Saul Elbein deserves a shout out for the article he wrote in the Texas Observer titled Anatomy of a Tragedy. If you haven’t read the article, you need to go get a cup of coffee, sit down and take it all in. I disagree with his suggestion that the problems raised in the article may have been the price of living in a “free market”, because a free market system would require more transparency, but I won’t let my disagreement with him on this point overshadow an excellent article.
The article chronicles how a neurosurgeon in Texas permanently injured and likely even killed multiple patients during surgery and how the Texas Medical Board failed to timely respond to complaints that were raised. As a result, the neurosurgeon, Christopher Duntsch, continued operating on patients and patients continued having bad outcomes from his surgeries. The article also shows the down side to tort reform in Texas – noneconomic damages are limited to patients who have been permanently injured and to families whose loved ones have died due to the physician’s malpractice.
One of the issues raised in the article that I wanted to expand upon was why patients kept going to Dr. Duntsch for surgical procedures. After all, this doctor reportedly maimed patients during surgeries. Who would go to him knowing that information? Obviously his quality as a physician was substandard, right?
Maybe not. Check out Dr. Duntsch’s profile on Healthgrades.com. What you would have seen before Healthgrades.com reomved the information was that the same doctor who was reported to have caused the deaths of several patients and who reportedly permanently injured multiple other patients was rated as a 4.3 out of 5 in patient satisfaction. Dr. Duntsch rated above the national average in every one of Healthgrades’ patient satisfaction survey details except the total wait time in exam rooms – where he rated the same as the national average.
Now Healthgrades.com has decided to remove all of the satisfaction information from Dr. Duntsch’s profile, so all you’ll see is a bunch of blanks on his ratings page.
But I got a screen grab of the ratings before Healthgrades erased them.
Why am I making such a big deal about Dr. Duntsch’s satisfactions ratings on Healthgrades.com? Simple. The discrepancy between Dr. Duntsch’s patient satisfaction and his quality of patient care clearly shows how patient satisfaction fails an a measure of health care quality.
Quite a few patients were extremely impressed with Dr. Duntsch … until they woke up from his surgeries paralyzed, in severe pain, or dead (yes, I really wrote “woke up dead” — how many of you remember that post?) Patients in the article told Saul Elbein that they didn’t know any better. They had no way to know how bad of a physician Dr. Duntsch may have been.
Healthgrades.com is not the way to make that determination.
In fact, Healthgrades.com has many complaints about the accuracy and validity of its ratings. It is rated at the lowest score by 88% of all people giving it a rating on ConsumerAffairs.com. I had one reader write me about how Healthgrades.com published that he was still seeing patients when he has been retired for 10 years, how Healthgrades published his home phone number, and how patients call his home phone number at all hours of the day and night, then yell at him because he is retired. According to the comments on the Consumer Affairs.com site, Healthgrades has repeatedly been accused of publishing inaccurate information about physician practices and of publishing a physician’s personal information (such as home addresses, private telephone numbers, and names of spouses). Before allowing the physicians to change the information, Healthgrades.com reportedly requires physicians to agree to legally inappropriate terms of service on its web site.
Of course when doctors complain about how patient satisfaction survey companies like Press Ganey have invalid statistics that don’t measure physician or hospital quality, those with a vested interest … like Press Ganey CEO Patrick Ryan … tell them to “suck it up.” We’re just a bunch of whiney professionals who can’t stand the fact that we’re being rated, right? Want to know the real kicker? Healthgrades.com CEO Roger Holstein has a lot of experience with healthcare information services. According to this article, he is a board member and director at … Press Ganey.
Healthgrades.com erased the ratings on Dr. Duntsch’s profile for a reason. That reason was that Healthgrades.com KNEW that Saul Elbein’s article exposed the disconnect between satisfaction and quality and if that disconnect is made public, it would adversely affect Healthgrades’ business model.
If you want to keep pretending that patient satisfaction is a good measure of health care quality, that’s your call. I’m sure that there are plenty of other physicians like Christopher Duntsch who will be rated highly at the Healthgrades.com web site. Healthgrades’ Twitter account states that more than 200 million people use its services to select physicians and hospitals and that it gives “comprehensive healthcare information to help you take action.” If you believe that what you read on Healthgrades.com or even on Press Ganey reports is an accurate reflection of health care quality, now you’ve got some transparency. You can now take full ownership of whatever bad outcomes may result from your decisions.
Oh, and if you want to talk to Healthgrades.com’s CEO Roger Holstein about this whole Dr. Duntsch issue, his number is 303-716-0041. If you need to speak to him, you better call him quickly, though … before Healthgrades.com changes that information, too.