interesting article on rating doctor-patient communications

Ruth Ryan ruth at RYAN-GRAHAM.COM
Tue Aug 28 20:57:52 UTC 2018


Hello All,

Thanks John.  Maybe we can also improve validity by reducing the number and length of the questionnaires we ask patients to fill out.  And the reading grade level required.

I well remember filling these things out for my elderly mother in waiting rooms and can attest that the length alone will bar most of the elderly, those with English as 2nd language, folks with less formal education, and all those with less patience or obedience to an unthinking authority. Considering who is left, that’s quite a skewing effect.

Ruth Ryan


From: John Brush <0000001122b4be5c-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG>
Sent: Tuesday, August 28, 2018 2:52 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] interesting article on rating doctor-patient communications

Maybe we can improve the validity of patient evaluations by exposing them to a range of experiences through simulation.
John

John E. Brush, Jr., M.D., FACC
Professor of Medicine
Eastern Virginia Medical School
Sentara Cardiology Specialists
844 Kempsville Road, Suite 204
Norfolk, VA 23502
757-261-0700
Cell: 757-477-1990
jebrush at me.com<mailto:jebrush at me.com>



On Aug 28, 2018, at 2:38 PM, Tom Benzoni <benzonit at gmail.com<mailto:benzonit at gmail.com>> wrote:

That's the conclusion we're supposed to reach.
So where might the conclusion be wrong; can we dis-enthrall ourselves of the expected conclusion?
Where is the cognitive debiasing here?
There is extensive literature on "perceived authority is greater than actual."
I'm assuming we're willing to posit the authorities authority here.
Should we? We've made that error before.

tom

(It's ok to say I'm being an anarchistic here. I've just know too many "authorities" who aren't.)


On Tue, Aug 28, 2018 at 1:24 PM John Brush <jebrush at me.com<mailto:jebrush at me.com>> wrote:
63% of the patients gave their provider a 100% rating, which shows that either they weren’t very discerning, or were biased, or were maybe just quickly filling out the forms.
Both the physicians and the experts had ratings that were a bell shaped curves, suggesting that they were trying to discern good from bad. Not surprisingly, physicians were easier on themselves than the experts.
It raises questions about the reliability of patient evaluations of providers. Patients, of course, are the people who count, but they only have limited experience with a few doctors and don’t see the range of possibilities, so they may be less capable of reliable evaluations. Rating physicians, like anything, may improve with experience, but patients will usually have limited exposure to physicians.
Patient satisfaction is obviously of paramount importance, but may not be a good measure for things like pay for performance.
John

John E. Brush, Jr., M.D., FACC
Professor of Medicine
Eastern Virginia Medical School
Sentara Cardiology Specialists
844 Kempsville Road, Suite 204
Norfolk, VA 23502
757-261-0700
Cell: 757-477-1990
jebrush at me.com<mailto:jebrush at me.com>



On Aug 28, 2018, at 1:53 PM, Tom Benzoni <benzonit at GMAIL.COM<mailto:benzonit at gmail.com>> wrote:

I'm really confused by this.

IF:
Perfect = 100 (top of scale)
Patients scored their physicians = 94
Physicians scored themselves = 75
Experts scored the physicians = 57
THEN:
1. Physicians are hard on themselves; they're doing pretty good.
2. Experts are out of touch.
This brings into question whether experts are experts, given that the patients are the experts on communication.

Help me out here.

tom benzoni


On Thu, Aug 23, 2018 at 11:20 PM David L Meyers <dm0015 at comcast.net<mailto:dm0015 at comcast.net>> wrote:

http://www.annfammed.org/content/16/4/330.full

David
David L Meyers, MD FACEP
Listserv Moderator/Board member
Society to Improve Diagnosis in Medicine
www.improvediagnosis.org<http://www.improvediagnosis.org/> |
Save the Dates: Diagnostic Error in Medicine, November 4-6, 2018; New Orleans, LA
Diagnostic Error in Medicine-2nd European Conference, August 30-31, 2018; Bern, Switzerland
AusDEM2019, April 28-30, 2019;
Melbourne, Australia


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