out-of-pocket costs, these direct-to-consumer pitches will surely resonate.

Sharing a palindrome for patient safety

Watch and read along. The whole two minutes.

Credit to David Mayer, MD, Vice President of Quality & Safety for MedStar Health, who writes eloquently on the issue.

Source: Not Running a Hospital blog.

Should you trust your doctor?

Yes. Maybe. But do a little asking around first.

An opinion piece on CNN.com from Anthony Youn, MD, a Detroit-based plastic surgeon, has some good, common-sense advice for everyone seeking a physician.

Start by poking around online. Online health care rating services like Healthgrades have long had information about quality and malpractice experience (usually taken from state databases). They are now being joined by the likes of Angie's List, where patients rate doctors on the experience they had.

One of Dr. Youn's specific pieces of advice: 

Be cautious of doctors who advertise too much. The quality of a doctor is often inversely proportional to the size of his or her ad.

This may be less true as physicians and large practices join even larger health systems where advertising will become an increasingly important part of practice building and practice management. The irony is when I accessed the page on CNN.com, the right column included sponsored links from physicians!

Dr. Youn's final advice:  

So should you trust your doctor?
After you do your research.

Just what the doctor ordered.


A patient-centered medical school (@NYULMC)

Yesterday was Day 1 at the NYU School of Medicine. Class, meet patients.

Joshua Phelps, first-year medical student at New York University. 

Joshua Phelps, first-year medical student at New York University. 

What an amazing way to start a medical education: Let the med students hear directly from the patients.

The students met four patients, each representing the four pillars of the medical education curriculum at New York University — metabolism and obesity, cancer biology, cardiovascular and microbial pathogenesis.

I know this because my stepson, Josh Phelps, is a first-year medical student.

"Today made me feel very much like I landed in the right place," Josh said. "This set the tone for the future of the semester and the program."

What a strong message NYU has sent to the 160 prospective physicians in the Class of 2017:

Your patients matter. Before anything else.

In fact, the oath each new student took last week during the White Coat Ceremony included this line:

My studies and the health of my patients will be my first consideration.

We spend a lot of time talking about patient-centered care and patient engagement. It is encouraging to learn that our medical schools are embracing this concept — on Day 1!

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