Gov. David A. Paterson’s measures aimed at improving patient safety and putting more teeth into physician discipline drew a mixed reaction yesterday from experts in health care and the legal profession.

During his news briefing yesterday, Paterson alluded to Dr. Harvey Finkelstein, the Long Island physician caught in controversy after more than 10,000 of his patients were notified they might have been exposed to hepatitis C, B and HIV.

Under the governor’s plan, physicians would not be able to practice while an investigation is under way. But that denies doctors the right of due process, said Dr. Melissa Palmer, a liver specialist in Plainview who evaluated dozens of Finkelstein’s patients for liver disease. “What happened to innocent until proven guilty?” she said yesterday.
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The findings aren’t new, but the sheer size of the study confirms what earlier research suggested.

Docs know they provide better care, faster, when they switch from paper to electronic medical records. They just don’t want to spend the money to heal more patients and kill fewer.

According to the New England Journal of Medicine, a poll of 2.758 doctors (with a 62 percent response rate) found that 17 percent were using some form of electronic record system.

But those who do use electronic record systems rave about them.

Among the small number of respondents who had fully functional electronic-records systems, most physicians reported the positive effects of the system on the quality of clinical decisions (82%), communication with other providers (92%) and patients (72%), prescription refills (95%), timely access to medical records (97%), and avoidance of medication errors (86%). Furthermore, 82 to 85% reported a positive effect on the delivery of long-term and preventive care that meets guidelines.

But those results probably underestimate the importance of electronic records because they don’t consider the benefit that patients will get when it’s easy for them to import all their own medical records into the personal health systems I wrote about earlier this week.
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Using “secret shoppers” to evaluate the way physicians manage relationships with patients could get in the way of providing needed care to actual patients, according to more than 12 doctors who testified before an American Medical Association panel, the Chicago Tribune reports.

On Sunday, AMA held its annual House of Delegates meeting in Chicago.

According to the Tribune, the use of secret shoppers “is becoming part of the consumer health information wave,” spurred by insurers, employers, consumers and others seeking to “ensure they are making informed choices about the kind of care and service they will receive.”

The group’s Council on Ethical and Judicial Affairs has asked that the 565-member House endorse the practice, noting that secret shopper evaluations would focus on professional relationships with patients, not on clinical practices (Japsen, Chicago Tribune, 6/16).

AMA information released on Friday stated that secret shoppers would be “individuals hired to act as patients to monitor service quality.” It added, “Secret shoppers have been used to evaluate most of the steps of the patient experience, from the ease of making an appointment over the phone, to the environment and flow of patients in the waiting room, to the encounter with the physician” (Snowbeck, “Medical Hotdish,” St. Paul Pioneer Press, 6/13).
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