The Doctors Next Door

How Do You Know if You're Getting Quality Medical Care?

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How in the world are you to judge the quality of the medical care you're getting or not getting?  For most people, the only things we have to go on fall into the categories of communication skills, appearance of the facility and service quality. Is the place clean?  Did I get a smile from the receptionist? Did the doctor introduce herself?

Do any of these things tell you anything about whether your healthcare team is adhering to best-practice standards in the treatment of your pneumonia?  Or that they follow protocols to prevent medication or surgical errors?  Or whether the nursing home you reluctantly placed your dad in adheres to quality standards set forth by the Center for Medicaid and Medicare Services, The Joint Commission and all the other regulatory bodies that have something to say in the matter? 

Uh... no! In this post, I will guide you to some valuable resources so you can base your medical decisions on good information as you travel with your loved ones through the healthcare morass. 

But first, a little story.  For some reason, I've been burdened with dental problems more so than general health problems.  I figure that's the lesser of two evils so I count my blessings.  Yes...I have another dentist story for you but first let me say that I have nothing against dentists.  I merely like to use these examples since I know nothing about dentistry. So the dentists chair truly places me in the naive trusting patient role.  Dentistry is also an important aspect of our healthcare system. 

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So when I was about 13 years old, my mother took me to a new dentist one

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day.  Going to the dentist was the worst thing I could imagine as a kid, so much so, that when I got to go to Disney World, I enhanced my joy by thinking of all the kids that were at the dentist that day.  That really put me over the top!

Arriving at Dr. Lance's (a made up name) that day I had the usual anxiety--is it going to hurt?  I dislike pain but especially the kind that happens randomly and perhaps not at all.  It's really the anticipation of unanticipated pain that drives me nuts. Dr. Lance and his office staff greeted us kindly and mom stepped back out into the waiting room after I was seated in the dreaded CHAIRDr. Lance reclined me back and proceeded with the usual treatment.  "Yes you have a new cavity, yes it needs to be filled and aren't you lucky--I happen to have time to do it today!"  Lucky me...

In my reclined position, I gazed around the room.  There's not much else to do when you're sitting there.  My eyes

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passed over the drapes, the walls, the pictures on the walls--a little dated but I'd come to expect that in my dental travels.  My eyes drifted upward toward the ceiling, passing once, then wait!  My eyes darted back to the corner near the ceiling--it is!Oh my!  A spider web!!!!  The dentist had just given me a shot of novocaine.  I started to feel faint.  I told him, "I sdon'ts feel fvary vwelll." 

He said, "what's up?" 

"I sdon't knooow, I ffeel rearry lights-sheaded." 

He reclined the chair and put a cool rag on my head.  I wanted my mom but was too embarrassed and shy to voice this desire.  Gradually, the lights came back on in the room for me and the dentist proceeded. 

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On the way home, I mentioned that I had some sort of problem in the dentist chair.  "I sthink I almosht fainted" I slured to my mother as I wiped the slobber from my lower lip. She was very bothered by this and especially over the fact that the dentist didn't tell her anything had happened.  I, on the other hand, could not get over the spider web. I told her, "I don't ever want to go back to that dentist!"  My reason why:  "What kind of dentist would have a spider web in his office?!"

I never did go back there.

I judged the quality of my dentist based on the lack of a long-handled feather duster.  The spider web got to me!  What else did I have to go on?  While I wouldn't recognize him if I passed him on the street, I can clearly see that spider web in the corner of his examining room even today. Now this little true story happened before the days of Angie's and Craig's Lists and but this experience is exactly what you might find posted there.  And who knows, maybe this dentist is a genius, graduated at the top of his class and is now working on prenatal genetic diagnosis of the overbite! 

And me--well I obviously had teenage girl syndrome. Translation: expect all manner of psychogenic symptoms.  I was freaked out by the spider web sighting coupled with a simultaneous injection in my gum and had a vasovagal episode.  Happens ALL THE TIME...to teenage girls and others.

So how in the world are you to judge the quality of the medical care that you're getting?  To really do a thoughtful job with it, you would have to go to medical school but that will cost you a bundle.  So allow me... I'd like to point out some currently available resources and some that are works in process so that you can start to use good information to inform your healthcare decisions.  These resources are built specifically for consumers but are grossly under-utilized. 

  1. Hospital Compare--this website gives you information on quality measures for commonly treated conditions in hospitals like heart attack, heart failure, pneumonia, surgical care and asthma.  It also shares patient satisfaction data on the hospitals. You can download information for specific hospitals and compare them to others in your area. The site will even tell you whether the death rate for conditions like a heart attack are better, same or worse than the national average. 
  2. Nursing Home Compare--yes, the Tribune has had a lot of reporting on the quality of care in nursing homes recently.  Check this website out before you make a choice for someone you love.
  3. Hospital websites: Rush-Copley Hospital and Northwestern Memorial Hospital are two hospitals that exemplify transparency and post quality data right on their website. And this is not marketing mumbo-jumbo--this is the real deal.  I give credit to the leadership at these organizations and others like them that put it right out there. If you work for one, by all means speak up!
  4. Physician practice quality initiatives--there are whole communities that have banded together to create excellent healthcare in the physician office.  Here's one in Cinncinati that puts physician practice quality data right out there. Similar initiatives exist in Wisconsin, Kansas City, Maine and Alburquerque.  While we don't have these in Illinois, it's not for lack of trying.  I'm not giving up. 
  5. Look for the Hospital Report Card on the Illinois Department of Public Health website--coming soon!

I'll keep you posted as things develop!

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