tag:blogger.com,1999:blog-7476621888383604834.post5847955216879846485..comments2024-02-15T03:26:38.897-05:00Comments on Health Care Organizational Ethics: The Customer Approach to PatienthoodJim Sabinhttp://www.blogger.com/profile/03087828142188534542noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-7476621888383604834.post-50561845704905304872011-11-07T07:56:50.468-05:002011-11-07T07:56:50.468-05:00Dear Anonymous -
Thank you for this interesting a...Dear Anonymous -<br /><br />Thank you for this interesting and relevant question. <br /><br />For readers not familiar with <a href="http://www.pcori.org/" rel="nofollow">PCORI</a>, I quote it's mission statement here:<br /> <br />"<em>The Patient-Centered Outcomes Research Institute (PCORI) helps people make informed health care decisions – and improves health care delivery and outcomes – by producing and promoting high integrity, evidence-based information – that comes from research guided by patients, caregivers and the broader health care community.</em>"<br /><br />PCORI and what Lazare conceptualized as the "customer approach" are similar in spirit in their patient-centered approach to health care. But there's a significant difference in emphasis. PCORI's mission is analagous to what Consumer Reports has done for decades, but health care has lacked - reliable information on what we already know we want. In business terms, Lazare's aim was more analagous to market research. He enjoined clinicians to find out and work with what patients are <em>really</em> concerned about, not what we as clinicians believe they <em>should</em> be concerned about!<br /><br />I appreciate your making this connection for me!<br /><br />Best<br /><br />JimJim Sabinhttps://www.blogger.com/profile/03087828142188534542noreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-57112532752430130552011-11-06T12:25:56.488-05:002011-11-06T12:25:56.488-05:00Do you think the language framework PCORI is artic...Do you think the language framework PCORI is articulating--questions asked from a patient's decision making viewpoint--is an improvement?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-64824868839386740252011-10-21T08:50:31.797-04:002011-10-21T08:50:31.797-04:00Hi Eric -
I know and admire the PACE program, so ...Hi Eric -<br /><br />I know and admire the <a href="https://www.cms.gov/pace/" rel="nofollow">PACE</a> program, so I am especially pained at the thought that CMS, with good intentions, is creating bureaucratic burdens for hard-working, caring clinicians. My guess is that concerns about (a) fraudulent billing and (b) capricious denials underlie the bureaucratic systems. I'm sure the aim is not to harass and burden clinicians, but it sounds as if that's the impact on you and your colleagues.<br /><br />There must be better ways to pursue valid goals like encouraging "customer service" (in Lazare's sense of the term) and fraud prevention. If outcomes were well ascertained requirements like the ones you describe could perhaps be done away with.<br /><br />It's always good to hear from you!<br /><br />Best<br /><br />JimJim Sabinhttps://www.blogger.com/profile/03087828142188534542noreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-6705509860472306732011-10-19T10:25:29.150-04:002011-10-19T10:25:29.150-04:00Jim--"Participant" is the term that CMS ...Jim--"Participant" is the term that CMS has mandated that we use to refer to our "patients/customers." I fear that my dream of a single payer may become reality, because of the byzantine system that CMS has mandated to operationalize "customer service." May I explain. I work at Program for All-Inclusive Care of Elders, which contracts with CMS to provide care to high-risk elders, with the goal of keeping our elders in their homes and out of nursing homes. CMS has ordered that we fill out a "service request form" for everything that a participant requests, from a pain pill to an MRI to a cane to a cab ride. This form includes spaces for team discussion and assessment and final resolution. CMS has also ordered that we fill out a "grievance form" for every dissatisfaction that our participants express, from cold soup to denial of the requests noted above. The grievance process has multiple levels of appeal. <br />Is this the way to enhance "customer service" or "quality patient care"?<br />Freedom of choice was not high on the list of freedoms that our country's founders had in mind. Freedom of speech, religion, assembly, the press, were and are important. But a choice between a Ford or a Chevy, an MRI or a CT scan, should be of less importance to our government. Mandating freedom of choice to the "n"th degree distracts from the true "business" of health care.<br />--Ericerichttps://www.blogger.com/profile/16137189911651175163noreply@blogger.com