pay for performance and the physician-patient relationship

In her column in The New York Times Dr. Pauline Chen explores the implications of pay-for-performance systems, in which physicians are paid based on quality indicators rather than volume. An emphasis on quality outcomes rather than volume may make it easier for physicians to spend more time with patients. But one of the concerns is that physicians will cherry-pick healthy patients who will have positive health outcomes, rather than difficult patients who do not comply with prescribed regimens.

You can find the article here and the comments here.

What do you think? Is there a balance to find between pay-for-service and pay-for-performance?

using social networks to self-medicate

The New York Times had an article today about how many young adults in New York go without medical insurance and the lengths they go to seek alternatives to aid in self-diagnose and sometimes self-medicate. Of particular interest is how some of the people interviewed used health web sites to find health information and social networks to find medications to share.

You can find the article here.

the camaraderie of healing

The New York Times offered an interesting patient perspective today about the camaraderie of physical therapy. Physical therapy patients work with therapists for weeks or months, in a facility with other patients of varying ages and walks of life. Caitlin Kelly examines the relationships that evolve. You can find the article here.

Rating your physician

The group that made restaurant, hotel and spa ratings by the public, available to the public, are now working with one health insurance group to rate physicians. The New York Times had an article today about WellPoint working with Zagat to allow patients to rate their physicians and read ratings of other physicians. Physicians are rated on such qualities as trust and communication. Some physicians and ethics groups are concerned that the ratings don't give patients useful information, and may ultimately cause harm to patients making decisions based on personality factors that have no correlations to patient outcomes. You can find the article here.

What do you think? Is this kind of rating system harmful? Is it possible for some kind of rating system to provide useful, accessible information?

Ads that promise too much

The New York Times published an article this week about Bayer, which is running a series of corrective advertisements about its birth control pill, Yaz. The FDA asked Bayer to run the corrective ads in response to previous advertisements for Yaz that claimed to also help with such sumptoms as pimples and premenstrual syndrome. The requirement from the FDA to run a corrective campaign is part of a new crackdown on deceptive consumer drug advertising. Given that the financial stakes are so high for drug companies, it likely won't be the last time the FDA has to ask a pharmaceutical company is asked to run a corrective advertising campaign.

You can see the article here.

What do you think?

Should you warn about bad news?

What is the best way to break bad news? Some communication research suggests that clinicians should give a"warning shot" prior to giving the patient bad news. Something like "The news I have to share may be upsetting." The idea is that preparing the patient for the prospect of bad news allows the patient to better prepare for and process the information. If bad news is just sprung, the patient may not hear anything else after the upsetting news and may be too upset to talk about important issues such as next steps. But is it possible that classifying news as upsetting may be more upsetting than just breaking news to a patient without prior qualification? Rather than qualifying information beforehand, maybe clinicians should instead give patients time to process the information before moving on to the next topic.

What do you think? What is the role of the warning shot?

Can nurses care too much?

The New York Times Well blog featured a guest blogger earlier this week that touched on an issue of particular interest to me: nurses and empathy. Theresa Brown, an oncology nurse, shares her stories about caring for patients and wonders if it is possible to care too much. You can find the story here.

What do you think? How can nurses balance empathy and the emotional strength to get through what can be a very draining profession?

New Research Opportunities

So the pace of the blogging has slowed down for me in the beginning of 2009. The reason is because I am in the process of pursuing new research opportunities in the Pacific Northwest. I am looking to apply my communication research and clinical research skills to a new research coordinator or clinical research monitoring position. It is a challenging time, but I am looking forward to new research possibilities and the prospect of applying my communication and research skills in a new setting.

Health care marketing - using all the tools available

The Centers for Disease Control published their annual report about their health marketing for 2008. The report shows all the activities the CDC has undertaken to empower patients and encourage the public to take an active part of their own health care. You can find the marketing blog here and the report here.

We have seen in the articles and discussion on this blog that it only helps both physicians and patients when everyone has access to good information to make health care decisions. And the CDC is showing that in order for messages to be effective you have to reach the intended audience. And that means going beyond a brochure and engaging in the types of media that draw people in.

What types of new media strategies health groups should cultivate and use in the upcoming year?