Health Front: Doc and Web Ratings, Skin Exam Videos

By DR. JERRY DeCAPUA, TRT Contributing Writer

Many Americans are choosing their doctor with the ratings supplied by online websites like Healthgrades.com and rateMDs.com. In a new survey of more than 2,100 Americans, researchers from the University of Michigan Medical School found that two-thirds of those surveyed knew f that the rating sites exist, and one quarter of those surveyed actually used the sites in 2013.

Apparently, people who visit the sites use the information to make important health care decisions. In the survey, 35 percent of the site users picked a doctor because of a good rating, while 37 percent avoided a doctor with a poor rating, investigators found. “We don’t really know how trustworthy the ratings on these sites are,” notes Dr. David Hanauer, the University of Michigan researcher. It appears the patients fill out a patient-satisfaction survey, much like any survey one would find for restaurants or hotels.

Healthgrades.com attempts to survey beyond happy/sad impressions. They include information on a doctor’s board certifications, types of procedures offered, and which insurance plans the office accepts. They include a list of a doctor’s hospital affiliations as well as government data on hospital performance. But while offering comprehensive information, it falls short on real objective assessment and fair ratings.

Frustrated and angry drug users and patients could have the indecency to retaliate against physicians that do not oblige them. Anyone, credible or not could fill out a rating survey. Employees at a hospital or clinic could rate a doctor. Disgruntled patients may under rate a doctor’s good performance while the dead would be lacking in their ability to vote.

There are multiple dimensions in an assessment of quality health care. The patient’s experience is one of the most important in this critique. However, relying on the positives and negatives listed on a web site may offer the same certitude as ketchup ratings. It could be only a matter of taste, an emotional reaction instead of a fair critique of a doctor’s effort, knowledge and standards.

• Giving older men an instructional video about skin awareness and self-examination (with glasses on) might lead to increased detection of skin cancer, reveals a new study. The recent issue of JAMA Dermatology notes that men who studied the video and then studied their skin had a much better chance at early detection of skin cancer.

“We acknowledge that routine use of a physician skin examination as a screening tool will place a burden on the health care system and could lead to the detection of skin cancers that are relatively slow-growing and may never cause death,” said Dr. Monica Janda, of Queensland University in Australia.

But evidence is increasing that clinical examination reduces the incidence of thick melanoma related death. In America melanoma death rates are rising. Any implementation of behavioral interventions, like an instructional video, to encourage skin awareness among men of 50 years is crucial.

• There’s drunk driving. There is buzz driving. There’s over medicated drivers. And now there is post-stroke driving. Many stroke survivors start driving again without any testing to ensure they can still drive safely, a new survey indicates.  Researchers from the University of South Carolina found that more than half of the 162 stroke survivors in their study returned to driving following their stroke, with 59 percent of those returning within one month.

Less than 6 percent of all stroke survivors received any formal driving evaluation, notes neurologists. Some of the problem is due to the nature of stroke itself. Stroke survivors are often “unaware that they have a problem walking or seeing.” Cerebration, coordination and reaction timing are impaired and “people don’t necessarily recognize they have deficits,” notes researchers.

Stroke is a leading cause of death in the U.S. where nearly 800,000 people suffer a stroke each year. This week at the International Stroke Conference in San Diego, it will be recommended that all stroke survivors obtain formal testing by a trained driving examiner. Just when you thought that the DMV couldn’t become any busier.

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Date
March 12th, 2014

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