BY TIMOTHY KELLEY
She was quite tactful about it, all things considered. Having prepared our cover article on interpreting recent surveys about managed care, health care opinion specialist Karen Donelan, Sc.D., of the Harvard School of Public Health had just seen for the first time the "fax-back" survey we're asking Managed Care's readers to complete. "Could you just indicate somewhere that I wasn't responsible for preparing that?" she asked in commendably gentle tones.
Our survey, you see, breaks some of the rules Donelan explains in her sidebar article, "How To Do a Patient Satisfaction Survey." Question 5, for instance, asks readers' views on the statement that, "With all its imperfections, managed care is preferable to full reliance on medical savings accounts, which could encourage people to neglect their health, or a government-run system, which could create a huge new bureaucracy." Replete with assumptions, that question is a survey professional's nightmare. What if one doesn't agree that managed care is imperfect, or that relying on medical savings accounts could encourage neglect, or even (it's possible) that a government-run system would promote a new bureaucracy?
No matter. We don't claim ours is a scientific sample. We're only trying to tease out some of the ambiguities in a subject that is rife with them. Besides, everybody who's anybody does a survey these days. A credit-card company sponsors a poll that finds (you'll never guess) that patients would like to be able to pay doctors with plastic. Beyond our cover article, pages 10, 14, 15 and 42 of this issue mention surveys of various kindswe didn't plan it that way; that's just how ubiquitous opinion sampling has become. And it has bottom-line importance, too. As author Donelan points out, "Nowadays, physicians can find the tables turned on them. Once it was 'nine out of 10 doctors recommend'; today doctors may have their payments adjusted because one out of five patients didn't recommend them."