Prioritizing Patients Over Reviews
By Joshua Bales, MD
Friends and colleagues,
As 2021 begins and medical coding pivots once more, both new and old challenges collide. From a physician perspective, I am relieved that policy makers are realizing the burden of EMR. However, I am saddened of the continued reliance on Press Ganey and online reviews in evaluating quality.
I never learned in medical school that we are supposed to tell our patient at the end of a visit, “Please give me five stars.” Physicians must remain steadfast of their role in educating the patient, encouraging healthy behavior, and choosing the appropriate treatment based upon evidence. Broaching the difficult discussions of smoking cessation, obesity, pain addiction and returning to work are often adversarial topics, not worthy of a five-star physician rating.
We know from our research that Press Ganey scores improve when we provide an intervention, such as a steroid injection or surgery. To the end that our practice patterns are influenced, not due to medical evidence, but in pursuit of the elusive 5 stars.
In addition to our self inflicted reliance to Press Ganey, fostering a favorable presence online steals time away from practicing medicine. Groups, both private and employed, spend thousands to nurture a pristine online presence. Yet, our reputation walks a tightrope.
A recent JAMA article revealed the danger of these online reviews, showing that up to 25% of physicians are harassed online. Yet, Press Ganey and other review sites march on under the auspices of quality.
In response to the above, I would advocate that we, as physicians, remain steadfast to our morals. We advocate that CMS, as well as other institutions, decrease their reliance on Press Ganey. We push for quality metrics that truly benefit the patient. We act as a physician, not concerned with 5 stars, but concerned with having a real impact on patient lives.