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AOK doctor navigator: Patients can grade doctors on the Internet and choose a doctor after assigning ratings.
(11.09.2010) The AOK doctor navigator has existed since the beginning of 2010. Patients can search for doctors by entering their place of residence and make their own evaluations. The health insurance company hopes that this will provide more transparency and a better overview for patients. A total of 24 million people insured with the Allgemeine Ortskrankenkasse AOK are called. The central basis should be the patient's experience. The survey, which can be called up at "www.aok-arztnavi.de", was scientifically developed in a multi-stage process.
But how did the doctor navigator work?
Initially, the offer is limited to Hamburg, Berlin and Thuringia. If the pilot project gets off to a good start, all other federal states should also join. Until then, it is only possible for insured persons from the named federal states to grade their general practitioners and specialists. In the results portal, the doctors are initially displayed according to their distance from their place of residence. With one click you can then generate a list in the next step in which the best rated doctors are at the top. Because the more satisfied the patients were with their treating doctors, the better the impact on the so-called ranking. If many stated that medical care was generally inadequate, the doctor slipped further down. The project should go online at the beginning of next year with exact figures in percent - it is planned that from then on all federal states will be represented in Germany. Answering the questions takes an average of 10 minutes at the most and can be done quickly with a few clicks.
At the moment it is only withheld from those with AOK health insurance to make the doctor grades. It is planned that after the end of the evaluation phase at the beginning of 2012 at the latest, further funds will be able to participate in the project in order to put the portal on a broad basis. The Barmer GEK is already aiming to participate in the project. Together with the approximately 24 million AOK insured persons, the "doctor's navigation system" would in future offer more than 30 million health insured persons the opportunity to rate their doctors. In order to participate, it is necessary to register. Participation is free.
When the pilot project started almost a year ago, there was great outrage, especially among the medical associations. The doctors did not want to be pilloried by the patient. Above all, it was criticized that the assessments are made subjectively. But the deputy chairman of the AOK Federal Association, Jürgen Graalmann, appeased, "The patients will not have the opportunity to make abusive criticism." One has moved away from the concept of offering free input fields. Although these are very popular with the insured, they would not bring any real gain in knowledge, as it was said. Instead, the offer should be more structured.
In the future there should be a total of 33 questions that can be answered. For example, a question might be, "Did the doctor listen well with him," or did the doctor organize his practice well. After answering the numerous questions, the crucial question then comes, "Would you recommend this doctor to your best friend?". Citizens who participate do not have to answer all questions. Because not everything can always be precisely assessed or has not been used. But at least 10 answered questions are necessary for doctor grading to be activated. The assessed doctor also has the option to object to the assessment. The rating will not be activated, but all patients can see that the rating was not published due to an objection. But that doesn't go down so well either.
Doctor navigator necessary.
According to a study by the Scientific Institute of the AOK (WIdO), one in four stated that the doctor had not fully addressed the cause of the health problem. In addition, around 22 percent of the total of 3,000 respondents did not feel they were fully and adequately informed by the doctor. One in ten respondents believes that some treatments and medical examinations were unnecessary. Overall, however, around 82 percent of those surveyed were satisfied or even very satisfied with the doctor's treatment.
The initial, sometimes very harsh criticism has now given way to tolerance or even approval from the ranks of the medical profession. The head of the National Association of Statutory Health Insurance Physicians, Carl-Heinz Müller, praised "The questionnaire was developed according to high scientific standards." However, it is necessary to expand the questions up to 60 ratings. According to the chairman of the doctors' association, the evaluations would then be meaningful and help doctors with quality assurance. But doubts also arise. Ulrike Dzengel from the Independent Patient Advisory Service said: "There can be no reliable statements here". Because such evaluations are very subjective and therefore too imprecise. In addition, many patients - especially in rural areas - are dependent on doctors' care. There is not much choice.
According to a survey by the "Stiftung Gesundheit", just 52 percent of doctors have introduced a quality system in their practice. In many medical practices, many work processes are therefore not clearly regulated. There is often a lack of the structure of responsibilities. Numerous processes, of which the patients mostly do not notice, are hardly regulated. For example, who cleans the examination equipment, sorts the files of the patients or sorts the findings from the laboratory. Even if these processes tend to run in the background, it does not remain hidden from the patient. Because such ambiguities are also noticeable in the waiting times and appointments. But with the doctor navigator, patients can evaluate precisely such quality deficiencies and help doctors to better structure their practice. A look from the outside can often be helpful.
Assessment by psychotherapists and dentists will also be possible in the future.
Once the doctor navigator starts nationwide, other specialties are to be added. In the future, insured persons should also have the opportunity to evaluate dentists and therapists. There seems to be a special need here. Because in the two professions mentioned, things like empathy and listening are particularly important. Currently only AOK insured persons from Berlin, Hamburg and Thuringia aged 15 and over can participate in the pilot phase. (sb)
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