Work Notes

[MGG1848]

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[AbbyNormal]

If an employee continually calls out sick with work notes, can employers still fire them?

My employer (hospital) did.

I worked with a nurse who was genuinely ill with a serious illness. But genuine or not she had exceeded her sick days and they terminated her employment. They told her while she was in-patient in the hospital.

The nurses did not have a union or a contract. We were all "at will" employees.

 

[southerndoc]

I had a patient once who signed in with URI symptoms. When I went into the room, he fessed up. He basically said he didn't want to waste my time doing an H&P and just requested a work note. I gave him one just for his honesty, although one cannot say he was honest to his employer.

 

[Apollyon]

I had a patient once who signed in with URI symptoms. When I went into the room, he fessed up. He basically said he didn't want to waste my time doing an H&P and just requested a work note. I gave him one just for his honesty, although one cannot say he was honest to his employer.

Once? This is status quo where I am now (and where I was).

 

[strongboy2005]

Why not just have a no-work-notes policy? Are you forced to write them or can you say no?

 

[docB]

We can say no but it's swimming up stream. Many nurses do think it's our duty to write work notes, RETURN to work notes (which is a whole seperate issue), ok to fly notes (which is really a seperate issue), notes saying the person was in the ER on such and such a day, notes saying the person was in the ER with a family member on such and such a day and so on and so on.

We are also held to customer orgasmic happiness standards via Gallup and PressGaney. It also is a choice between an entire new time consuming conversation about why we won't do it because no nurse would deprive any patient denied anything the opportunity to plead their case to the doctor or just writing the note.

 

[Arcan57]

Do you think we'll eventually have the opportunity to become accreditated as Level I work note centers of excellence? Followed by the inevitable CMS core measures for work notes...

To those that have a "no work note" policy, does your hospital just not care about PG scores? Also, do the nurses back you up and tell the patient to shove off, or do you then spend 5 minutes explaining to a patient why you won't give them off? And if you do talk to them, how do you deal with them accusing you of wanting their entire family to get thrown out onto the streets and starve?

 

[southerndoc]

I really think this Press Ganey thing is a fad and will likely fade away in another 5-10 years as hospitals realize not every hospital in America can be in the top 1% and then realize just how much money they are spending on surveys and consultants.

 

[docB]

I really think this Press Ganey thing is a fad and will likely fade away in another 5-10 years as hospitals realize not every hospital in America can be in the top 1% and then realize just how much money they are spending on surveys and consultants.

I hope to God you're right. Seriously. I have just been informed that my entire group will now be wearing matching scrubs and a white coat because "it looks more professional."

I hate white coats.

 

[Arcan57]

The data provided by Press-Ganey is written in a language that is easily read and interpreted by the MBAs that act as hospital CEOs. It speaks to them in a way that excellence in delivering care (especially care that does not have CMS core indicators) does not. There are very few customer service industries that do not closely track customer satisfaction, and I don't think hospital CEOs are going to be willing to give up the information PG provides. I see the use of PG in private sector healthcare as a decision making tool increasing. Especially as the pool of well-insured patients becomes proportionately smaller with recent legislative changes.

 

[quinsy]

I don't think people should let this get to them so much.
I also think it is unlikely that not giving work notes will lead to decreased volumes, because every day a group of new slackers comes up with this idea, and they are not known for networking and scheming amongst one another.

I just give work notes to people who asked for them that say the person can return to work on the date of the visit to the ED, unless I think there is some reason why the person cannot return that day. The patient gets their note, I don't have to have an argument, and it's between the employer and the employee what happens after that. I believe that the patient uses this note to argue to their employer that they deserved the day off, but if they want to play that game, then it's on their conscience. It only takes like 5 minutes to see patients like this, so I don't feel it's a big time sink.

 

[deuist]

I hope to God you're right. Seriously. I have just been informed that my entire group will now be wearing matching scrubs and a white coat because "it looks more professional."

I hate white coats.

Bah, my new program requires the residents to wear dress shirts and neckties. White coats are optional.

 

[dmitrinyr]

Bah, my new program requires the residents to wear dress shirts and neckties. White coats are optional.

I may be wrong, but I think that there is one EM program in Pennsylvania that requires all of their residents to wear dress shirts and ties all of the time. I think it's Geisinger Health Systems Program.

That's one think that I love about EM and most EM docs/residents. Many just like to wear scrubs and don't like white coats and/or neckties. So I think it might be a little bit annoying to have a shirt and tie on in the ED, especially if you're running a code or treating a trauma pt. Same think applies to surgical residents and ICU residents. That's one of the things that I loved about working in the unit, just wearing scrubs 24/7. If I did a compressions for 20 minutes or a whole bunch of procedures and got a little sweaty, then just freshen up and get a new pair of scrubs and you're good. You can't do that with a shirt and tie.

A friend of mine who is a surgical resident has to deal with this all the time. He must wear scrubs when in the OR, but has to be in a shirt/tie when outside the OR. This means that he has to change multiple times per day.

As far as work notes... there will always be a steady supply of slackers that want will come in with a BS complaint and will want a note for work/school. Unless your hospital has a strict policy against it, you have to deal with them and sometimes it's just easier to give them a note (which takes a few minutes) than trying to explain to them that they don't need one/they're fine/they're wasting your time, etc.

I usually just listen to the CC that they have, do a focused H/P (few minutes) and then deal with the results. 99% of the time, it's a BS compaint that you can smell as soon as you enter the room. With these pts, I just tell them that they are going to be fine, that what they have does not require hospitalization and they can resume working that day. I give them a note stating that they were in the ED that day and can go back to work that day. If they have something that I think will require a day of bedrest or further treatment via pt's PCP (without hospitalization), I'll write that as well. This doesn't take more that a few minutes and I can go on to patients who hopefully have a worthy complaint and who can benefit from my care.

Pt's are usually satisfied with the notes and go on. Half of the time it's not even people that are trying to get off work, but it's actually people that might be a little hypochondriac and think that they have something that actually needs to be seen in the ED. Often, what these pts have is a flu, cold, musculoskeletal pain, etc. that would be helped with a 5 minute trip to their closest CVS/Duane Reade/Pharmacy for Over the counter remedy.

 

[DeLaughterDO]

I may be wrong, but I think that there is one EM program in Pennsylvania that requires all of their residents to wear dress shirts and ties all of the time. I think it's Geisinger Health Systems Program.

Not anymore. Scrubs only for the past 3 years, but they have to be monogrammed If you want to wear shirt/tie/slacks/white coat, you still can.

 

[xaelia]

I hate white coats.

White coats, long-sleeves, non-bowtie ties, stethoscopes, etc all fomites for spread of pathogenic bacteria between patients. I wouldn't even wear a white coat rounding on Medicine. The NHS is on the ball: http://news.bbc.co.uk/2/hi/health/6998195.stm

Even though there hasn't been any evidence of patient-oriented outcomes to physician clothing colonization, it's a zero-cost/zero-harm intervention* so it doesn't matter what the number needed to treat is. It's just not worth the risk.

* except for women doctors whose patients complain that they never saw a doctor, only nurses

 

[docB]

White coats, long-sleeves, non-bowtie ties, stethoscopes, etc all fomites for spread of pathogenic bacteria between patients. I wouldn't even wear a white coat rounding on Medicine. The NHS is on the ball: http://news.bbc.co.uk/2/hi/health/6998195.stm

Even though there hasn't been any evidence of patient-oriented outcomes to physician clothing colonization, it's a zero-cost/zero-harm intervention* so it doesn't matter what the number needed to treat is. It's just not worth the risk.

* except for women doctors whose patients complain that they never saw a doctor, only nurses

But there are a lot of studies out there that link the damnable white coats to higher patient satisfaction and even to greater patient perception of pain control if it was ordered by a doc in a white coat. There have been no (to my knowledge) instances of a patient being able to trace their infection back to their doctor's coat so to administrators the former is a real, measurable gain and the latter is a theoretical loss. So I'm stuck wearing that white shroud of heat from now on.

 

[Arcan57]

We just went to that. I hadn't had to wear a white coat since I rotated through plastics as a third year. The beauty is that there are no coat hooks anywhere, so whenever I have to do any procedures I have to drape it over the towel dispensor.

 

[southerndoc]

But there are a lot of studies out there that link the damnable white coats to higher patient satisfaction and even to greater patient perception of pain control if it was ordered by a doc in a white coat. There have been no (to my knowledge) instances of a patient being able to trace their infection back to their doctor's coat so to administrators the former is a real, measurable gain and the latter is a theoretical loss. So I'm stuck wearing that white shroud of heat from now on.

In the world of patient satisfaction, and in the eyes of hospital administration: patient satisfaction >>> patient safety/treatment.

 

[xaelia]

In the world of patient satisfaction, and in the eyes of hospital administration: patient satisfaction >>> patient safety/treatment.

Bad care that looks good - the enviable model for delivery of medical treatment in the 21st century.

This is the stuff they should warn pre-meds about, just to make sure their doe-eyed idealism for humanism in medicine gets some solid doses of reality.

 

[dmitrinyr]

But there are a lot of studies out there that link the damnable white coats to higher patient satisfaction and even to greater patient perception of pain control if it was ordered by a doc in a white coat. There have been no (to my knowledge) instances of a patient being able to trace their infection back to their doctor's coat so to administrators the former is a real, measurable gain and the latter is a theoretical loss. So I'm stuck wearing that white shroud of heat from now on.

I would agree that I think patients feel more confident in you and you might get better results in pain control when pt is treated by a doctor with a white coat, but it still doesn't change one simple fact: I HATE wearing my white coat!!

If it was up to me, I'd wear cargo pants (for their multiple pockets) and a scrub top to all of my shifts in the ED. After all, don't we want our residents and attendings to be comfortable when they are at work and treating patients? As a medical intern last year, I often got crap from my program for not wearing my white coat during the work day and they didn't care one bit that I was uncomfortable. Still, I maybe comfortable in my cargo pants, but maybe the patient wants to see that white coat and not have his doctor look like his painter or carpenter Remember, to patients, perception is reality.

 

[Doctor Bob]

If it was up to me, I'd wear cargo pants (for their multiple pockets) and a scrub top to all of my shifts in the ED.

Rather than use the hospital-provided scrubs, I pay for my own and I get aviator scrubs. Cargo pockets in the pants, built in belt, sleeve pen holders, etc. I can carry as much stuff as the guy wearing the fanny pack but much less obviously.

 

[DrMom]

White coats, long-sleeves, non-bowtie ties, stethoscopes, etc all fomites for spread of pathogenic bacteria between patients. I wouldn't even wear a white coat rounding on Medicine. The NHS is on the ball: http://news.bbc.co.uk/2/hi/health/6998195.stm

Even though there hasn't been any evidence of patient-oriented outcomes to physician clothing colonization, it's a zero-cost/zero-harm intervention* so it doesn't matter what the number needed to treat is. It's just not worth the risk.

* except for women doctors whose patients complain that they never saw a doctor, only nurses

[side comment] The white coat on female docs doesn't really help with the nurse comments. I wear mine all of the time because I get really cold and I always introduce my self as Dr. yet I still get the "I have to get off the phone because my nurse is here" or "I haven't been seen by a Dr" comments [/side comment]

 

[deleted109597]

... I get aviator scrubs...

Flippin' awesome. I hope they look like this

As an aside, no study has shown fomites spread germs (unlike washing hands, etc). I wear my white coat to distinguish myself, even as a guy. It also protects my clothes.

 

[NYRN]

I know a few years ago there was some sort of policy in place at my hospital that ER docs not being able to give work notes for anything over 2 days due to some sort of legal issue?

Tell your patients if they act now, for only $14.97, they can save themself a trip to the ER and make up their own note.

http://www.bestfakedoctornotes.com/

 

[SoCuteMD]

One of my colleagues writes people work notes whenever they ask. And dates them for the day BEFORE their visit.

 

[Hamhock]

I write work notes for whatever days the patient wants...I don't even think about it, unless it is crazy.

A "strep throat" who asks for the next three days: no problem.

It never occurred to me to not write the note.

Why should I care? [and I am not being a jacka** here - I really don't see why it would matter to an ED doc as long as they are not asking for something crazy like a month]

HH

 

[kungfufishing]

I guess I'm a jackass about these. I tell people that their capacity to work is between them and their employer - I have decided you are well enough to leave the ED, now it is up to you to decide if you are well enough to provide for yourself.

 

[Flopotomist]

I guess I'm a jackass about these. I tell people that their capacity to work is between them and their employer - I have decided you are well enough to leave the ED, now it is up to you to decide if you are well enough to provide for yourself.

Seems a bit jaded to throw the burden of making a medical determination onto an employer. If a patient is ill and would benefit from resting at home for a few days, what is the harm in writing a note? Seems like good patient care to me. If the patient has an acute injury of some sort and needs verification that they were in the ED, why not write a note?

 

[GeneralVeers]

I personally don't care and will give them the note.

It's not costing me money.

If they want to be lazy and sit home they aren't making money.

Their employer will eventually not tolerate the behavior.

 

[WerdSalid]

If a note is requested by the patient, I usually provide one that simply states they were seen in the ED on that particular date. If they have an acute injury I'll give them a few days off work. In a few instances I have seen school-age kids brought in by their bonehead parents in the morning for bogus complaints - in these instances my "school note" states they are cleared to return to school THAT DAY.

 

[deleted65604]

When I first started my job, I saw numerous students from a certain nation that were university students. They would always have numerous complaints, that were rather vague and my work-ups consistently were negative. At the end, it would become crystal clear when they asked for a school note.

For example, the other day, a student said he had had a fever the day before and a headache, but all of his symptoms were gone. I've come to say, "so you just want a work note, right?" Their English is poor enough that they usually act like they don't get it, but in the end, they have learned, that if they just ask for a school note, we'll give it.

Initially, this behavior really bugged me. I didn't think it was fair for other students to not have the advantage of one more day for assignments and for studying for tests.

I talked to my boss about it, who told me in no uncertain terms, to give them a school note. Their nation pays their medical costs 100%, no questions asked. I talked to my in-law who is a professor, who said that she didn't care if a doctor gave a kid a work note, that students aren't doing themselves a favor by cheating.

If I were a professor, I would say, sure, you can have one more day to study, and then give them 10 extra "special" (impossible) questions that would negate the benefit of a day extra of study or tips from fellow test-takers.

On two recent students who were so flagrantly abusing the system, I wrote on the note, "Please excuse Allazybutt, he was seen in the ER and feels he should be excused." But that was in a person who had normal vitals, and no current complaints.

On the other hand, if you have legitimate pneumonia, or pyelonephritis, etc. I'll go out of my way to get you excused from school/work/etc. It seems like the least I could do.

 

[quinsy]

I guess I'm a jackass about these. I tell people that their capacity to work is between them and their employer - I have decided you are well enough to leave the ED, now it is up to you to decide if you are well enough to provide for yourself.

Since there is no such thing as calling out sick for us, this is certainly a system I am unfamiliar with, but basically, I do think you're being an ass not to provide notes, because my understanding is that many workplaces absolutely require a note as proof that the person was seen in the ER. It doesn't have to say why, whether you think the problem was important or not, or any of that, it just has to be proof that they were truly at a doctor.

Since we used nice, printed discharge instructions, if there is not much personal info on the instructions and I have no time, sometimes I just suggest "why don't you just use this paper I'm giving you as proof?" and this seems to make a number of people perfectly happy. But I can understand them not wanting to show their employer a paper that says something very personal about a medical problem, so I oftentimes do make the note for them so that they don't have to show their employer discharge instructions for 'thrombosed hemorrhoid' or something.

 

[southerndoc]

Why should I care? [and I am not being a jacka** here - I really don't see why it would matter to an ED doc as long as they are not asking for something crazy like a month]/QUOTE]

Work notes I don't have a problem with. The best were the two patients over the past year who've asked me to fill out the paperwork to certify them as being disabled.

 

[n2b8me]

 

[kungfufishing]

Seems a bit jaded to throw the burden of making a medical determination onto an employer. If a patient is ill and would benefit from resting at home for a few days, what is the harm in writing a note? Seems like good patient care to me. If the patient has an acute injury of some sort and needs verification that they were in the ED, why not write a note?

Well, when the patient clearly has an injury that will impede upon their ability to perform their required task, it tends to self evidently speak for itself. Otherwise, you can try to make it work as best you can. Has anyone else here taught his or herself to write with the nondominant hand after breaking the dominant one? If you really need the work you'll find a way to do it.

 

[docB]

I'm finally back to a real computer. I've been limited to my iPhone for a few days and I didn't want to try to type this with my thumbs.

I think the fact that we have to give people work notes is a sign of the apocalypse. How can we as an ostensibly civil society continue to exist if employers can't/wont' trust their employees to take a sick day? I think of the jobs people in my area do. They carry guns. They operate heavy equipment. They manipulate huge amounts of cash. But take a sick day? Oh no! I can't trust you with that! You've gotta go to the ER and get a note. Now get back up on that crane and lift that cooling tower up on top of the casino.

We all know this is a bad situation. Unnecessary ED visits. Unnecessary work ups. How many of us have ever gotten the "I really just came in for a note." at the end of a work up that included CT scans, blood work, etc. It creates an incentive for patients to lie and it makes up a party to that.

I'm a pretty libertarian guy but I think there should be a regualtion that if your employee has sick days or PTO or whatever they can't be required to get a note to use it. The fact is that there are lots of conditions that necessitate a sick day but not a doctor visit (flu, bronchitis, GE, etc.) so just leave me out of it.

 

[VA Hopeful Dr]

I'm finally back to a real computer. I've been limited to my iPhone for a few days and I didn't want to try to type this with my thumbs.

I think the fact that we have to give people work notes is a sign of the apocalypse. How can we as an ostensibly civil society continue to exist if employers can't/wont' trust their employees to take a sick day? I think of the jobs people in my area do. They carry guns. They operate heavy equipment. They manipulate huge amounts of cash. But take a sick day? Oh no! I can't trust you with that! You've gotta go to the ER and get a note. Now get back up on that crane and lift that cooling tower up on top of the casino.

We all know this is a bad situation. Unnecessary ED visits. Unnecessary work ups. How many of us have ever gotten the "I really just came in for a note." at the end of a work up that included CT scans, blood work, etc. It creates an incentive for patients to lie and it makes up a party to that.

I'm a pretty libertarian guy but I think there should be a regualtion that if your employee has sick days or PTO or whatever they can't be required to get a note to use it. The fact is that there are lots of conditions that necessitate a sick day but not a doctor visit (flu, bronchitis, GE, etc.) so just leave me out of it.

Many jobs nowadays don't separate vacation days from sick days. I get I believe 21 days off per year. I can do whatever I wish to do with those days (subject to what service I'm on, of course). I have a friend who's a public school teacher - 12 days off per year for whatever you want, no questions asked.

But you're right on the whole, no reason not to trust employees at least when they start work.

 

[BurnENickcoles]

[side comment] The white coat on female docs doesn't really help with the nurse comments. I wear mine all of the time because I get really cold and I always introduce my self as Dr. yet I still get the "I have to get off the phone because my nurse is here" or "I haven't been seen by a Dr" comments [/side comment]

You sure spend a lot of time commenting in various threads that you get mistaken for a nurse.

Sheesh. Can you leave the defensive feminism at home sister? Some of the rest of us women have moved beyond and are sick and tired of the woe-is-me-woman-in-medicine act.

 

[dmitrinyr]

You sure spend a lot of time commenting in various threads that you get mistaken for a nurse.

Sheesh. Can you leave the defensive feminism at home sister? Some of the rest of us women have moved beyond and are sick and tired of the woe-is-me-woman-in-medicine act.

Totally uncalled for.

 

[BurnENickcoles]

Totally uncalled for.

Whatever. That poster just never misses a chance to point out she gets mistaken for a nurse. It's an urban legend that gets perpetuated and does nothing for the rest of us women in medicine. Whether she's a MOD or not, I call it like I see it.

 

[Dwindlin]

Whatever. That poster just never misses a chance to point out she gets mistaken for a nurse. It's an urban legend that gets perpetuated and does nothing for the rest of us women in medicine. Whether she's a MOD or not, I call it like I see it.

Not sure what you mean by urban legend...I see it happen all the time with the female attendings/residents I follow.

 

[RxnMan]

Whatever. That poster just never misses a chance to point out she gets mistaken for a nurse. It's an urban legend that gets perpetuated and does nothing for the rest of us women in medicine. Whether she's a MOD or not, I call it like I see it.

Not an urban legend. One night when I was an ED volunteer - with scrubs of a distinctly different color, with "volunteer" monogrammed on the chest - I was emptying the linens when a patient started arguing with their doc (a woman). The doc told the patient to sit back and let her do the exam, but the patient wanted to see a real doctor, and pointed to me.

 

[GeneralVeers]

Not an urban legend. One night when I was an ED volunteer - with scrubs of a distinctly different color, with "volunteer" monogrammed on the chest - I was emptying the linens when a patient started arguing with their doc (a woman). The doc told the patient to sit back and let her do the exam, but the patient wanted to see a real doctor, and pointed to me.

And this is why we should not have the soul-sucking entity called the "Press-Ganey".

 

[southerndoc]

Whatever. That poster just never misses a chance to point out she gets mistaken for a nurse. It's an urban legend that gets perpetuated and does nothing for the rest of us women in medicine. Whether she's a MOD or not, I call it like I see it.

As an administrator, I have to deal with patient complaints all the time. One of the complaints I see frequently is that the patient failed to see a physician. One that I received yesterday was "was there for 90 minutes and never saw a physician, only a nurse." Everytime this occurs, it's always a female physician who treated the patient.

Once I had a complaint against a doctor where the "doctor had to ask the nurse what dose of pain medicine to give." When I talked with the individuals involved, the male nurse asked the female physician (who always wears a white coat) what dose of morphine to give.

 

[NYRN]

Not sure what you mean by urban legend...I see it happen all the time with the female attendings/residents I follow.

One of our female attendings had a male med student with her, and the patient insisted on talking to him instead of her. She said to him, if you want the medical student to take care of you rather than the attending, go right ahead!

I think older patients are more likely to confuse every female for a nurse and every male for a doctor. I have had patients think I am the doctor because I take time to explain things and ask questions to them when I am giving d/c instructions. Its pretty funny because the entire time they have been there for that day, I'm clearly wearing cartoon scrubs and doing things nurses do.

Anyway, patients will have in their minds certain biases and stereotypes, and I don't think there is really much we can do to change them.

 

[Arcan57]

As an administrator, I have to deal with patient complaints all the time. One of the complaints I see frequently is that the patient failed to see a physician. One that I received yesterday was "was there for 90 minutes and never saw a physician, only a nurse." Everytime this occurs, it's always a female physician who treated the patient.

Once I had a complaint against a doctor where the "doctor had to ask the nurse what dose of pain medicine to give." When I talked with the individuals involved, the male nurse asked the female physician (who always wears a white coat) what dose of morphine to give.

It seems like complaining to administration is a pretty good deal for patients. Chances are that there was either: a delay, a hurried caregiver who didn't answer every question, or lack of attention to dignity/comfort on almost every patient. And if I can get the hospital to eat the bill by being very vocal in my complaints, why wouldn't I?

 

[southerndoc]

It seems like complaining to administration is a pretty good deal for patients. Chances are that there was either: a delay, a hurried caregiver who didn't answer every question, or lack of attention to dignity/comfort on almost every patient. And if I can get the hospital to eat the bill by being very vocal in my complaints, why wouldn't I?

1. We get a lot of complaints because we do patient callbacks. If the patient advocate calls them back and they mention anything negative, they are asked if they want to file a formal complaint. What was only one complaint per month now is about 2-4 per week.

2. We do not waive bills based on complaints. We get a lot of complaints, but if the care rendered was appropriate, then they are still responsible for the bill.

3. Some of the things you mentioned are complained about, but the complaints are from everything like the bathroom was dirty (written on a Press-Ganey comment in the physician section) to being in the waiting room forever to the nurse not shaking the patient's hand when entering the room. I've even had complaints from patients because we charge $2 for parking.

 

[Arcan57]

Good to hear you guys don't let them off the hook for the bill. I've worked at a place that did, though I'm not sure how much of that was simply a pragmatic assessment that we were never going to collect on that patient anyway.

We've had historically low response rate (and low ratings) with PG, so I hear we are going to go to a 1:1 or 1:2 rate of surveys to patients. With a volume creeping up on 60k, I can't help but think the money spent on the survey could help fund some FTEs to deal with our chronic nursing and ancillary staff shortages.

Back to the original topic, we have computerized prescription/discharge instructions that logs you out frequently. So as a time saver I just print out a work note for anyone between the ages of 18-65 giving them the day off. Otherwise it takes me ~3 minutes to log back into the system, go through the list of discharged patients, and then print out a work excuse.

 

[Laryngophed]

Good to hear you guys don't let them off the hook for the bill. I've worked at a place that did, though I'm not sure how much of that was simply a pragmatic assessment that we were never going to collect on that patient anyway.

I'm willing to guess from my very limited experience that the patients who complain the most (or rather, file the most complaints) are often the ones who have no intention on paying the bill. I could be wrong and much too jaded, but from what I've seen those two often go hand in hand.

We've had historically low response rate (and low ratings) with PG, so I hear we are going to go to a 1:1 or 1:2 rate of surveys to patients. With a volume creeping up on 60k, I can't help but think the money spent on the survey could help fund some FTEs to deal with our chronic nursing and ancillary staff shortages.

Is PG so important that its worth sending out so many (I'm guessing the postage is waved if the hospital is NFP, thank goodness for them) but I wonder how much they pay some firm to analyze the data and then tell them what you and the rest of the medical staff can do to improve your scores. This may have been discussed elsewhere, but is there another metric that could be used to determine patient satisfaction or could be replaced by something that is a stronger indicator of the quality of care delivered? It seems, as a whole, that physicians revile PG but I don't know that I've come across anything that could be used to replace it.

 

[southerndoc]

I'm willing to guess from my very limited experience that the patients who complain the most (or rather, file the most complaints) are often the ones who have no intention on paying the bill. I could be wrong and much too jaded, but from what I've seen those two often go hand in hand.

If they don't pay the physician portion of the bill, it goes to collections. The hospital does something similar.