Wednesday, December 17, 2014
YOLO COUNTY NEWS
99 CENTS

Check doctors’ vitals before they check yours

By
From page A7 | July 27, 2014 |

Americans consider insurance and a good bedside manner in choosing a doctor, but will that doctor provide high-quality care? A new poll shows that people don’t know how to determine that.

Being licensed and likable doesn’t necessarily mean a doctor is up to date on best practices. But consumers aren’t sure how to uncover much more. Just 22 percent of those questioned are confident they can find information to compare the quality of local doctors, according to the poll by The Associated Press-NORC Center for Public Affairs Research.

Today, 6 in 10 people say they trust doctor recommendations from friends or family, and nearly half value referrals from their regular physician. The poll found far fewer trust quality information from online patient reviews, health insurers, ratings web sites, the media, even the government.

“I usually go on references from somebody else, because it’s hard to track them any other way,” said Kenneth Murks, 58, of Lexington, Ala. His mother suggested a bone and joint specialist after a car accident.

“I guess you can do some Internet searches now,” he added, but questions the accuracy of online reviews.

The United States spends more on health care than most developed nations, yet Americans don’t have better health to show for it. A recent government report found we miss out on 30 percent of the care recommended to prevent or treat common conditions. At the same time, we undergo lots of unneeded medical testing and outmoded or inappropriate therapies.

Yet people rarely see a problem. In the poll, only 4 percent said they receive poor quality care.

About half believe better care is more expensive, even as the government, insurers and health specialists are pushing for new systems to improve quality while holding down costs.

It’s hard to imagine buying a car without checking rankings, but checking out a doctor is much more difficult. Many specialists say standardized measures of health outcomes are key, though very little is available.

Doctors who listen are important, but “some of the nicest doctors are the least competent,” cautioned Dr. Elliott Fisher of the Dartmouth Institute for Health Policy and Clinical Practice. Higher-quality care actually tends to be less expensive, by keeping people healthy and out of the hospital, and avoiding errors and the complications of unneeded care, he said.

It’s getting a little easier to compare multi-physician offices, if not individual doctors. Online report cards in a few states have begun offering some information on quality outcomes from group practices.

In Minnesota, for example, consumers can compare how many people have diabetes, high blood pressure and some other chronic conditions under control in different practices, plus how satisfied patients are. Report cards in California and Massachusetts add how well certain group practices follow guidelines on cancer screening and avoiding unneeded X-rays and MRIs for back pain.

By year’s end, Medicare plans to have released quality measurements for more than 160 large group practices, with more information on smaller clinics set for 2015. Called Physician Compare, the online star ratings also will include patient feedback.

The goal is to spur better care as doctors check out the competition.

The arrival of large amounts of quality information “is a big deal. It’s a huge shift in terms of transparency and driving quality improvement,” Dr. Patrick Conway, Medicare’s chief medical officer, told the AP.

Consumers think it would help. More than 7 in 10 say quality would improve if doctors had to publicly report their patients’ health outcomes and how satisfied they are.

The AP-NORC Center poll found about 1 in 5 Americans recall seeing information comparing the quality of health providers in the last year. Nearly half aren’t confident they even could learn if their doctor had been disciplined. (Some state licensing boards offer free online searches; the Federation of State Medical Boards provides reports for a fee.)

In choosing a doctor, not surprisingly the top factor is insurance coverage, the poll found. For the uninsured, it’s cost.

Eight in 10 look for the doctor’s experience with a specific procedure. A nearly equal number say bedside manner — their impression after a face-to-face meeting and how much time is spent with a patient — is crucial. About three-quarters say a helpful office staff and how long it takes to get an appointment are important. A majority, 62 percent, also factor how long they sat in the waiting room.

Asked the characteristics of a high-quality doctor, a good listener is by far the top answer. Others value the right diagnosis, a caring attitude, a good bedside manner and knowledge, in that order.

“Some don’t even give you the time of day. They just look at you and write you a prescription,” said Vince Jimenez, 51, of Albuquerque, New Mexico.

When his primary care physician retired, Jimenez got a reference for a new doctor but checked online for complaints. “You can’t believe one person, but if there’s a bunch of people, if there’s a lot of complaints,” he said he’d pay attention.

Dartmouth’s Fisher said consumers should ask how the office — the doctor’s team — supports safe and effective care: Are patient outcomes tracked? Do they check on patients with chronic diseases between visits? Does the person taking after-hours calls know what medications you take?

“We tend to think, ‘Oh our friend had a great experience with this doctor.’ But I’d encourage people to think about the systems around that as well,” he said.

The AP-NORC Center survey was conducted with funding from the Robert Wood Johnson Foundation, which has financed projects to publicly report data on care quality.

It was conducted by telephone May 27 to June 18 among a random national sample of 1,002 adults. Results for the full survey have a margin of sampling error of plus or minus 4.0 percentage points. It is larger for subgroups.

————

By Lauran Neergaard and Jennifer Agiesta. Associated Press writer Stacy A. Anderson contributed to this report.

 

Comments

comments

The Associated Press

.

News

 
Million Cat Challenge aims to rescue shelter felines

By Pat Bailey | From Page: A1 | Gallery

Everest visit fulfills judge’s lifelong dream

By Lauren Keene | From Page: A1 | Gallery

 
Supervisors remove Saylor from First 5 Yolo Commission

By Anne Ternus-Bellamy | From Page: A1

GPAS and test scores up for UCD’s newest undergrads

By Julia Ann Easley | From Page: A1

 
Fatal Capay crash leads to driver’s arrest

By Lauren Keene | From Page: A2

U.S., Cuba seek to normalize relations

By The Associated Press | From Page: A2

 
Water officials fret over rain’s effects

By The Associated Press | From Page: A2 | Gallery

Bob Dunning: Not enough hours in the month

By Bob Dunning | From Page: A2

 
Donate to STEAC at Original Steve’s

By Enterprise staff | From Page: A3

Beer and film tour boosts bike group’s coffers

By Enterprise staff | From Page: A3

 
Yolo Crisis Nursery in full swing

By Special to The Enterprise | From Page: A3

 
Creative women share food, friendship

By Enterprise staff | From Page: A3

Pedal around Davis on weekly bike ride

By Enterprise staff | From Page: A3

 
Traditional carols service is Saturday at St. Martin’s

By Enterprise staff | From Page: A4

Have coffee with the mayor on Friday

By Enterprise staff | From Page: A4

 
Stockings brighten holidays for special kids

By Enterprise staff | From Page: A4 | Gallery

Evening tai chi classes start Jan. 6

By Enterprise staff | From Page: A4

 
Overeaters get support at meetings

By Enterprise staff | From Page: A4

 
Fibro Friends will update their journals

By Enterprise staff | From Page: A4

Input sought on county’s facility needs

By Special to The Enterprise | From Page: A4

 
Name Droppers: Law prof earns peace prize for nonfiction

By Enterprise staff | From Page: A5 | Gallery

Community menorah lighting set Wednesday

By Enterprise staff | From Page: A5

 
Latest immunization data shows little improvement locally

By Anne Ternus-Bellamy | From Page: A5

School board will vote on repairs, new portables

By Jeff Hudson | From Page: A6

 
Study: National monument could boost local economy

By Special to The Enterprise | From Page: A6

Parent/toddler art and music program offered

By Enterprise staff | From Page: A7

 
Libraries will be closed around the holidays

By Enterprise staff | From Page: A7

Cloudy — yet safe — tap water adds to negative health effects

By Special to The Enterprise | From Page: A7

 
Round up at the registers for Patwin

By Enterprise staff | From Page: A7

Come Worship with Us

By Special to The Enterprise | From Page: A10

 
.

Forum

This ought to teach her love

By Creators Syndicate | From Page: B5

 
Many thanks to The Avid Reader

By Letters to the Editor | From Page: A8

Language failed me that night, but not now

By New York Times News Service | From Page: A8

 
Steve Sack cartoon

By Debbie Davis | From Page: A8

Grand jury function clarified

By Letters to the Editor | From Page: A8

 
Defying Western academic norms

By Letters to the Editor | From Page: A8

Boycotters are our future profs

By Letters to the Editor | From Page: A8

 
.

Sports

UCD reveals a challenging softball schedule

By Enterprise staff | From Page: B1 | Gallery

 
Tumey talks about state of Aggie athletics, where they’re headed

By Bruce Gallaudet | From Page: B1 | Gallery

Davis gets Rio Linda as Curry Invitational starts Thursday

By Bruce Gallaudet | From Page: B1 | Gallery

 
Sports briefs: Former Aggie Descalso inks deal with Colorado

By Staff and wire reports | From Page: B8

 
Westbrook, Durant lead Thunder past Kings

By The Associated Press | From Page: B8 | Gallery

.

Features

Some vegetables just can’t be beet

By Julie Cross | From Page: A9 | Gallery

 
.

Arts

.

Business

.

Obituaries

Rena Sylvia Smilkstein

By Special to The Enterprise | From Page: A4

 
.

Comics

Comics: Wednesday, December 17, 2014

By Creator | From Page: B6