John Weeks July 2012 Integrator Round-up on Employers & Payers to cover updates on:  Bastyr Center for  Natural Health; Study suggests medicine’s “patient-centered” efforts are more thought than action

Bastyr Center for  Natural Health ranks highest among 46 primary care practices in major survey of patient experience by the Puget Sound Health Alliance

The report, proudly published as the first of its kind in the nation by the Puget Sound Health Alliance is entitled Your Voice Matters: Patient Experience with Primary Care Providers in the Puget Sound Region. This “2012 Community Checkup Overview” look at 46 medical groups with clinics in 156 locations across Puget Sound. The assessment was based on the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey instrument. Of the group, the Bastyr Center for Natural Health, with its broad pharmacy right naturopathic doctors, licensed acupuncturists, nutritionists and other natural health practices ranked:

  • 1st of the 46 overall
  • 1st in “getting timely care, appointments and information”
  • 1st in “how well providers communicate with patients”
  • 2nd on “helpful, courteous staff”
  • 3rd highest of the 46 on “overall rating of the provider.” 

Bastyr was one of just 4 of the primary care clinics surveyed to rank above average on each of the areas surveyed. Naturopathic doctors are considered primary care doctors in Washington state. An introductory section to the report describes why the Puget Sound Alliance of employers, government agencies and health plans believe patient experience is so critical: “Patient care experience is linked to clinical quality.” The authors add: “Patient-centeredness is now widely accepted as a core dimension of health care quality. The term may
seem like jargon, but it refers to important, basic ideas.” These include,  according to the PSHA authors: patient self-knowledge, patient self-efficacy, reduced cost of care (less non-value-added or duplicative care), increased adherence to provider recommendations for care and for use of medications, and reduced medical errors and adverse events.”

Comment: It is fascinating how antagonists to whole person care that includes taking time with people, such as patients experience with the naturopathic physicians at Bastyr’s teaching center, will dismiss the positive outcomes as merely a function of time spent with patients. Given the extraordinary number of outcomes that are linked to patient experience, perhaps providing patients something patients clearly like should be honored rather than dismissed. If the values noted above are not sufficient to make this point, the Alliance, by the way, also links positive patient experience to: patient empowerment, better independent decision-making and self-care, reduced medical errors and adverse events; improved clinical outcomes (e.g., blood pressure or cholesterol levels); improved quality of life and well-being; reduced disparities in care; and improved survival. Huge. Credit the Bastyr providers and disciplines. This report is an interesting companion piece to a patient survey from the Canadian College of Naturopathic Medicine reported here.


Afraid to speak up: study suggests medicine’s “patient-centered” efforts are more thought than action

The New York Times “well blogs” piece by Pauline Chen, MD is entitled: Afraid to Speak up at the Doctor’s Office. Chen references all the focus on “patient-centered” care and “shared decision making” and concludes: ” … one thing has been missing in nearly all of these earnest efforts to encourage doctors to share the decision-making process. That is, ironically, the patient’s perspective.” Chen notes a May issue of Health Affairs that included an article entitled: Authoritarian Physicians And Patients’ Fear Of Being Labeled ‘Difficult’ Among Key Obstacles To Shared Decision Making. Chen says the study “uncover(s) some of that perspective (that) …in our enthusiasm for all things patient-centered, we seem to have, as the saying goes, taken the thought of including patient preferences for the deed.” The authors of the Health Affairs piece conclude that “physicians may not be aware of a need to create a safe environment for open communication to facilitate shared decision making.” 

Comment: This seemed a good companion piece to the article above on patient experience in a naturopathic doctor-led primary care practice. (Thanks to Mitchell Bebel-Stargrove, ND, LAc for forwarding the link.)