An important anniversary for the healthcare industry just took place. It has been four years since the Affordable Care Act (ACA), now widely referred to as Obamacare, was passed.
A lot has changed — and continues to change — in healthcare because of the ACA. The major impetus behind the law is ostensibly to reduce healthcare costs while improving quality. This is easy to say, but obviously very difficult to do.
This illusive formula has been driving the healthcare conversation for many years, well before the ACA, with a number of methods proposed and adopted to measure improvement. Many of these measures are now being used to push and incent quality under the ACA.
Because a number of these tools measure so-called “soft skills,” medical professionals often take them less seriously — until they face a lawsuit that includes a healthy dose of allegations involving the patient interaction.
Soft Skills Enter the Equation
The issue of how to measure quality is one of great debate. But the industry is certainly putting physicians under the proverbial microscope when it comes to cost and quality. Surveys, reports, even analysis of keystrokes on the computer, are supposedly designed to “quantify” the quality of care you provide. This is increasingly moving into the area of patient communication and patient interaction — measuring a patient’s quality perception of interactions with you — or the “soft skills” of medicine.
For example, the Consumer Assessment of Healthcare Providers and Systems (CAHPs) surveys are one tool public payers use to gauge quality. The AHRQ notes the surveys: “…ask consumers and patients to report on and evaluate their experiences with healthcare. These surveys cover topics that are important to consumers and focus on aspects of quality that consumers are best qualified to assess, such as the communication skills of providers and ease of access to healthcare services.”
The surveys ask very basic questions such as:
Did my doctor listen to me?
Did my doctor involve me?
Do I think my doctor understood my health experience?
Clearly, this survey is all about how patients perceive their interaction with you.
I’ve found from personal experience with physicians over 30-plus years that they are deeply committed to quality of care and cost effectiveness. No one needed to develop thousands of pages of guidelines and legislation to promote that aspiration. But, we now live in an era of quality measurement, and, much as I hate to point it out, plaintiff attorneys will look at all this survey data if a claim is filed, or even considered. The higher you rank on quality interactions, the stronger your defence of a claim can be. This is reinforced by research showing that miscommunication, not clinical error, is the highest contributor to malpractice litigation in more than 70 percent of cases.
What all this means to physicians today is that interpersonal skills, how you communicate and interact with patients, will become increasingly important to your quality assessment rankings, reimbursement (including profit sharing and risk pools), and even your risk profile.
What Can You Do?
There a few simple steps you can take to reduce your risk of these developments impacting you negatively:
• Recognize that the landscape is changing. While soft skills are hard to quantify and measure, they are a reality of today’s healthcare environment. Right or wrong, accurate or not, they will increasingly be used to measure doctors’ performance.
• Take advantage of programs or courses that focus on soft skills and how to improve them. There are some excellent new CME accredited resources built on extensive peer-reviewed data that are proving to be very effective.
• To an extent, “practice to the test.” By knowing and understanding the measures that are being collected from patients, you can be especially vigilant on those points in your practice style.
Start Where You Are
There’s a lot we still don’t know about the long-term liability implications for the ACA. But we can start now by focusing on what we do know is being measured and rated. And regardless of how the industry continues to evolve, physicians and patients will be better served when communication Improves.
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