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State survey finds Winona Clinic, others in state give strong care, but struggle with delays

2 hours ago  • 

While patients at Winona Clinic are generally satisfied with their health care providers, they are less pleased with how long it takes to get an appointment.

According to statewide data released last week by the Minnesota Department of Health and Minnesota Community Measurement, 80 percent of surveyed patients at Winona Clinic gave their health care providers a top rating of 9 or 10 on a 10-point scale.

However, just 39 percent of respondents said they got a top level of access to care — such as timely appointments, answers to questions, and short waiting room times. That’s well below the statewide average for satisfaction with access, at 60 percent, with numbers for individual clinics across many specialties and regions ranging from 30 to 90 percent.

Winona Health CEO Rachelle Schultz said in an interview Tuesday that the access problem isn’t news to Winona Health, which has been tracking patient satisfaction for years.

As far as the most recent set of data, Schultz said it reflects national trends the industry has been anticipating: an aging population with more health care needs, a shortage of primary care physicians and health care reform.

“There’s been this kind of impending knowing, that there’s going to be this huge demand on the health care system everywhere. At the same time, when we look at workforce issues, you have the opposite thing happening,” she said.

Fewer doctors are choosing primary care, and recruiting medical school graduates can be a three-year process, Schultz said, which is not fast enough to keep up with the demand.

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Area clinics score high on patient satisfaction survey

By Jessica Bies jbies@mankatofreepress.com | Posted 7 days ago

MANKATO — With only a few exceptions, area clinics scored high on a statewide survey about the quality of patients’ experiences during appointments and interactions with staff.

Most notably, Daniels Health Center in St. Peter, a branch of Mankato Clinic, scored among the top 15 clinics in the state for having courteous and helpful office staff.

The high ranking is not a happy accident but instead the result of a concentrated effort on part of the clinic, CEO Randy Farrow said.

“We have been putting a big focus on our staff, and customer service has been a big area of focus for us,” he said Wednesday. “We do a lot of staff training around that.”

Patient opinion unchanged

This is the second time the Minnesota Department of Health and MN Community Measurement has conducted the Patient of Experience of Care Survey. It is the nation’s largest statewide patient experience survey, and 2015’s responses show that consumer opinion hasn’t changed much since 2013.

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Ratings reveal Minnesota clinics with best communication, access

Nearly 80 percent awarded their doctors and clinics top marks in a 2014 survey.

By Star Tribune – August 26, 2015 — 10:56pm

Doctors might not be able to turn on the charm overnight, but new Minnesota patient survey data show it is entirely possible for them to become better at seeing and talking with patients.

The second release of patient satisfaction data by MN Community Measurement on Wednesday shows little change overall — 79 percent of patients gave top marks to their doctors in 2014, compared to 78 percent in 2012. But some clinics made substantial progress.

“It doesn’t have to be that somebody really competent should also be rude to you,” said Jim Chase, executive director of the nonprofit rating organization. “The [patient] experience still matters.”

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Local clinics score above average in patient experience

By Stephanie Dickrell, sdickrell@stcloudtimes.com 10:31 a.m. CDT August 26, 2015

Nearly 80 percent of Minnesota’s patients give their health care providers a top rating of nine or 10 on a 10-point scale, but only about 60 percent of patients said they experienced a top level of access to care.

The results of the 2015 Patient Experience of Care Survey were released Wednesday by the Minnesota Department of Health and MN Community Measurement.

Locally, CentraCare and a few other clinics were included in the survey, scoring average or above in all categories.

This is the second time that Minnesota has conducted the nation’s largest statewide patient experience survey.

Patient opinion hasn’t changed much since the first survey in 2013, according to officials.

The survey included 200,500 patients at 765 clinics in Minnesota and neighboring communities who had appointments between September 1 and November 30, 2014. This year’s survey indicates that patient opinion hasn’t changed much since the first survey in 2013.

Local results

Here are the local results. Categories include: getting care when needed, how well providers communicate, courteous and helpful office staff and providers with “most positive” rating.

  • CentraCare River Campus — Rheumatology in St. Cloud scored above average in all indicators.
  • CentraCare Health Sauk Center scored average on getting health care when needed and courteous and helpful office staff. It scored above average in providers with a “most positive” rating. Results on how well providers communicate were not available.
  • CentraCare Health — Monticello Medical Group scored average on getting care when needed and how well providers communicate. It scored above average on courteous and helpful office staff and a “most positive” rating.
  • CentraCare River Campus — Nephrology scored above average in all categories.
  • CentraCare Health Paynesville-Richmond scored above average in getting care when needed and the “most positive” category. It scored average in how well providers communicated and courteous and helpful office staff.
  • CentraCare Health Plaza — Dermatology scored scored average in getting care when needed and the “most positive” category. It scored above average in how well providers communicated and courteous and helpful office staff.
  • Lakewood Health System — Sartell Clinic scored average in getting care when needed and the “most positive” category. It scored above average in how well providers communicated and courteous and helpful office staff.
  • Williams Integracare Clinic scored average in getting care when needed and above average in the rest of the categories.

Other highlights

Though patients are generally having a good experience, the survey did find significant differences between clinics. Here are some highlights from the survey:

  • 79 percent of respondents gave their provider a top rating of nine or 10 on a 10-point scale – a statistically significant one point increase over the 2013 result. Individual clinic ratings ranged from 49 to 97 percent of providers receiving a top rating.
  • 83 percent of respondents described communication from their providers as top-level. Across individual clinics, the low score was 54 percent and the high score was 94 percent.
  • 81 percent of respondents gave the office staff at their clinics top marks for being respectful and helpful. However, a 40 percentage point difference can be seen between the highest and lowest scoring clinics.
  • Nineteen percent, or 121, more clinics participated in the survey than two years ago.
  • Clinics participating in the state’s Health Care Homes initiative included additional questions in the patient experience of care survey. For over half of all certified Health Care Homes, at least 60 percent of their patients reported a positive score in relation to shared decision making, and at least 50 percent of their patients reported a positive score in relation to attention to mental health.

Results are based on 200, 500 patient-completed surveys on patient experience of care – known as the Clinician and Group Surveys – Consumer Assessment of Healthcare Providers and Systems. Thirty-three percent of the patients surveyed responded, which is a similar response rate as 2013.

Minnesota conducts the nation’s largest statewide patient experience survey.

Follow Stephanie Dickrell on Twitter @SctimesSteph, call her at 255-8749 or find more stories at www.sctimes.com/sdickrell.

Survey measures

The survey measures patient experience in terms of whether patients were:

  • Getting care when needed.
  • Being listened to and receiving understandable information and instructions.
  • Experiencing courteous and helpful office staff.
  • Satisfied with their provider.

View the original article from the SCTimes

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Mayo’s Somali health project aims to build trust with community

By Nate Gotlieb
Free Press of Mankato
Posted: 06/20/2015 11:01:05 AM CDT | Updated: 2 days ago

When Fardousa Jama and her father, Hussein, surveyed 400 Somalis last year in Mankato, Minn., they found many misunderstood and mistrusted the American health care system.

Some weren’t taking their prescribed medicine, they found, and some with diabetes were testing their blood sugar too frequently. Others faced language barriers and didn’t know how to access prescription medication.

“There is a huge gap and mistrust that happens with doctors and Somalis,” Fardousa Jama said. “We just want to help bridge the gap.”

That desire led to the Somali Health Literacy Project through Mayo Clinic Health System, which kicked off this month at the St. Peter Community Center. The project consists of 18 classes during the next 18 months on health topics ranging from defining health to diabetes and depression.

Mayo doctors said they hope the project can improve trust between providers and the Somali community and decrease emergency-room and urgent-care visits.

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Area’s Health Care is Most Expensive

By Jeff Kiger, Rochester Post Bulletin
June 18, 2015

The cost of health care in southeastern Minnesota was higher than in any other region in the state or even neighboring states in 2013.

The nonprofit MN Community Measurement released a new analysis of its Total Cost of Care report this week. Total Cost of Care, which was first released in December 2014, looked at the costs of 1.5 million patients at 1,052 clinics in Minnesota and border cities. It tracked patients covered by the four top insurers – Blue Cross & Blue Shield of Minnesota, HealthPartners, Medica and PreferredOne.

This week’s analysis compared costs for those patients treated in six Minnesota regions, Wisconsin, North Dakota and South Dakota. It also broke the numbers down by adult patients versus pediatric ones as well as in-patient care to out-patient costs this time.

While the latest report did not reveal any new findings, it adds to the very new pool of health cost data using this new standard measurement.

“This is just another step in sharing information that we thought might be useful,” said MNCM President Jim Chase.

The average monthly cost of care per patient in Minnesota is $435. That monthly cost spiked to $535 in the southeastern area. That’s not surprising with Mayo Clinic, the most expensive provider at $826 a month per patient, based in Rochester. Olmsted Medical Center’s not far behind, as it’s ranked as seventh most expensive out of 115 medical groups.

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Somali Health Project Aims to Build Trust

By Nate Gotlieb, Mankato Free Press
June 3, 2015

Some weren’t taking their prescribed medicine, they found, and some with diabetes were testing their blood sugar too frequently. Others faced language barriers and didn’t know how to access prescription medication.

“There is a huge gap and mistrust that happens with doctors and Somalis,” Fardousa Jama said. “We just want to help bridge the gap.”

That desire led to the Somali Health Literacy Project through Mayo Clinic Health System, which kicks off Friday at the St. Peter Community Center. The project will consist of 18 classes during the next 18 months on health topics ranging from defining health to diabetes and depression.

Mayo doctors said they hope the project can improve trust between providers and the Somali community and decrease emergency-room and urgent-care visits.

“When people come into the doctor, we assume a certain understanding of health,” said Dr. Erin Westfall, who led the effort to coordinate the project. “Those assumptions aren’t accurate, and it leads to a lot of safety issues.”

Minnesota is home to about 45,000 Somalis and their children, according to state demographer Susan Brower. There isn’t an exact count of the greater Mankato Somali population, she said, though 327 kids in the Mankato Area school district reported speaking Somali at home in 2014-15, according to the state Department of Education.

Despite the relatively small numbers, Somalis have the poorest health-care outcome rates among all Minnesota minorities, according to a 2014 MN Community Measurement report. In colon cancer screening, for example, patients born in Somalia were screened at a rate of 22 percent compared to the 70 percent state average. Somalis also had the lowest health-care outcome rates in diabetes, vascular and asthma care.

The report doesn’t say why Somalis have such poor outcome rates, but Anne Snowden, who directed the report, said it sometimes can take foreign-born populations time to learn the U.S. health-care system.

Westfall said chronic diseases and mental illness are rare in Somalia. She noted that people without access to health care, such as those in refugee camps, aren’t used to talking about preventive efforts.

“For someone that comes from that culture, prevention efforts are looked at with suspicion because doctors may find something wrong when they feel fine,” she said in an email. “This is a difficult concept to grasp for everyone — Americans and Somali Americans alike.”

‘Risk is on you’

Jama, an interpreter at Mayo Clinic Health System, came with her family to Mankato in the late 1990s. She said her family was the first Somali family in Mankato.

Last year she and her father founded the Somali Community Barwaaqo Organization in an effort to help Somalis transition into the community. The organization has an office on Madison Avenue and offers no-cost citizenship classes, employment and housing assistance, and tutoring, among other services.

Jama said the medical system in America is better but a lot different than her home country. In Somalia people go the pharmacy to get their medicine, she said, whereas in America you need a prescription first.

“If you have the money, you can buy whatever you want,” she said. “The risk is on you.”

Abdikarim Abdulle can attest to that. He arrived in Mankato with his wife and five kids last month after spending 15 years as a refugee in South Africa. He said the hospitals in Somalia were dismantled once civil war broke out in the early 1990s.

“Once the health system gets dismantled, it goes away,” he said, with Jama interpreting. “It’s hard for the clinic to open up again.”

Interest in diversity

Westfall directs the osteopathic program for the University of Minnesota’s Mankato family medicine residency program. She secured a $5,000 grant from Enventis for the project.

Resident Dr. Vicki Zbikowski will be leading the classes. Zbikowski, who has a master’s degree in bioethics, said she is interested in cultural diversity and exploring how to best serve underrepresented health-care populations.

“It’s important to understand where this particular population is coming from in terms of what health means to them,” she said. “If we can’t understand where they’re coming from, then we’re unable to kind of meet them where they are at.”

The sessions will cover a range of topics, from defining what health is to diabetes, heart disease, immunization and more. The goal, Westfall said, is to affect at least 100 families.

The Barwaaqo organization is providing free rides to those in need. Call 507-625-2111 or visit somalicbo.org to learn more.

Read the original article in the Mankato Free Press.

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Medical Professionalism and the Future of Public Trust in Physicians

Viewpoint by Noam N. Levey, The Journal of the American Medical Association
May 12, 2015

The medical profession in the United States, by some measures, has much to be pleased about. Public confidence in the honesty and ethical standards of physicians has remained high for decades, even as other professions, including bankers, the clergy, and members of Congress, have endured a steady erosion in public trust. Even though physicians may not enjoy the exalted, even unquestioned, position they did in the middle of the last century, they remain among the most trusted professionals in the United States.

As major changes reverberate through the US health care system, however, the trust that patients have historically placed in clinicians is being challenged. A revolution in transparency in medicine is making an unprecedented amount of information available to the public, potentially undermining confidence in the profession. At the same time, the public is growing increasingly anxious about the broader health care system as increasing costs erode workers’ stagnating wages. Patients also are seeking to be more engaged in their own medical care, including how they confront the end of life, a subject that poses special challenges for the medical profession.

Together, these changes may transform expectations of physicians’ qualifications and affect how the public views organized medicine in general. That raises the stakes in the current debate over the medical profession’s systems of self-governance.

Few developments may be more transformative than the advent in recent years of new data and new federal disclosure requirements. Patients—as well as journalists, politicians and health care purchasers—can now obtain and analyze information about physicians’ billing practices, their ties to other entities in the health care industry, and the outcomes they achieve for patients in their care. This is subjecting the medical profession to a level of scrutiny that was once unimaginable.

For example, the 2014 release of Medicare physician payment data spawned multiple media reports identifying the nation’s top billers and prompted new questions about the kind of care physicians are providing. This has contributed to increased public concern about how much medical professionals and health care organizations of all kinds charge for the delivery of health care services. These data are also fueling demands that the famously opaque US health care system provide consumers with more meaningful information about how to select medical services and practitioners.

The work of investigative news organizations such as ProPublica with data on payments from the pharmaceutical and medical device industries to physicians has also focused attention on potential conflicts of interest in medicine. In the past several years, newspapers around the country have reported often unflattering stories about individual physicians in their communities.

Meanwhile, an increasing number of regional quality organizations, such as Minnesota Community Measurement and Maine Quality Counts, are collecting and posting outcome measures for local medical practices. Augmenting these data, new government and private sector payment systems such as the Medicare Shared Savings Program, although still imperfect, are publicly identifying and rewarding physicians and health care organizations that meet quality targets. These systems will increasingly allow patients to see which clinicians are lagging on key indicators.

How the public uses the new data and what precise effect the information will have remain unclear. To be sure, research suggests that even patients with chronic illnesses have limited awareness about publicly available physician quality information.

However, patients are learning more about their physicians at a time when their faith in the broader health care system and those who lead it is not high. In a recent nationwide poll of 1027 adults, just one-third of respondents expressed confidence in the US medical system, far behind other institutions, including the military, small business, and the police. Moreover, unlike residents of other industrialized nations, those in the United States are highly skeptical of the leaders of the US medical profession, a phenomenon that some researchers attribute to the perception that organized medicine has been more focused on protecting its own interests rather than working to advance broader public health goals.

Layered on top of this is a burgeoning public conversation about a disconnect between patients’ expectations for their medical care and what the health care system is configured to provide. Growing out of a decades-old consumer movement, this discussion in some sense is not new. However, the focus on some of the more complex health-related topics, such as death and dying, has raised new questions about how well the medical profession is prepared to meet patients’ desires and needs.

These may be difficult topics for individual physicians and for organized medicine to address, but the recent proliferation of articles and books on end-of-life care and dying well suggests that the public is eager to delve further into these subjects. Gawande’s moving new book about mortality, which, among other topics, explores medicine’s struggles to confront issues surrounding aging and death, has been on best-seller lists for weeks.

The medical profession has weathered other major shifts in the US health care system. Indeed, the revolution in managed care of the 1990s, which threatened to further undermine public trust in physicians, arguably had the opposite effect. Confidence in physicians, which had been slipping, stabilized as patients focused their dissatisfaction on insurers.

Today, patients may once again look to physicians as a trusted source and harbor amid the turmoil in the broader health care system, including narrowing insurance networks and rising cost-sharing requirements for consumers, as well as the ongoing political and legal battles over the Affordable Care Act. The medical profession could also emerge stronger as a result of many of the current challenges and ongoing changes in health care. Greater transparency, although threatening to some, improves performance, potentially boosting public confidence. More patient engagement should deepen the relationships between physicians and the people they care for, ultimately fortifying public trust in the medical profession.

Physicians ignore the forces shaping public expectations at their peril, however. While Americans may retain confidence in their own physicians, affording the profession some protection from threats to physicians’ credibility and authority, the shield may not be impenetrable. A national survey of 1508 adults about their views on medical care revealed some potentially troubling findings for physicians. Most survey respondents reported that physicians do not spend enough time with patients. Most respondents do not consider physician fees reasonable. Even fewer believe that physicians are trying to hold down the cost of medical care. Perhaps most relevant for the current debate over self-governance is that nearly 1 in 4 survey respondents disagreed with the statement “Doctors are usually up to date on the latest advances in medicine.”

Perhaps a new system for recertifying physicians will restore some patients’ trust, although the effect may be small. Arcane procedures by professional societies that few have heard of seem unlikely to fundamentally move public opinion. Most patients would rightfully assume that organized medicine at a bare minimum had adequate protocols for self-regulation.

More consequential may be the behavior of physicians and their willingness to adapt to the changes under way in the US health care system. Patients across the country are experiencing new models of care that are more coordinated, more transparent, more responsive, and more personal. The best of these systems not only deliver better results, they make patients happier, as anyone who has seen them can attest. If physicians are viewed as standing in the way of these models, they risk the trust the profession has worked so hard to earn.

Read the original viewpoint at The Journal of the American Medical Association.

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Providers: Data helps patients be good consumers

By Nate Gotlieb, Mankato Free Press
Saturday, April 18, 2015

Local medical leaders appear to support the publication of health data, noting how it creates a level of transparency for patients.

“It really creates an element of accessibility which historically health care hasn’t had to do,” said Dr. Steve Campbell, chief quality officer of Mayo Clinic Health System Southwest Minnesota Region.

The site MNHealthScores.org ranks medical providers statewide on a variety of measures, with all the data publicly available. The site includes data on clinics, medical groups and hospitals, not individual doctors.

Dr. Julie Gerndt, chief medical officer for the Mankato Clinic, cautioned consumers from using the site to compare individual clinics, noting they won’t be able to draw accurate conclusions because of the small sample size. Medical group data provide a more accurate picture of the Mankato Clinic, she said.

Campbell said Minnesota should be proud of developing a culture of health care improvement. He said the scores are a reasonable tool for consumers if they want to look at health care providers based on metrics.

The electronic world is relatively new for health care, he said, noting that health care has historically been more reactive than proactive. He also said health care is shifting from a volume-based system to a value-based system and that future insurance reimbursements are going to be based on quality measures.

“It’s a different paradigm and one that is not without challenges,” he said. “(But) it’s still about providing the best care you can every day.”

Dr. Dan Holmberg of New Ulm Medical Center said this information motivates providers to work harder and try to improve. Allina uses data to compare clinics internally, he said, while the HealthScores help the center compare to its regional peers.

He said patients will get a better sense of being a consumer in the health care market over time.

“We don’t want our quality to be a mystery,” he said. “We want people to see the things we’re doing.”

Read the original article in the Mankato Free Press.

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Minnesota is leading the movement to reduce overtreatment and make health care more affordable

Minnesota is leading the movement to reduce overtreatment and make health care more affordable

By Sanne Magnan and Jim Chase | 06:00 am

A recent MinnPost article by Susan Perry shared excerpts from an article by Shannon Brownlee from the Lown Institute. In “Over-treated: Why Too Much Medicine Is Making Us Sicker and Poorer,” Brownlee delivered three main points: 1) only a few “lone ranger” doctors are working against a powerful medical complex that keeps delivering treatments patients don’t need; 2) these doctors can’t “buck” this aspect of modern medicine because of factors such as pharmaceutical marketing, fear of lawsuits, misguided patients, and lack of knowledge about medical evidence; and 3) reducing medical overtreatment will require large-scale political mobilization.

We applaud Brownlee for shining a light on the fact that many of our nation’s health-care systems have for too long overdiagnosed and overtreated patients, contributing to inappropriate care and waste we cannot afford. We as a nation — both the health-care system and citizens — have the flawed belief that more care is always better care, and that more expensive care provides even better care.

However, we disagree with the conclusions that only lone rangers are working on this issue and are unable to change the system. Minnesota is leading the movement to reduce overtreatment and make care more affordable.

No lone-ranger effort

The Institute for Clinical Systems Improvement (ICSI), a nonprofit health-care-improvement organization, and MN Community Measurement (MNCM), a nonprofit health-care measurement organization that publicly reports cost, quality and patient experience results, have been working with medical groups, hospitals and nonprofit health plans in Minnesota to deliver high-quality, appropriate care for years. This is not a lone-ranger effort; ICSI is composed of more than 50 medical groups representing 8,000 doctors, and MNCM reports on more than 300 medical groups, 1,600 clinics and 140 hospitals.

Through collaborative efforts, medical groups, health plans, patients and other stakeholders are focused on achieving the triple aim of better care, better health and lower costs. Some recent examples include:

  • Medical groups and health plans collaborated to embed evidence-based criteria into electronic health record systems to ensure appropriate diagnostic imaging scans were ordered. This saved an estimated $234 million, prevented an estimated 100 cancers from unnecessary X-rays and improved patient experience.
  • The RARE (Reducing Avoidable Readmissions Effectively) Campaign, led by ICSI, the Minnesota Hospital Association and Stratis Health, engaged 86 hospitals and 104 community partners to prevent 7,975 avoidable hospital readmissions. This saved an estimated $110 million and allowed Minnesotans to spend an estimated 31,900 more nights sleeping in their beds rather than in hospitals.
  • MNCM recently released the nation’s first publicly reported, statewide Total Cost of Care results for medical groups. By gathering all costs for treating patients — professional, inpatient, outpatient, pharmacy, lab, radiology and more — into an average monthly patient cost, consumers can now for the first time compare costs of care across 115 Minnesota medical groups, representing 1,052 clinics. Medical groups are using the information to evaluate how to provide more high-quality, cost-effective care.
  • ICSI, the Minnesota Medical Association, and the Minnesota Health Action Group are raising awareness statewide of the national Choosing Wisely campaign, which seeks to foster meaningful conversations between doctors and patients on care that is appropriate.

We agree wholeheartedly with Brownlee’s call to reduce medical overtreatment. Current health-care costs are unsustainable, especially since the health-care system alone only contributes to 20 percent of the population’s health. If we are overspending on health care, we take money away from education, employment and the environment — other factors that contribute more to our population’s health than doctors and clinics.

We also agree a large-scale mobilization is needed to reduce medical overtreatment. But it doesn’t have to be solely political — the work locally proves it.

New products, systems and efforts

Sanne Magnan, Jim Chase

Sanne Magnan, Jim Chase

We all have to mobilize — the health-care industry, our communities, and we as individuals. Politically this is being recognized through federally funded initiatives to develop and test health-care payment and care delivery models that will improve performance, increase the quality of care and decrease costs. Minnesota nonprofit health plans are designing new insurance products and payment systems that reward value, not just volume. Mobilization is also being encouraged through grant-funded efforts. ICSI is leading the Robert Wood Johnson Foundation (RWJF) funded initiative “Going Beyond Clinical Walls” to help bring clinicians together with community leaders and resources to provide better care and lower costs; a MNCM-led, RWJF-funded effort is helping consumers better understand and access information on the quality of healthcare provided by local physicians.

A better health-care system can emerge from existing strategies. We’re doing it here through strong community and health-care partnerships, and the willingness of diverse stakeholders to tackle complex issues that no entity can solve alone. There is still considerable work to be done, but Minnesota is a leader.

Sanne Magnan, M.D., Ph.D., is the president and CEO of the Institute for Clinical Systems Improvement. Jim Chase, M.H.A., is the president of MN Community Measurement. Learn more at ICSI.org and MNCM.org.

Visit MinnPost to read the original Community Voices commentary>>

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Picking the best?

How physicians get named to those top-doctor lists

BY SUZY FRISCHMNMonthly, Minnesota Medicine MARCH 2015

Who doesn’t like a thumbs-up for their work every now and then? For Clare Kearns McCarthy, MD, getting named to a local list of top doctors provides welcome validation that other physicians value her skills as an orthopedic surgeon. McCarthy says the lists can be helpful to patients and other physicians. Patients see making the list like getting a Good Housekeeping Seal of Approval.

“Patients like to see that you’re on the list. It’s a conversation starting point, and they are satisfied knowing their doctor is recognized. They are seeing someone who others trust as well,” says
McCarthy, a hand and upperextremity surgeon for Twin Cities Orthopedics in Edina who has appeared on MPLS.St.Paul Magazine’s list seven times and Minnesota Monthly’s three times. She also believes being on the lists may be helpful for physicians who need to refer patients. “It gives them a level of confidence when someone is on the list.”

There are numerous benefits to being named to a best-doctors list, say those who get cited. Physicians whose names appear on them often get props from their patients and other medical professionals. It also shines a light on their abilities, says Pamela Gigi Chawla, MD, a pediatrician and pediatric hospitalist at Children’s Hospitals and Clinics of Minnesota and senior medical
director of primary care.

Chawla, who has been honored by MPLS.St.Paul Magazine and Minnesota Monthly more than a dozen times, says Children’s receives a surge of calls from potential patients who want to see their doctors after the annual lists come out. “I don’t think people really look at this and say that this is about me,” she says. “It’s more about highlighting my institution and all the people who make what I do even possible.”

Peter Sershon, MD, chief of surgery at United Hospital and a urologic surgeon with Metro Urology in St. Paul, graced the cover of MPLS.St.Paul Magazine’s Top Doctors issue in 2013. He sees another benefit to the lists: They raise awareness about health and medical services. MPLS. St.Paul Magazine included an article about the robotic surgery program Sershon runs at United in conjunction with its Top Doctors list. He believes such attention might make screening for prostate cancer top of mind. “If this leads to more men with aggressive prostate cancer being diagnosed
early because they read something about it and got checked—even if it’s one guy—then it’s worth it,” he says.

Behind the scenes

Minnesota Monthly started publishing its Best Doctors list about a decade ago, and MPLS.St.Paul Magazine has done Top Doctors lists for nearly 20 years. The issues in which those features appear happen to be some of the magazines’ best-sellers.

So how do doctors get named to these lists? MPLS.St.Paul Magazine outsourced its research a few years back to Key Professional Media, which publishes “Super Doctors” and “Super Dentists” lists in national magazines. To generate nominations each year, it sends paper ballots to 5,000 licensed metro-area physicians and registered nurses asking them for names of one or more doctors they or a loved one have seen or would go to for care. The firm also emails all area physicians asking for nominations. This year, MPLS.St.Paul Magazine received 1,386 nominations.

In addition, the company does its own research. Staff members tap health-related government websites, volunteer and humanitarian organizations, universities, hospitals, medical societies and other professional organizations to add names to the list of nominees, including those of doctors who might work in smaller clinics or highly specialized areas. “There are numerous resources we use,” says research director Becky Kittelson.

The research team then evaluates candidates based on years of experience, fellowships, leadership positions, hospital appointments, academic achievements and positions, professional activities, board certifications, publications and lectures, and other honors, awards and achievements. The top-scoring doctors are named to a blue ribbon panel. Those physicians are asked to provide feedback on the nominees as well as other potential candidates from their specialty. Then the number crunching begins, taking into account all the points each candidate receives during the process, Kittelson says. From this, they generate the final list, which typically includes between 5 and 8 percent of local doctors.

“The rigor of our process is pretty astonishing,” says Deb Hopp, publisher of MPLS.St.Paul Magazine. She notes that rankings of other professionals are often done by those who use their services. “Our Top Doctors list has always been rankings by expert peers.”

For the magazine, the work is worth it, as newsstand sales for the Top Doctors issue are 30 to 40 percent over that of other issues, says Hopp. “It’s huge,” she adds. “People rely on it, and I think
doctors are extremely proud to be on it. They’ve come to understand how carefully the research is done, and it’s repeated every year.” The magazine also gives clinics and health systems a plaque honoring the physicians named to the list and the opportunity to buy congratulatory ads in that issue.

Minnesota Monthly has a similar process. It obtains the names of all physicians with active licenses in the 11-county metro area, plus Olmsted County to capture Mayo Clinic. Previously, the magazine sent those physicians postcards requesting nominations, but this year it hired Michigan-based Professional Research Services to administer the process. Now that company emails a group of approximately 10,000 doctors asking them to nominate physicians in about 30 specialty and subspecialty categories, says Editor Rachel Hutton.

It’s only a popularity contest if that’s the way doctors are voting.
– Rachel Hutton

During a three-week period, those doctors can log onto a website and vote for up to three physicians per specialty. Hutton says the response rate varies from year to year, but they get a representative sampling. The research firm then determines the number of votes doctors need before they are named to the list. That threshold can vary slightly each year, depending on the number of responses.

Minnesota Monthly’s final 2013 list included 509 names. In 2014, the magazine added several specialties including addiction medicine and Alzheimer’s disease, which expanded the list to
about 700 doctors. “The threshold is set so the number of doctors named is large enough that it gives people a good selection,” Hutton says. “We want to give people a few options in each category, if possible, but we also don’t want to overwhelm them with five pages of cardiologists.”

She explains that they only include specialties that have enough practitioners so that there is a choice about who is named to the list. They also restrict both nominations and Best Doctor
designations to local physicians who are in good standing with the Minnesota Board of Medical Practice.

Second opinions

Although most doctors feel honored to be chosen, many wonder why some truly excellent physicians don’t make the lists. “Some argue that it’s a popularity contest,” Hutton says. “But it’s only a popularity contest if that’s the way doctors are voting,” she adds. “It’s all in the hands of the doctors. We ask them to vote for peers they think are most qualified and whose performance is excellent, and we rely on them to vote with integrity.”

Jim Chase, president of the nonprofit quality improvement organization MN Community Measurement, says that when it comes to choosing a physician or clinic, he hopes patients also consider data on clinical outcomes and patient satisfaction. “The public thinks the lists are a good thing to have, and they are valid for what they are,” he says. “But it’s only providers who respond, and it’s not every provider, and being named might have to do with who you know and not really the data.”

He notes that MN Community Measurement provides information on the quality of care at clinics and patient experience ratings on its Minnesota Health Scores website.

Tim Anderson, MD, a pediatrician with Southdale Pediatric Associates in Burnsville, agrees that magazine lists shouldn’t be the deciding factor when choosing a physician. Anderson, who takes care of babies and children with complex mental and physical conditions, says he thinks the reason he’s made MPLS.St.Paul Magazine’s Top Doctors list is because he works with so many hospital specialists and nurses, so he is known and his name comes to mind when they’re voting for pediatricians.

Anderson says finding a doctor you feel comfortable with and can communicate with is what really matters. “Feeling listened to and understood at the end of a visit is the most important thing.”

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