jlumsden Posted March 23, 2018 Share Posted March 23, 2018 Received my second six month Press Ganey summary today. I’m just over one year into my job. Results reasonably good, I suppose. Even so, I’m below average for my clinic. I noticed an unsettling pattern in our clinics. We share scores. On the whole, nurse practitioners and physician assistants are scoring lower than MDs. The APs score at about 4.6/5.0 overall. The MDs score at about 4.8. There’s a wide range of personalities, experience levels, clinical interests, and bedside manners among the APs. What accounts for this lower score? Is this common in other institutions? I wouldn’t let it bother me, except the Press Ganey scores are built into our performance evaluations. This ties to our compensation packages. So if there’s some sort of bias, the playing field isn’t level. Do you have similar experiences? Link to comment Share on other sites More sharing options...
dfw6er Posted March 23, 2018 Share Posted March 23, 2018 So all APP scores are averaged together and your clinic cuts a bonus check to each APP based on this score? Are the physicians' scores also averaged out for all physicians? Also, have you seen the questions PG is sending out to patients? Are they the exact same questions for every encounter, whether it's a physician encounter or APP encounter? Lots of unknowns here. If you do have certain APPs pulling down the average for the rest of you, what is the clinic doing about those poor performers? Link to comment Share on other sites More sharing options...
dfw6er Posted March 23, 2018 Share Posted March 23, 2018 I guess I should add the biggest problem I've seen w/ PG scores: The number of responders is typically too small to make meaningful conclusions.....n is often in single digits for me and it's not uncommon for me to see 800-900 per month. And as we all know, the people who respond to PG are often those with an axe to grind. Link to comment Share on other sites More sharing options...
sas5814 Posted March 23, 2018 Share Posted March 23, 2018 They shouldn't lump all the APPs together. We recently got our (urgent care) Press Gainey scores and they weren't "good enough." They had us lumped in with the ER, couldn't break out the data for the aspects that were good and bad etc etc. I told the presenter that until he had better data that was actually useful he shouldn't come to our meetings telling us we aren't doing "good enough." Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 23, 2018 Moderator Share Posted March 23, 2018 13 hours ago, jlumsden said: Received my second six month Press Ganey summary today. I’m just over one year into my job. Results reasonably good, I suppose. Even so, I’m below average for my clinic. I noticed an unsettling pattern in our clinics. We share scores. On the whole, nurse practitioners and physician assistants are scoring lower than MDs. The APs score at about 4.6/5.0 overall. The MDs score at about 4.8. on any other scale 4.6/5= 46/50=92/100. That's an A. this whole concept of a 99 is a failing grade is BS. every place is doing it now. My car repair guy at honda tells me if I don't rate him perfect in all categories when the survey folks call that he won't get a raise this year. total bs. Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted March 23, 2018 Moderator Share Posted March 23, 2018 A theory- In most ERs, the APP's are going to be handling a larger volume of lower-acuity patients. Since many of those patients have problems that cannot be fully addressed in the ER, they ultimately leave unsatisfied- "They didn't do anything" for my chronic *insert condition here*. And since Press Ganey doesn't send surveys to patients who are admitted- which of course most of those patients will be happier with their care because they had a legitimate problem that the ER had to address, AND that in general the MDs are going to be handling more of those patients by percentage- the discharged patients, who may or may not have had their problems fully addressed, aren't going to be happy, and it will reflect in their Press Ganey scores- which would, as a whole, drop the scores of the APPs relative to the docs. Link to comment Share on other sites More sharing options...
thinkertdm Posted March 23, 2018 Share Posted March 23, 2018 Press ganey measures shit. It's a bullshit survey that purely exists so admistrators can justify their jobs. Of course, when it's tied to your compensation, that sucks. Remember, very rarely do happy people fill those things out. The statistics used on that and similar scales are not science. Link to comment Share on other sites More sharing options...
sas5814 Posted March 23, 2018 Share Posted March 23, 2018 7 minutes ago, thinkertdm said: Press ganey measures shit. I don't think that is fair at all. You can apply quantifiable scientific methodology to measure shit. Link to comment Share on other sites More sharing options...
lkth487 Posted March 23, 2018 Share Posted March 23, 2018 This is what I think about press ganey: In a nationally representative sample, higher patient satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1108766?resultClick=3 Our job shouldn't be to do just what the patient wants. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 23, 2018 Moderator Share Posted March 23, 2018 2 hours ago, lkth487 said: This is what I think about press ganey: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1108766?resultClick=3 Our job shouldn't be to do just what the patient wants. yes, great study: The cost of patient satisfaction. should be required reading. Link to comment Share on other sites More sharing options...
Guest Paula Posted March 24, 2018 Share Posted March 24, 2018 We got rid of PG due to the invalid scores and low response rate from patients. Our administration kept dogging us to tell every patient to pick up a survey and score us high. I just couldn't hawk myself like that and never did. We have a new satisfaction survey now and I got my results a month ago. Dang.....I had many fabulous reviews but there were two that were so horrible, I thought I must have turned into Satan, and am now sitting in from of him with a pass to hell. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted March 24, 2018 Share Posted March 24, 2018 Press Ganey is contributing to the death of the Art of Medicine. Press Ganey could apply to maybe a restaurant or a retail store but not to medicine. Not getting antibiotics, not getting pain meds, being told to stay home, rest and push fluids just doesn't jive in our world. The VA has some horrid version of PG that doesn't get mailed out until about 2 months after the visit and the only respondents are the chronically angry folks - so - that whole system is for bunk. Something like a 15% response rate. They won't let us hand out anything at visits or do anything regionally or locally - all national and all requiring umpteen committees to approve even a one word change. I just keep doing my thing - see folks, use my smarts, be nice and keep going. Link to comment Share on other sites More sharing options...
sas5814 Posted March 24, 2018 Share Posted March 24, 2018 20 minutes ago, Reality Check 2 said: The VA has some horrid version of PG that doesn't get mailed out until about 2 months after the visit and the only respondents are the chronically angry folks - so - that whole system is for bunk. Something like a 15% response rate. They won't let us hand out anything at visits or do anything regionally or locally - all national and all requiring umpteen committees to approve even a one word change. Worse....active duty military going on sick call and seen at military facilities are being given patient satisfaction surveys to fill out. Madness.... Link to comment Share on other sites More sharing options...
jlumsden Posted March 24, 2018 Author Share Posted March 24, 2018 On 3/23/2018 at 0:08 AM, dfw6er said: So all APP scores are averaged together and your clinic cuts a bonus check to each APP based on this score? Are the physicians' scores also averaged out for all physicians? Also, have you seen the questions PG is sending out to patients? Are they the exact same questions for every encounter, whether it's a physician encounter or APP encounter? Lots of unknowns here. If you do have certain APPs pulling down the average for the rest of you, what is the clinic doing about those poor performers? The app scores aren’t grouped. The questions are identical. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted March 25, 2018 Share Posted March 25, 2018 Our VA issue is that the surveys are mailed about randomly 2 MONTHS after the visit by a national office. TWO MONTHS after a visit - what do I remember? Well, the chronically angry remember a lot - all the time - in perpetuity. The questions are nebulous and don't really apply to actual medical practice. Since an overwhelming majority of VA patients have a controlled substance prescription - we have a lot of detailed discussions, regulations and needs to monitor medications and lower them a lot of the time based on national directives and plain old common sense. The VA has a checkered history for a lot of folks - and I work to overcome a lot of old bad karma. If you want to know how my patient felt about an appointment I had with them - ask them as they are leaving - not two months later. Then ask me how it went and compare notes. Link to comment Share on other sites More sharing options...
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