AHRQ Ad Campaign: Questions are the Answer

I came across this well thought out commercial that has appeared on TV from the U.S. Department of Human Health & Services' Agency for Healthcare Research & Quality (AHRQ). Their website has a few other public service announcement-type of ads. With their, "Questions are the Answer" campaign, they are encouraging patients to ask questions about their care and to take an active role in the provision of their care. Hopefully, patients and providers alike will embrace this idea so that there are more answers than questions.

Any questions?

H1N What?

With all the talk about H1N1 influenza, I think it;s important for folks to understand where the H1 and N1 come from.

The "H" comes from the substance hemagglutinin and the "N" comes from neuraminidase. There have been identified influenza strains of the H and N types and this is how some influenza viruses are classified. The particular "swine" flu that has garnered so much attention is of the H1N1 type. A few years ago, the fear was of the avian type, H5N1.

This past Spring, the Wall Street Journal Health Blog did a good job explaining some of the background regarding the naming of this particular strain of influenza.

This may help us all understand the nomenclature and rationale behind what has become household names.

Provider Ratings

I recently decided to obtain auto insurance quotes from most of the major insurance companies websites. The quote process is generally very simple: enter your information and you get an instant on-line quote. As I feel it necessary to perform some due diligence and not just go with the least expensive quote, I Googled "auto insurance ratings." Well, what a frustrating experience. I wouldn't say that I am now more confused - only that it wasn't at all helpful. The Web is filled with a smattering of reviews and many of the negative ones seem that there is more to the story than what is written. In addition, we mostly know that an unsatisfied customer is much more likely to take their story to the Internet and post it as opposed to a satisfied customer with no issues.

What's my point to this post? I have come across various articles and websites that give patients the opportunity to rate their health care provider. In fact, here is an example of such a site. One can even go to Yelp to get provider-specific ratings from their patients. I have some concerns over what impact these ratings may have on providers and patients. Clearly, objective data cannot be disputed such as the education, training and the certification of providers. However, how much emphasis can we place on subjective data? Does this truly help us when choosing a provider? The patient who claims to be "mis-diagnosed" is much more likely to post this experience than someone who is truly satisfied and happy with their care.

I would much rather see some sort of qualitative data (i.e. percentage of patients with diabetic complications, number of hospitalizations, etc) when choosing a provider. Unfortunately, much of that data is nearly impossible to aggregate with the archaic paper and pen records system of most practices. So, we are largely left with subjective data to guide our decision when choosing a provider (this also assumes that we actually have a choice when it comes to choosing providers - I'm not sure most of the un or underinsured are taking to the Internet to research this kind of data).

What do you think? Are these rating sites helpful? After all, nearly every other industry uses customer ratings on their websites (think eBay and Amazon). Should health care also follow suit? Could this create a new independent agency whose purpose is to perform these ratings (such as a J.D. Power & Associates)?

Now I must go back to making that auto insurance decision!

Mandatory Flu Shots

The New York State Department of Health recently passed emergency regulations requiring all healthcare personnel working in hospital and nursing homes to receive mandatory influenza vaccinations or face termination of employment.

I am a vaccine advocate and believe that vaccinations have decreased and in some cases eradicated some infectious illnesses. I do, however, worry about the mandate aspect of this law and how it will be truly be enforced.

What do you think? Good idea? Cutting-edge? Violation of privacy? I'd love to hear your thoughts.

You Can Count On Us

Pennsylvania Governor Ed Rendell, a longtime champion of NP practice writes a column in today's USA Today, "Health reform can count on nurses." I am encouraged by this support and recognition for the thousands upon thousands of NPs, Nurse Midwives, Nurse Anesthetists, and Physician Assistants practicing and caring for patients in community, hospital and out-patient settings every day. We are not a new concept nor fad. Our practice is centered on our patients.

I invite everyone to read the blogs on my NP Blogroll. You will find examples of the extreme care and commitment we give to our patients. It certainly seems as if Governor Rendell is reading. Its exciting to ponder who else may be reading as well.......

Forms, Forms and more Forms

It's back to school time and that means droves of physical forms flowing into offices as a requirement for school. Each form is different in its length, complexity and readability. Some practices have refused to complete forms and will attach a copy of their own. Some practices charge an additional fee to have the forms completed.

Why can't we ascribe to a standardized school form that everyone can use? I have seen some forms ask only for height, weight blood pressure and immunization history while others require a complete review of systems, physical exam, diagnosis, and dietary restrictions.

What do you think? Should we have a standardized physical form? Do you charge extra for completing patient's forms? If you are a parent or a patient, what do you think of this superfluous and redundant paperwork?

I'd love to hear your thoughts.

Evidence-Based Prevention

Here is an article from the U.S. Preventative Services Task Force and is a resource for NPs to implement evidenced-based preventative practice.

When the buzz today is about health care reform, here is a good place for us all to start - talking about a preventative proactive evidenced-base approach rather than the opposite of that (which is what we largely have now!)