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Originally posted at:San Jose Mercury News
Area patients give medical groups low marks for careBy Julie Sevrens LyonsMercury News
California now rates medical groups like movies, and there are no blockbusters coming out of the Bay Area.
Not one medical group in the South Bay, East Bay or Peninsula received three stars -- the highest rating -- for its overall care in the first-ever ratings of medical groups issued by the state Office of the Patient Advocate. And two San Jose medical groups -- including San Jose/Good Samaritan Medical Group, which declared bankruptcy Monday -- received just one or no stars in the four categories the agency evaluated.
``A missing star can mean a missing surgeon or specialist or life-saving drug,'' said Daniel Zingale, director of the California Department of Managed Health Care.
The scores are based on information collected from a random sample of medical charts and responses to patient satisfaction surveys. The report card also collected patients' answers to mail and phone surveys, and records of services provided to patients.
The state's patient advocate, Martin Gallegos, said several themes emerged from the thousands of patient surveys. ``They're certainly happy with the doctor-patient communication,'' Gallegos said. But ``they're dissatisfied with their ability to access care.''
The five Bay Area medical groups that received low ratings for overall care are: Kaiser Permanente, Physicians Medical Group of San Jose, San Jose/Good Samaritan Medical Group, Santa Clara County IPA, and Alta Bates Medical Group in Alameda County. Some of these groups questioned the assessments, wondering if they weren't simplistic and somewhat inaccurate measurements.
To earn three stars, 80 percent of a medical group's patients had to have responded that their experience with the organization was ``always'' positive, Gallegos said. But Dr. Dean Didech, chairman of the board of San Jose/Good Samaritan Medical Group, said that means a majority of patients could report they received excellent or very good service, and the medical group still wouldn't earn a top rating.
But Didech said his group, which is not related to San Jose Medical Center or Good Samaritan Hospital, has gotten the message that some constructive changes can be made.
``We are determined to address the issues brought up in the ratings,'' Didech said. ``We feel the reorganization will improve our ability to address patient satisfaction issues.''
Leonid Grossman, a Cupertino software engineer, said he wishes the report card had been available years ago when he and his wife were shopping for medical groups.
They were unhappy with their first selection, San Jose/Good Samaritan. They had to rely on word-of-mouth, the only source of information available to them, before settling on a replacement, the Palo Alto Medical Foundation.
Officials for other groups say the ratings do not offer an accurate enough picture to help consumers like Grossman. They have issues with the methodology used to determine the ratings. Only about 45 percent of the Northern California patients asked to fill out satisfaction surveys actually did so.
It would stand to reason that those who took the time to fill out the questionnaires were those who had the worst experiences, skewing the results, said Linda Kenigsberg, CEO of the company that does administrative work for Physicians Medical Group of San Jose.
She also wondered if there was a language barrier for some of those answering the questions, given the diverse population in the Bay Area.
``When we conduct our own member satisfaction surveys,'' Kenigsberg said, ``our rates are higher.''
Alta Bates Medical Group, Kaiser Permanente and Santa Clara IPA did not return phone calls Tuesday.
But even groups earning above-average marks said they worried the new star system might be too superficial.
``We applaud the state's efforts to provide consumers with easy-to-understand information about health care quality,'' said Bill Gleeson, a spokesman for Sutter Health, which includes the Palo Alto Medical Foundation, Camino Medical Group and the Santa Cruz Medical Clinic. But ``it's difficult to reduce physician quality to a series of stars.''
--------------------------------------------------------------------------------Contact Julie Sevrens Lyons at (408) 920-5989 or jlyons@sjmercury.com. IF YOU'RE INTERESTED To view the California HMO Report Card, which includes Bay Area medical groups, visit the Web site www.opa.ca.gov/report_card/.