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Wednesday, August 31, 2016

Patient surveys and the opioid epidemic

I spent a few hours back in June shadowing Dr. S. Michael Keller, the emergency room director at Marion General Hospital in Marion, Ind. The photos were for a story in The New York Times about patient satisfaction surveys and their effect on the opioid epidemic. Under the Affordable Care Act, hospitals’ Medicare reimbursements were tied to patient satisfaction surveys. The idea of this was to encourage quality care, but many health care professionals argue the surveys incentivized doctors to prescribe powerful and potentially addictive painkillers such as opioids to patients in order to score well on the surveys. Marion General bucked the trend by cutting opioid prescriptions, leading to a drastic drop in the patient satisfaction surveys.

S. Michael Keller

Dr. S. Michael Keller, director of Marion General Hospital’s emergency department and ambulance services, examines William Joseph, a patient from Van Buren, Ind., in the Emergency Room on Wednesday, June 15, 2016, in Marion, Ind. Marion General Hospital urged its doctors to limit opioid prescriptions resulting in lowered patient satisfaction scores, particularly in pain management. As part of the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) incentivizes quality care by rewarding hospitals that score well on patient satisfaction surveys. (James Brosher for The New York Times)

S. Michael Keller

Dr. S. Michael Keller, director of Marion General Hospital’s emergency department and ambulance services, speaks with Deseric Inman, a patient from Marion, Ind. experiencing eye discomfort, in the Emergency Room on Wednesday, June 15, 2016, in Marion, Ind. (James Brosher for The New York Times)

S. Michael Keller

Dr. S. Michael Keller, director of Marion General Hospital’s emergency department and ambulance services, examines Deseric Inman, a patient from Marion, Ind. experiencing eye discomfort, in the Emergency Room on Wednesday, June 15, 2016, in Marion, Ind. (James Brosher for The New York Times)

S. Michael Keller

Dr. S. Michael Keller, director of Marion General Hospital’s emergency department and ambulance services, speaks with a patient in the Emergency Room on Wednesday, June 15, 2016, in Marion, Ind. (James Brosher for The New York Times)

S. Michael Keller

Dr. Michael Keller, left, director of Marion General Hospital’s emergency department and ambulance services, and Ann Vermilion, the hospital’s administrative director, pose outside of the Emergency Room on Wednesday, June 15, 2016, in Marion, Ind. (James Brosher for The New York Times)

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