Local hospitals address patient surveys' connection with painkillers

National concern over surveys boosting opioids

Local hospitals address patient...

LA CROSSE, Wis. - After visiting the hospital, a patient may be asked to fill out a survey about the experience, and those scores can affect doctors' pay.

There is concern, however, that pain management ratings can put pressure on doctors to prescribe more painkillers.

Both Mayo Clinic and Gundersen Health Systems administer a national patient survey called HCAHPS, or the Hospital Consumer Assessment of Healthcare Providers and Systems survey. It is required for all hospitals that serve patients with Medicare coverage.

"It's an opportunity to see how we're performing in our patients' eyes,” Mayo's Chief Medical Officer at Mayo Dr. David Rushlow said.

As a doctor, providing quality care to your patients is vital.

Surveys like HCAHPS ask patients about their experience, including if they believe their provider adequately addressed their pain.

"When we're measuring satisfaction, or how well did the patient feel about the care they received, there's a lot of things they could expect that they won't get,” Rushlow said. “Narcotics would be one of those things."

Since high survey scores can be a financial incentive for physicians, including at Mayo and Gundersen, there is worry that doctors could prescribe more painkillers to please their patients and get a good review.

However, according to business intelligence specialist at Gundersen, Galen Papaconstantinou, their primary focus is using the survey information to make improvements, and he said doctors are trusted to make the right call.

"I have complete confidence that they are providing the best care for each patient to the level that is safe,” he said.

And as Mayo administrator Pauline Byom explained, starting this year, pain management questions will no longer be used as part of the Centers for Medicare and Medicaid Services pay for performance program.

"We still care about patients' perception of how we're treating and addressing pain goals, but we're not going to tie payment to that,” she said.

Byom thinks it's a step in the right direction.

"But I think there's a broader conversation to be had about how we effectively manage and treat pain through other means other than prescription pills,” she said.

Rushlow said that conversation can start by balancing patients' wants with their needs.

"It's our job to take those expectations and teach them what is the most important way to meet those needs. When we do that, we satisfy our patients,” he said. “We don’t need to give them exactly what they expect to get good grades on satisfaction scores.

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