• 72°

Dr. Magryta: Medical rating systems bring unintended consequences

We rate everything now. Google, Facebook, TripAdvisor are a few of the many internet based platforms where people can rate their experiences.

While well-intentioned ratings can be useful in many cases, there are also places where it is a mess. Hospitals and physician practices are a few such places.

I have been reading a lot about the scourge of the narcotic epidemic in America. It destroys lives while upending families in the process.

It is quite personal for pediatricians, as it directly affects many newborns that are born addicted. It is beyond sad to witness a withdrawing newborn!

I bring this up because I think that to some extent physicians are partly to blame for this epidemic. We have given in to the societal pressure to satisfy patients, often giving out drugs that have unfortunate side effects.

Hospitals and corporate-owned clinics have turned to ratings systems for their employees over the past few decades, following the national trend that has been pushed by the federal government.

The original idea was that this would have meaningful repercussions on health care quality. As always, intentions and outcome are often different.

Hypothetically, let us say you are Dr. X in the emergency room seeing patient Y. Patient Y has back pain and after reviewing his chart, you notice a drug-seeking pattern that is worrisome. To prescribe more narcotics for this person is violating your hippocratic oath to do no harm, as this chronic drug use will only hurt this patient more over time, as every study has proven.

You also think about the possibility that patient Y may sell his drugs to a young pregnant girl who is addicted as well. She then delivers an addicted baby who needs narcotics for a month to detox. What a mess!

If you do not oblige this patient, you will rack up poor ratings and get a call from your friendly non- clinical administrator. What to do? With the narcotic, antibiotic and antacid use data in full view, clearly, too many people are choosing to follow the wrong path.

In our office we have similar pressures from parents to prescribe drugs such as antibiotics. We refuse to use narcotics because there are better ways to handle most pain issues than a masking and addicting drug.

The FDA has finally banned codeine (a narcotic) for use in kids, adding to a growing list of drugs used to help symptoms but having more downside then upside.

We have chosen to not have a rating system based on the data and we feel it is our duty to always do the right thing without fear of influence. Our goal is every child’s wellness with the best path with or without medicine as dictated by the clinical scenario. This should be the goal of every clinic in the country.

In our opinion, patients should have a grievance mechanism in place. We have an office manager that handles any concerns, and my partners and I try to personally contact any parent regarding these concerns to help rectify the situation or improve it where possible.

Ultimately, the most important mechanism in place for a consumer is choice. If they are not happy, moving to another provider is the best solution. However, providing unnecessary care or worse care that hurts the child, but pleases the parent in the long run, is against our ethos and every physician’s hippocratic oath.

The satisfaction game is a slippery slope toward unintended consequences and we are not willing to gamble with children’s health.

Knowing that over-using antibiotics, narcotics and antacids will lead to more disease in children has driven us to draw a line in the sand that makes ratings and peer influencing mechanisms of no benefit, despite the growing trend.

Dr. M

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3979780/

https://hbr.org/2015/10/health-care-providers-should-publish-physician-ratings

Dr. Chris Magryta is a physician at Salisbury Pediatric Associates. Contact him at newsletter@salisburypediatrics.com

 

About Post Lifestyles

Visit us on Facebook: https://www.facebook.com/SalPostLifestyle/ and Twitter @postlifestlyes for more content

email author More by Post

Comments

Crime

Blotter: April 13

Coronavirus

County switches vaccines for Livingstone clinic after federal, state guidance

Coronavirus

US recommends ‘pause’ for J&J vaccine over clot reports

Education

Superintendent talks first 100 days, dives into district data

Business

‘It was an answer to a call:’ TenderHearted Home Care celebrates 10 years of providing care at home

News

Political Notebook: Local polls find increasing number of North Carolinians want COVID-19 vaccine

News

Trial begins on challenge to latest NC voter ID law

Local

Burch, Fisher, Marsh honored as 2021 recipients of Elizabeth Duncan Koontz Humanitarian Award

Landis

Landis board talks revenues, budget planning, department updates

College

College baseball: Catawba rolls 7-1 and 24-1

Nation/World

Student fires at officers at Tennessee school, is killed

Nation/World

Police: Minnesota officer meant to draw Taser, not handgun

Crime

Man receives consecutive prison sentences for sex offenses

Education

RSS Board of Education approves Faith Elementary sale

Coronavirus

Rowan Health Department receives 400 Pfizer, 800 Johnson & Johnson vaccines for week

Crime

Blotter: Accident in Food Lion only weekend shooting to produce injuries

Crime

Salisbury man charged with felony drug crimes

Crime

Second person charged in thefts from house near county line

Crime

Police use tear gas to end robbery stand off, arrest suspect

Local

Ask Us: When will Rowan Public Library’s West Branch open?

Nation/World

Prosecution case nears end in ex-cop’s trial in Floyd death

Nation/World

Officer accused of force in stop of Black Army officer fired

Crime

Blotter: Man charged with hitting man with car, fleeing while intoxicated

Local

‘Meet the need’: Rowan County Health Department looks to add to vaccination options