Katarina Kesty, BSc, Steven R. Feldman, MD, PhD, Phillip M. Williford, MD
A key component of the Patient Protection and Affordable Care Act (PPACA), health insurance exchanges, opened October 1. With the further implementation of this law, patients, physicians and other stakeholders are still trying to understand how it will affect Americans’ healthcare experiences. To understand how the new healthcare law relates to patients’ concerns for quality, we compared word clouds of the 50 most frequently used words in the 906 pages of the PPACA to those in 234,000 online patient satisfaction questionnaires.*
The main focus of the patient comments is the direct interaction with the doctor and the office staff (Figure 1A). Contrastingly, the overarching themes of the PPACA’s word cloud are government/legal jargon (ie, subsection, secretary, paragraph) and the healthcare system in general (Figure 1B).
Figure 1. The 50 most common words used in (A) patients comments about the quality of their healthcare visit on the www.DrScore.com doctor rating/patient satisfaction website, and (B) The Patient Protection and Affordable Care Act. These word clouds demonstrate that the prism of focus is different for patients and policy makers.
Differing Viewpoints
This disparity may in part stem from the difference between viewpoints developed as a patient and those born out of participating in an analytical, regulatory bureaucracy. The patient experience is one that engenders for many people the sense of need, fear, pain and uncertainty. These powerful emotions create lasting shadows in medical patients’ minds and are often alleviated by their physician’s care. The doctor-patient relationship theme makes up the majority of the word cloud, indicating the importance of the direct contact of the physician and the associated support staff.
Conversely, a bureaucratic entity lacks the patient perspective. This is clearly demonstrated by their inadequate patient focus in an act that ultimately affects said patient. The focus of the word cloud from the PPACA is regulation, oversight and the law. This analysis raises concerns as to whether the PPACA will be perceived as adequately addressing patient concerns and common issues with the healthcare system. More specifically, the PPACA may ultimately affect the doctor-patient relationship, but the direct and indirect effects will be unpredictable and perhaps even unintended. Are the architects of change addressing the foundational problems that patients are concerned with or simply restructuring the system with hopes, but little evidence, of a better patient outcome?
Both of these texts, the PPACA and patient comments, are focused on the quality of healthcare in the United States. The PPACA is a system-wide approach to quality, cost and access of care, whereas patients’ views on healthcare clearly take a more narrow perspective. The patient comments word cloud demonstrates that patients’ idea of quality healthcare stems from their personal health and outcome, as well as the positive and negative qualities they perceive about their healthcare providers and other players directly involved in their care (nurses, office staff, etc.).
The PPACA is a top-down reorganization of the system that aims to improve the experiences that Americans have as a patient and to provide an opportunity to access healthcare for those previously uninsured. By allowing a bureaucracy to dictate the terms of our healthcare system’s restructuring, which focuses on the system in general, the needs of patients, as they perceive them, could be overlooked. As the PPACA is further implemented, we are moving from patient-centered to system-centered healthcare.
These word clouds demonstrate that the prism of focus is different for patients and policy makers. Ultimately, patients will have to bear the results of a healthcare system that is constructed from a perspective very different from their concerns. With this qualitative analysis in mind, is the PPACA a viable solution to American’s healthcare system?
Ms. Kesty is with the Center for Dermatology Research, Department of Dermatology, at Wake Forest School of Medicine; Winston-Salem, NC..
Dr. Feldman is with the Center for Dermatology, Research and the Departments of Dermatology, Pathology and Public Health Sciences at Wake Forest University School of Medicine in Winston-Salem, NC.
Dr. Williford, is with the Center for Dermatology Research, Department of Dermatology, at Wake Forest School of Medicine; Winston-Salem, NC.
*Comment data was obtained from a validated online patient satisfaction survey (www.DrScore.com). The website quantifies patients’ rankings and comments and uses this data to provide feedback to patients and healthcare providers with the goal of improving medical care. Data from this survey has been used previously to characterize qualities that influence patient satisfaction. Data for the PPACA was obtained from https://www.gpo.gov/fdsys/pkg/BILLS-111hr3590enr/html/BILLS-111hr3590enr.htm.
CALL FOR Voices Guest Commentary Submissions
If you have an guest commentary (750 to 1,400 words) you would like to submit to the Voices section, send the electronic file and a headshot photo of yourself to lsamalonis@hmpcommunications.com
If you have questions, call 610-560-0500 x243.
Katarina Kesty, BSc, Steven R. Feldman, MD, PhD, Phillip M. Williford, MD
A key component of the Patient Protection and Affordable Care Act (PPACA), health insurance exchanges, opened October 1. With the further implementation of this law, patients, physicians and other stakeholders are still trying to understand how it will affect Americans’ healthcare experiences. To understand how the new healthcare law relates to patients’ concerns for quality, we compared word clouds of the 50 most frequently used words in the 906 pages of the PPACA to those in 234,000 online patient satisfaction questionnaires.*
The main focus of the patient comments is the direct interaction with the doctor and the office staff (Figure 1A). Contrastingly, the overarching themes of the PPACA’s word cloud are government/legal jargon (ie, subsection, secretary, paragraph) and the healthcare system in general (Figure 1B).
Figure 1. The 50 most common words used in (A) patients comments about the quality of their healthcare visit on the www.DrScore.com doctor rating/patient satisfaction website, and (B) The Patient Protection and Affordable Care Act. These word clouds demonstrate that the prism of focus is different for patients and policy makers.
Differing Viewpoints
This disparity may in part stem from the difference between viewpoints developed as a patient and those born out of participating in an analytical, regulatory bureaucracy. The patient experience is one that engenders for many people the sense of need, fear, pain and uncertainty. These powerful emotions create lasting shadows in medical patients’ minds and are often alleviated by their physician’s care. The doctor-patient relationship theme makes up the majority of the word cloud, indicating the importance of the direct contact of the physician and the associated support staff.
Conversely, a bureaucratic entity lacks the patient perspective. This is clearly demonstrated by their inadequate patient focus in an act that ultimately affects said patient. The focus of the word cloud from the PPACA is regulation, oversight and the law. This analysis raises concerns as to whether the PPACA will be perceived as adequately addressing patient concerns and common issues with the healthcare system. More specifically, the PPACA may ultimately affect the doctor-patient relationship, but the direct and indirect effects will be unpredictable and perhaps even unintended. Are the architects of change addressing the foundational problems that patients are concerned with or simply restructuring the system with hopes, but little evidence, of a better patient outcome?
Both of these texts, the PPACA and patient comments, are focused on the quality of healthcare in the United States. The PPACA is a system-wide approach to quality, cost and access of care, whereas patients’ views on healthcare clearly take a more narrow perspective. The patient comments word cloud demonstrates that patients’ idea of quality healthcare stems from their personal health and outcome, as well as the positive and negative qualities they perceive about their healthcare providers and other players directly involved in their care (nurses, office staff, etc.).
The PPACA is a top-down reorganization of the system that aims to improve the experiences that Americans have as a patient and to provide an opportunity to access healthcare for those previously uninsured. By allowing a bureaucracy to dictate the terms of our healthcare system’s restructuring, which focuses on the system in general, the needs of patients, as they perceive them, could be overlooked. As the PPACA is further implemented, we are moving from patient-centered to system-centered healthcare.
These word clouds demonstrate that the prism of focus is different for patients and policy makers. Ultimately, patients will have to bear the results of a healthcare system that is constructed from a perspective very different from their concerns. With this qualitative analysis in mind, is the PPACA a viable solution to American’s healthcare system?
Ms. Kesty is with the Center for Dermatology Research, Department of Dermatology, at Wake Forest School of Medicine; Winston-Salem, NC..
Dr. Feldman is with the Center for Dermatology, Research and the Departments of Dermatology, Pathology and Public Health Sciences at Wake Forest University School of Medicine in Winston-Salem, NC.
Dr. Williford, is with the Center for Dermatology Research, Department of Dermatology, at Wake Forest School of Medicine; Winston-Salem, NC.
*Comment data was obtained from a validated online patient satisfaction survey (www.DrScore.com). The website quantifies patients’ rankings and comments and uses this data to provide feedback to patients and healthcare providers with the goal of improving medical care. Data from this survey has been used previously to characterize qualities that influence patient satisfaction. Data for the PPACA was obtained from https://www.gpo.gov/fdsys/pkg/BILLS-111hr3590enr/html/BILLS-111hr3590enr.htm.
CALL FOR Voices Guest Commentary Submissions
If you have an guest commentary (750 to 1,400 words) you would like to submit to the Voices section, send the electronic file and a headshot photo of yourself to lsamalonis@hmpcommunications.com
If you have questions, call 610-560-0500 x243.
Katarina Kesty, BSc, Steven R. Feldman, MD, PhD, Phillip M. Williford, MD
A key component of the Patient Protection and Affordable Care Act (PPACA), health insurance exchanges, opened October 1. With the further implementation of this law, patients, physicians and other stakeholders are still trying to understand how it will affect Americans’ healthcare experiences. To understand how the new healthcare law relates to patients’ concerns for quality, we compared word clouds of the 50 most frequently used words in the 906 pages of the PPACA to those in 234,000 online patient satisfaction questionnaires.*
The main focus of the patient comments is the direct interaction with the doctor and the office staff (Figure 1A). Contrastingly, the overarching themes of the PPACA’s word cloud are government/legal jargon (ie, subsection, secretary, paragraph) and the healthcare system in general (Figure 1B).
Figure 1. The 50 most common words used in (A) patients comments about the quality of their healthcare visit on the www.DrScore.com doctor rating/patient satisfaction website, and (B) The Patient Protection and Affordable Care Act. These word clouds demonstrate that the prism of focus is different for patients and policy makers.
Differing Viewpoints
This disparity may in part stem from the difference between viewpoints developed as a patient and those born out of participating in an analytical, regulatory bureaucracy. The patient experience is one that engenders for many people the sense of need, fear, pain and uncertainty. These powerful emotions create lasting shadows in medical patients’ minds and are often alleviated by their physician’s care. The doctor-patient relationship theme makes up the majority of the word cloud, indicating the importance of the direct contact of the physician and the associated support staff.
Conversely, a bureaucratic entity lacks the patient perspective. This is clearly demonstrated by their inadequate patient focus in an act that ultimately affects said patient. The focus of the word cloud from the PPACA is regulation, oversight and the law. This analysis raises concerns as to whether the PPACA will be perceived as adequately addressing patient concerns and common issues with the healthcare system. More specifically, the PPACA may ultimately affect the doctor-patient relationship, but the direct and indirect effects will be unpredictable and perhaps even unintended. Are the architects of change addressing the foundational problems that patients are concerned with or simply restructuring the system with hopes, but little evidence, of a better patient outcome?
Both of these texts, the PPACA and patient comments, are focused on the quality of healthcare in the United States. The PPACA is a system-wide approach to quality, cost and access of care, whereas patients’ views on healthcare clearly take a more narrow perspective. The patient comments word cloud demonstrates that patients’ idea of quality healthcare stems from their personal health and outcome, as well as the positive and negative qualities they perceive about their healthcare providers and other players directly involved in their care (nurses, office staff, etc.).
The PPACA is a top-down reorganization of the system that aims to improve the experiences that Americans have as a patient and to provide an opportunity to access healthcare for those previously uninsured. By allowing a bureaucracy to dictate the terms of our healthcare system’s restructuring, which focuses on the system in general, the needs of patients, as they perceive them, could be overlooked. As the PPACA is further implemented, we are moving from patient-centered to system-centered healthcare.
These word clouds demonstrate that the prism of focus is different for patients and policy makers. Ultimately, patients will have to bear the results of a healthcare system that is constructed from a perspective very different from their concerns. With this qualitative analysis in mind, is the PPACA a viable solution to American’s healthcare system?
Ms. Kesty is with the Center for Dermatology Research, Department of Dermatology, at Wake Forest School of Medicine; Winston-Salem, NC..
Dr. Feldman is with the Center for Dermatology, Research and the Departments of Dermatology, Pathology and Public Health Sciences at Wake Forest University School of Medicine in Winston-Salem, NC.
Dr. Williford, is with the Center for Dermatology Research, Department of Dermatology, at Wake Forest School of Medicine; Winston-Salem, NC.
*Comment data was obtained from a validated online patient satisfaction survey (www.DrScore.com). The website quantifies patients’ rankings and comments and uses this data to provide feedback to patients and healthcare providers with the goal of improving medical care. Data from this survey has been used previously to characterize qualities that influence patient satisfaction. Data for the PPACA was obtained from https://www.gpo.gov/fdsys/pkg/BILLS-111hr3590enr/html/BILLS-111hr3590enr.htm.
CALL FOR Voices Guest Commentary Submissions
If you have an guest commentary (750 to 1,400 words) you would like to submit to the Voices section, send the electronic file and a headshot photo of yourself to lsamalonis@hmpcommunications.com
If you have questions, call 610-560-0500 x243.
