By Jeff Segal, MD, JD (founder and CEO of eMerit)
I tackled this proposition at the recent conference “15th Annual Advanced Forum on Obstetric Malpractice Claims.” Speaking on the panel discussion with me were:
- Bruce Patsner, MD (Vice Chair, Quality, INOVA)
- Angela W. Russell (Partner, Wilson Elser Moskowitz Edelman & Dicker LLP)
- Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety)
I noted that far too often patients and staff see near-misses (which should more accurately be called near-hits), and say nothing. These early warning signals receive no action. Why? Because no one transmits this information to anyone with authority to take action. These are missed opportunities.
The good news is that patients CAN be the eyes and ears for a practice. The way to turn this idea into substantive action is to gather patient feedback on an iPad at the point-of service. This information is uploaded, with the patient’s authorization, to the dominant review sites found on page one of a Google search. Other survey questions are fed back to the practice internally. Crowdsourcing patient reviews + transparency is a winning formula for enabling positive change in a non-adversarial, non-threatening way.
Let’s give this color.
Many doctors are not religious about washing their hands prior to examining patients. This simple step prevents transmission of disease from one patient to another. One practice fixed this problem in one week. They posted a sign at the reception desk which said that patients would receive a survey before leaving. One question will ask about hand washing. Please observe if the doctor washed his/her hands before examining you.
50% compliance went to >90% compliance.
When patients were watching, no doctor wanted to be THAT person who couldn’t be bothered to wash his hands.
In the business world, this is not a new idea. The sign over many cash registers states if you don’t receive a receipt, your purchase is free. The store’s owner is deputizing you, the customer, to “guard the register.” You, the customer, are being incentivized to make sure the clerk doesn’t stuff a $20 bill into his pocket, embezzling day after day.
Take it one step further and post results online. This not only identifies safety practice problems which can be quickly solved. It telegraphs the message to the public that safety and clinical outcomes are important and you are proud of your results and open to identifying problems sooner rather than later. A number of systems are commercially available to capture patient feedback for posting online in a HIPAA complaint fashion.
For a pdf of Dr. Segal’s presentation, click here.
Dr. Segal is a board-certified neurosurgeon who trained at Baylor College of Medicine. Dr. Segal also graduated from Concord Law School with highest honors. Dr. Segal launched Medical Justice in 2002. Medical Justice is a physician based organization focused on keeping doctors from being sued for frivolous reasons. Dr. Segal also founded eMerit to help doctors protect and preserve their reputations – particularly online. Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice and online reputation.