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    A call for physicians to denounce third parties once and for all

    Editor's Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with Kumar Yogesh, MD, a practicing independent physician in Dresden, Tennessee. The views expressed in these blogs are those of their respective contributors and do not represent the views of Medical Economics or UBM Medica.

     

    When I began my career in medicine as a physician, patient satisfaction meant something for employers. If a physician had a reputation for bringing satisfaction to patients by practicing good medicine and treating people well, he or she was of interest to clinics and hospitals to hire.

     

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    It seems to me that America’s healthcare system is deviating further each day from this simple idea as third parties are becoming progressively more involved in management of patient’s healthcare. The focus for medical directors and managers of clinics and hospitals has now become: How do we satisfy insurance companies and the government so we can get compensation for our physicians’ work?

    When this happens, guess who gets to decide what “patient satisfaction” means? No, not, the patient. No, not you, the doctor. No, not even the management at your clinic or hospital. Yes, the third parties. That is, the people who do not even spend one second of facetime with the patient, the doctor, the patient-doctor exam room or the facility!

    Recently, I received a letter from Humana to update me on “my performance” according to the company’s Physician Quality Star Rewards program. I was befuddled as I continued to read Humana’s perception of my quality of care given to my patients based on their data. The program is supposed to promote “improvement in quality and to recognize primary care physician practices for demonstrating achievements for specific NCQA HEDIS measures.”

    The data illustrated my practice target performance in several areas, such as breast cancer screening, A1c diabetes control, high-risk medications in the elderly, and so on.

     

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    First, from the perspective of a physician who diligently sees patients every day in a facility that is meant to provide healthcare to people, this data seemed to have been pulled from the sky. I have never had a visit from a Humana agent to collect any such data on patient quality of care or patient satisfaction. So where were they getting all of this information from?

    Next: 'Let us denounce (this) with a single voice'

    Kumar Yogesh, MD
    Practicing physician at Dresden Family Clinic for 24 years. Owner of practice, self-employed physician, medical director.

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    • Anonymous
      Wow! Where does Dr. Kumar practice medicine? Doctor who do you think pays the bill of healthcare. The day patients pay for their entire care, that day you can demand all this. When third parties pay for a service that you provide that the direct consumer of those services does not pay, third parties will call the shots. Just see how costs and utilization have increased over the years.

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