A persistent dearth of doctors in most of New York...

A persistent dearth of doctors in most of New York could slow the implementation of health care reform unless something is done to alleviate the shortage, a new analysis has concluded. Credit: Istock

The article "Urgent goal for LI hospitals" [News, Feb. 3] addresses the upcoming changes to reimbursements, in which hospitals will see their rates increased or decreased in part based on patient satisfaction surveys. While no one would argue that medical personnel should do their best to make the hospital experience as comfortable as reasonably possible, there are pitfalls to making this a greater priority.

Hospitals have limited resources. If health care workers are required to spend time in "inspirational" meetings, when they should be at the bedside or in training, we may get an improvement in the perceived quality of care but a reduction in the actual quality.

Also, a patient may request or even demand a treatment that is unlikely to lead to the best outcome and may even be harmful. The patient may insist on a CT scan for a mild headache, an antibiotic for a cold, or a narcotic pain medicine for a minor injury.

Do we really want to put physicians and nurses in a position where they might agree to such requests against their better judgment, to placate a demanding patient and prevent a potentially bad review? People who are dissatisfied are far more likely to fill out a survey. This gives dissatisfied patients a disproportionate influence over a facility's rating.

If the incentive is small and the efforts to improve patient satisfaction are modest, we may see some improvements in the perception of care with little detriment to the quality of actual medical care given. Only time will tell.

Dr. Michael Melgar, Great Neck