{"id":17933,"date":"2019-05-01T17:45:17","date_gmt":"2019-05-01T22:45:17","guid":{"rendered":"https:\/\/feminem.org\/?p=17933"},"modified":"2019-05-01T17:52:14","modified_gmt":"2019-05-01T22:52:14","slug":"patient-survey-satisfaction-scores-are-biased-against-protected-groups","status":"publish","type":"post","link":"https:\/\/feminem.org\/2019\/05\/01\/patient-survey-satisfaction-scores-are-biased-against-protected-groups\/","title":{"rendered":"Patient Survey Satisfaction Scores Are Biased Against Protected Groups"},"content":{"rendered":"\n
We know implicitly that patient satisfaction survey scores are biased against women, doctors of color, and physicians who are foreign-born (or with names that make you think they are.<\/a>) Every single one of us has seen the bias play out in real life \u2014 either as a witness to a colleague who has been the recipient of frank (or subtle) bias or as the recipient ourselves. We are ethically obligated to treat all, regardless of how poorly they treat us. <\/p>\n\n\n\n It\u2019s not a secret. We discuss how to handle explicit patient racism. We discuss what tactics we can take (e.g. wearing the white coat<\/a>, wearing fake glasses and a bun<\/a>, special name tags, acting differently<\/a> and attempting to change our \u201cresting *#&!$ face\u201d<\/a> among others) so that we can overcome this handicap. We are working diligently to improve our own organizations to mitigate against implicit bias and correct systems that perpetuate bias. Yet, we cannot control the public and we don\u2019t have time (or the ability) to change public biases. Patient satisfaction scores are often measured and reported as percentiles and so very small differences in scores, lead to a huge variation in force-ranked percentiles. <\/p>\n\n\n\n A small body of healthcare-specific research is demonstrating and quantifying the bias in surveys:<\/p>\n\n\n\n Isn\u2019t it absurd that we continue to be judged by measures we know to be unfair due to the implicit bias and explicit racism\/genderism of the public whom we cannot control?<\/strong><\/p>\n\n\n\n It is illegal to discriminate against protected classes according to federal law. <\/p>\n\n\n\n Furthermore, the US Supreme Court ruled in Griggs v. Duke Power Co.<\/strong>, 401 U.S. 424 (1971)<\/a> that employment practices that do not directly discriminate against a protected category may still be illegal if they produce a disparate impact on members of a protected group, even if unintentional.<\/strong><\/p>\n\n\n\n However, many physician employers currently compensate (at least a portion) and promote based on these scores<\/a>. Lower scoring physicians are required to do extra unpaid work to improve their \u201cdeficiency\u201d. Physicians have lost their jobs based on these scores.<\/p>\n\n\n\n This is biased. This is wrong. This is illegal.<\/strong><\/p>\n\n\n\n We can demand that individual physician satisfaction scores should not be considered in performance evaluation. They should not be used for compensation, promotion or termination. <\/p>\n\n\n\n How do we effect this change? We could advocate that the patient satisfaction companies stop releasing data reports for individual physicians. This might work. <\/p>\n\n\n\n Or we could work with the lawyers and sue to make this illegal. This would require physicians to work together to gather evidence to make the case. In order to interest a lawyer in this lawsuit, we would need to lay some groundwork to demonstrate duty, breach and damages. We need to:<\/p>\n\n\n\n If the courts rule it illegal to use these scores for pay or promotion, it is likely that the reports will no longer be used. It would also be helpful to find an alternative, less biased way to collect patient feedback as we all value learning from patients on how we can do better. The NHS in the United Kingdom has implemented a different system to accomplish this<\/a> that may be less susceptible to bias yet still enable physicians to learn and improve based on meaningful patient feedback.<\/p>\n\n\n\n We need physicians advocating and working together as a coalition. It is possible. <\/strong><\/p>\n\n\n\n Things you can do NOW to help advance this campaign:<\/p>\n\n\n\n This piece was written in a collaborative effort by Dr. Amy Cho, MD MBA (Emergency Medicine), Dr. Christina Dewey, MD (Pediatrics), Dr. Dana Corriel, MD (Internal Medicine), Dr. Torie Shatzmiller Sepah, MD (Psychiatry), and Dr. Natasha Sriraman, MD MPH (General Pediatrics and Breastfeeding Medicine), with contributions by other physicians who have chosen to remain anonymous. <\/em><\/p>\n","protected":false},"excerpt":{"rendered":" We know implicitly that patient satisfaction survey scores are biased against women, doctors of color, and physicians who are foreign-born (or with names that make you think they are.) Every single one of us has seen the bias play out…<\/p>\n","protected":false},"author":210,"featured_media":8552,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_mi_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":"","_jetpack_memberships_contains_paid_content":false,"jetpack_publicize_message":"Patient Survey Satisfaction Scores Are Biased Against Protected Groups and we should be doing better. @amychomd\n@drcorriel","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[1],"tags":[877],"coauthors":[321,872,873,874,875],"jetpack_publicize_connections":[],"acf":[],"yoast_head":"\nIt Is Illegal to Discriminate Against Protected Classes\u2014Even If It Is Unintentional<\/strong><\/h1>\n\n\n\n
What We Can Do?<\/strong><\/h1>\n\n\n\n
Let\u2019s Work Together to Get This Done<\/strong><\/h1>\n\n\n\n