Roy Exum: Hospital Ratings Are Ridiculous

Friday, August 9, 2013 - by Roy Exum
Roy Exum
Roy Exum

When Consumer Reports graded hospitals on surgical care several weeks ago, a cursory glance at the statistics revealed it was a ridiculous stretch at best. A hospital has little, if anything, to do with the individual ability or performance of a given doctor and for our community to get all riled up that the area’s largest hospitals – Erlanger and Memorial – were rated as “poor” by a far-away magazine is a bunch of poppycock.

Last year Erlanger, our Level 1 trauma center, was chosen as the top regional hospital by U.S. News & World Report and that is equally mystifying, given Erlanger’s huge financial losses at the time. The truth is that Erlanger and Memorial, as well as Parkridge that was rated “good” by the Consumer Reports findings, all offer quality medical care despite the senseless statistical data that was used.

As a quick example, the Houston Astros and Chicago White Sox have the worst records in Major League baseball. There is little doubt Consumer Reports would rank both as “terminal.” The Astros have lost 75 of 112 games this season and the White Sox are now 24 games behind Detroit in the AL Central alone. But that has absolutely nothing to do with the fact Houston second baseman Jose Altura is batting a healthy .279 with 117 hits or that Chicago’s Adam Dunn has already hit 26 home runs with 68 RBIs.

I’ll be the first to acknowledge there are some doctors that are much better than others. You see it everywhere you look; some lawyers are brilliant and some chase ambulances, some teachers are thrilling and some are hall monitors, some truckers win mileage awards and some crash their rigs. The trick in picking a doctor is choosing who you trust and learning who you want to avoid.

I have been blessed by the parade of wonderful doctors who have come into my life. Oh, I’ve shied away from several but having a physician you admire and trust is a big part of staying healthy. Once you get to know and appreciate their staff it gets even better and today, with more and more “physician’s assistants” able to see you quickly, the team approach is a blessing in itself.

I had one doctor, a nice guy, who did a procedure on me one Friday about two years ago and over the weekend I got pretty sick as a result. I try hard not to bother a doctor on the weekend, instead going to the ER if absolutely necessary. When I called his office the first thing Monday morning, I was promptly patched through to his nurse and was stunned by the crass message. After listening to her recording, I wouldn’t go back to that doctor on a bet. Oh, he was a good guy but my thinking is that if a psycho nurse is my only lifeline I’m better off finding a different crowd that cares about me.

Another great test is to note how long you wait to be seen. I understand about emergencies – that has been me before – but I have found if I wait over 30 minutes from the time of my appointment, chances are there is some other doctor in the same field who cares more about his business plan. That’s not unreasonable – my time is valuable. When I waste it needlessly, all I think about is what a fool I am to allow such a situation to occur in my life.

All the big hospitals – Vanderbilt, Emory, UAB and others – now have in-house telephone numbers for the patient to call if “the 30 minute rule” is violated. Whether a doctor wants to admit it, the competition for patient satisfaction has raised the bar. Granted, for it to work, the patient must be on time, too, but the days of being a victim are over.

My biggest failure of all time happened this summer when I was referred to an orthopedic clinic for the very first time after I fractured my shoulder. I waited 55 minutes before I was seen by this male nurse who had a good number of tattoos. I don’t have anything against tattoos but that is what I remembered. “Nurse Tattoo” took my history and then I waited another 40 minutes before the physician’s assistant finally showed up.

The physician’s assistant left several times to relay questions to the doctor and then come back with the answers. I’ve never seen anything like it. When I finally left, I had been a patient in that office for two hours and 20 minutes and, get this, I had neither met nor did I even know the name of the doctor I was to see.

I realized at the time there was little I could do to have avoided what had happened but I can guarantee it will never occur to me again. Patients must remember they have a choice – they should use it -- but they should also realize no website in the world can possibly know this stuff goes on at different hospitals.

How can you possibly rate surgical care based on Medicare statistics? Some doctors refuse to see Medicare patients – the paperwork alone is horrendous – but that hardly means the doctors who do see Medicare and Medicaid are not quality physicians who are keenly interested in the people they help.

Don’t fall for meaningless grades and rankings. Understand the magazine’s chief goal is to sell subscriptions and by ranking the top two hospitals in Chattanooga as “poor” creates exactly the firestorm and sensationalism it takes in today’s climate of “got cha’” journalism.

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