How to be Annoying and Useless: an Introduction to JCAHO and Press-Ganey.

Apropos of prior posts, I feel the NEED to highlight for the readers what, in my mind, is the doucheiest of doucheitude in medicine: JCAHO and Press-Ganey.

We've talked about these gorillas (see cartoon) in the past, but for you new readers, let me briefly introduce you:

JCAHO, (which, for some reason, is pronounced "Jay-Co", not "Ja-Ca-Ho"), also alternatively called, unironically, by the self-designated Orwellian moniker, "The Joint Commission", is a clusterfuck group that "accredits" hospitals by coming in for about one day a year and making sure a bunch of forms have been properly filled out. They have introduced to the medical lexicon gems such as "sentinel events", "core measures" and, the "do not use" list of abbreviations. I went to their web site to see if I could dig up some bullshit and it took me, oh, seconds to navigate all the way to the home page to find the first of many sucktasticisms: They are announcing the Speak Up! program to help patients understand docs better. Each letter in "speak up", of course, stands for something (these turd farmers love the acronyms). And we get to the "U":

"Speak Up™ urges patients to:
Use a hospital, clinic, surgery center, or other type of health care organization that has undergone a rigorous on-site evaluation against established state-of-the-art quality and safety standards, such as that provided by The Joint Commission."

Hmmmm. Self-serving? Annoying? Chock-full-o-'business-speak'? Oh yeah. If they were just merely useless that would be OK, but these fucksticks have literally changed the practice of medicine by putting up continuous blockades to the delivery of care: fill out yet another form; 'accredit' yourself to wipe shit on a card and see if it changes color; answer to clipboard carrying nurses if you don't fulfil your core measures; and on and on...

Now, Press-Ganey. This is a survey company that asks patients to respond to questions about the quality of care they received. Really it is the PERCEIVED quality of care measured, often from non-paying "customers", who demand perfection and know very little about medicine (a hospital, by the way, is not a hotel. Sorry.) A 'mean nurse' can fuck your Press-Ganey scores relative to other hospitals. A doc who will say "no, I know better" to the annoying patient will drop you to the bottom of the list.

I learned about these a-holes when a rep from the company came to present their survey findings to the hospital. First, he introduced his company by mentioning that it was founded by "Doctors Press and Ganey". I looked up "doctors" Press and Ganey and they, in fact,are not real doctors but PhDs in statistics and cultural anthropology. Nice to be lied to right out of the box. Anyway, I shit you not when I say I was in awe of the audacity of the rep, standing in front of a group of doctors and making the following statement (one of many winners): "Patient privacy is important. On your survey patients said the privacy in the ER was lacking. Let me tell you how you can fix this for NOTHING! When you pull the curtain to separate the beds, say 'I'm doing this for your privacy', and your scores will, I guarantee, improve!" In other words: privacy is a problem; instead of ACTUALLY making the ER more private, PRETEND that it is more private and the PERCEPTION will improve. Fix perception, not the actual problem. Great recommendation, Jackoff. This is the essence of Press-Ganey.

This is but a brief introduction to the people who now dictate how medicine is practiced. Control has been handed to the paper pushers and taken away from the doers. I weep for our profession.