Do you remember when doxycycline used to be 5 cents a pill? Not anymore! Doxycycline has been relatively expensive for a few months now.
Do you remember when drug reps incessantly touted Rocephin as the antibiotic “Wonder Drug” that would kill any bacteria and also clean your kitchen? It was ridiculously expensive but sold very well! Now it is not so expensive—and nobody is promoting it.
How about Levaquiin and Zithromycin? Those are really expensive drugs–right? Wrong!
I think everybody would agree that in the wide world of medicine outside of jails and prisons, patient satisfaction is critically important. Partly this is because patients are not just patients, they are also business clients. If they are not happy, they will go to some other doctor and some other hospital. Many studies have shown that patient satisfaction scores have a strong correlation to revenue and market share. That is why hospitals routinely track patient satisfaction scores. Studies have also shown that roughly 80% of patient complaints are generated by less than 10% of practioners. These complaint-prone physicians, PAs and NPs are often “shown the door” by hospitals and practice groups. Their negative impact on revenue is just too great to ignore, even if they otherwise practice good medicine.
But, as I have often heard, correctional medicine is different. Our patients are a captive group (literally!). They cannot go to a different practitioner if they are unhappy. We do not have to please our patients to stay in business. Our “market share” does not rely on patient satisfaction. Plus, because of safety and security issues, we have to say “No” to patient requests more than outside physicians; and, of course, inmate patients are not going to be happy about that. So who cares if inmate patients are unsatisfied?
I ran across a quite good article the other day entitled A Powerful Tool in the Doctor’s Toolkit written by Dr. Danielle Ofri. It was about how the placebo effect is underappreciated in medicine. Far from being an esoteric “Gee-Whiz!” phenomenon, the placebo effect and its counterpart, the nocebo effect, are things we can use to our advantage in almost every clinical encounter.Continue reading →