The following guest blog post was submitted by Trudy Lieberman, veteran health care journalist, resident of New York City, and sometimes-TV-watcher.
For the last several months Daniel Jacobs, a boxer by trade, has shown up on my TV screen extolling the virtues of New York-Presbyterian, one of New York’s biggest and best known hospitals. Jacobs earnestly tells his story, letting TV viewers know that “everyone had high hopes” for his career until one dark night in 2011 when it went “completely” downhill. Jacobs woke up totally paralyzed, and according to the hospital’s website, “doctors knew immediately where he had to go: New York-Presbyterian” where Jacobs told us his doctor “aced it.” A massive tumor had wrapped around his spine. The grateful boxer said, “They resurrected me. They resurrected my career. They gave me a second chance at life.” On August 9, 2014, Jacobs announces, he became the WBA middleweight champion of the world.
Other commercials have recounted more amazing stories like that of young Heather McNamara who can barely pronounce the world “Presbyterian.” A cancerous tumor had entangled her vital organs and blood vessels, and the seven-year-old was told she wouldn’t live to see another Christmas; that is, until New York-Presbyterian stepped in. “They just said go to Philadelphia. Philadelphia didn’t want to touch me. They said to go to Florida. Florida didn’t want to touch me. They just told us to go to different places,” she said recounting her family’s struggles to find a facility to perform the tricky surgery. Heather explains that Dr. Kato “took all my organs out and put the ones that I needed back in,” and I was “so happy to be better and cancer free.” There are others like Jessa Scott who got a double lung transplant thanks to seven medical teams and Nicole Marquez, an aspiring dancer who fell six stories from a rooftop in her apartment building. New York-Presbyterian fixed her broken neck, pelvis, and back. “They didn’t invest in a patient,” she says. “They invested in me.”
Three years ago Advertising Age reported that under new CEO Dr. Steven Corwin, New York-Presbyterian’s philosophy had changed and was now centered around “‘putting patients first.’” The hospital “wants to emphasize that it is prepared to go ‘above and beyond the call of duty’ for its patients.”
TV commercials often mask reality, and in the case of New York Presbyterian there’s a lot of reality that would-be patients might want to know about — though it’s not likely the media are going to tell them. Hospitals are to television what car dealers once were to newspapers—sacred cows to be slain by reporters at their own peril. The millions of dollars in ad revenue from car dealers were too important to sacrifice for an expose of schlock sales practices.
With hospital advertising, there should be new data-driven questions. There’s a saying that “the plural of anecdote is not data,” and these advertised anecdotes don’t tell the whole story. How many New York TV stations are going to dig into the data that show a hospital comes up short when it comes to basics like making sure patients don’t get potentially deadly central line infections? In New York City, “there’s a race to the top to see who is delivering the most complex care, but the nuts and bolts may be left behind,” says Leah Binder who heads The Leapfrog Group, a national watchdog group that keeps an eye on the quality and safety of care at the nation’s hospitals. The organization is gaining a reputation for its unbiased, no-holds-barred data on hospital safety measures. It uses a variety of public data but also relies on hospitals across the country to answer survey questions. New York City hospitals are notorious for not responding. “The hospitals may be coasting on their reputations, but they need to demonstrate they deserve their reputation,” Binder added.
This year Leapfrog awarded New York-Presbyterian’s Cornell Weill and Columbia University campuses a B for its overall safety score. It’s worth noting that both these flagship campuses scored below average when it came to preventing dangerous bedsores, surgical site infections after colon surgery, and blood and urinary tract infections during ICU stays.
When it came to patient satisfaction, data from the Centers for Medicare and Medicaid Sevices (CMS) show that New York-Presbyterian got only three stars out of a possible five. Surveys sent to recent patients ask about things that are important to making their hospital experience as pleasant as possible. Surveys looked at questions such as: if patients’ pain was controlled; if doctors and nurses communicated well with them; if bathrooms were clean; if the area around their rooms was quiet at night; and if they received help as soon as they wanted it.
The SPARCS (Statewide Planning and Research Cooperative System) data from the New York State Health Department, which gives information about quality, enforcement actions, patient satisfaction, and deaths also seem to align with the Leapfrog and CMS results for New York-Presbyterian. Both the Weill and Columbia campuses were listed as average performers for bloodstream and surgical site infections and patient satisfaction, and poor performers for timeliness of emergency room treatment and patient readmissions within 30 days, a widely used measure of hospital care.
Unfortunately, more patients are hearing compelling TV commercials than checking stars and other website symbols that signal safety and quality of care. Binder told me that in the group’s own consumer surveys, Leapfrog found that the public is interested in probing hospital quality. They “are quite forgiving for mistakes,” she said, “but completely unforgiving” when hospitals refuse to report their data. If that’s the case, maybe it’s time for more bravery on the part of reporters who cover hospitals. Back in the day, some reporters did write about car dealers and newspapers and some TV stations sometimes lost advertising, which usually eventually returned. In the meantime, car shoppers had been warned and clued in on which sharp practices to watch for. It was a valuable public service.
Still, it’s going to take a Herculean effort on the part of committed journalists and the public to trump the reach of clever hospital marketing that is so prevalent today. Peter Rabot, the founder of New York-Presbyterian’s ad agency Munn Rabot, told Advertising Age, the “Amazing Stories” campaign is “creating a long term relationship with consumers in the area. People will hopefully see these ads and feel good about the brand. I’ve had many people come up and say to me, ‘when I get sick, I am going to go there.’”
Let’s be clear: New York-Presbyterian is not the only hospital eager to engage in brand advertising. Increasingly, hospitals all over the country are promoting their high-tech skills to grab more patients. The health systems — doctors included — that control the largest number of patients are better able to dictate the prices, the CEO of one large New York physician group told me recently. Few hospitals advertise how safe they are, and none is eager to talk about so-so or poor quality ratings. That should be a prime target for more journalists.