How to get the answers you want from a survey

This isnt about religion or politics, two subjects I tend to avoid. This is about surveys and how they can mislead.

I received this survey in the mail last week. It is from CatholicVote.org and is touted as the "largest survey of Catholics ever conducted on the issue of ObamaCare."

CatholicVote.org promises that the results will "send a strong and clear message to every politician running for election or reelection in the 2014 midterm congressional elections, that the overwhelming majority of Catholic voters demand ObamaCare be repealed."

Judging from the way the questions are framed, I think the message will be clear.

Here are a few examples:

From Section B "ObamaCares War on Christianity and Morality"

Question #2: Do you think ObamaCare is violating the Constitutions First Amendment protections for freedom of religion and freedom of conscience by forcing pro-life Americans to purchase health coverage that includes abortion inducing drugs?

A) Yes, this is certainly a violation of the Constitutions First Amendment protections.
B) No, this is not a violation of the Constitution
C) Not Sure
D) Other

Question #4: As a state lawmaker in Illinois, Barack Obama voted twice to deny lifesaving medical care to babies born in botched abortions. What is your reaction to this fact?

A) I support President Obama on this.
B) I am horrified and angered by this.
C) Not Sure
D) Other

From Section C "ObamaCares War on Freedom"

Question #5: Do you think President Obama knew about the crushing cost of ObamaCare for families across America, and was just lying about the cost to get ObamaCare passed into law? Or do you think he shares our shock and dismay at the staggering cost of ObamaCare?

A) I believe President Obama knew about the crushing cost of ObamaCare for families across America, and was just lying about the cost to get ObamaCare passed into law.
B) I think he shares our shock at the staggering cost of ObamaCare and was just unaware of it.
C) Not Sure
D) Other

Question #6: How do you think the mass exodus of doctors from medicine will impact your ability to see a doctor and get the medical treatments you need?

A) A doctor shortage on this scale will certainly drive healthcare costs up dramatically and make it far more difficult for me to see a doctor and get the medical care I need.
B) I dont think well see much impact from this doctor shortage.
C) Not Sure
D) Other

Had enough?

I look forward to seeing the results.

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The solo general surgeon is a dying breed What is next

This is a guest post by Dr. Paul A. Ruggieri, a general surgeon in Fall River, MA and author of a new book “The Cost of Cutting: A Surgeon Reveals the Truth Behind a Multibillion-Dollar Industry.”

A potential casualty of employment in a hospital system may be the ability to openly disagree with the organization. Will surgeons, as highly paid employees, be confident enough to speak up against hospital policies affecting patient care without worrying about corporate retaliation? Will employed surgeons be able to speak out against hospital cost-cutting measures that infringe on patient care without being labeled whistleblowers or troublemakers? Can they voice their displeasure without worrying about the security of their job? If you are branded “not a team player,” referrals may dry up. Or, you may suddenly be “asked” to take more emergency room call. You may also be asked to travel farther to see patients and generate surgical business in another town. You may be replaced. You could end up as a surgeon without a practice. If let go, you may discover that the clause in your contract prohibiting you from practicing within the area drives you out of town.

Will employed surgeons be able to openly highlight waste and fraud without fear of losing their jobs? As highly paid employees, surgeons risk much if they criticize the organization that employs them, even when the intent is improved patient care. Knowing the economic stakes of speaking against the corporate team, I suspect many may choose to be silent.

Now that more surgeons are giving up their independence and joining the ranks of the employed, will they have the ability to unionize? Historically, surgeons have been an extremely independent breed of physician, perhaps too independent for their own good. For whatever reasons—ego, stubbornness, a view of themselves as well above the average working stiff, money, competitive juices—surgeons have never been able to use their local muscle to influence hospital behavior. Instead of being able to unionize freely decades ago, surgeons may now be forced to in order to survive.

Will unionized surgeons be given collective bargaining rights when negotiating with their employers? Will surgeons be able to strike if they feel the hospital systems they work for are not negotiating salaries or working conditions in good faith? Can you see it now, a Teamster walking the picket line in solidarity with a white-coated surgeon over improving health benefits? Will there be appeal boards to contest unfair firings? As employees, will surgeons be able to negotiate for vacations, sick time, or family leave?

The writing is on the wall for all surgeons, including me. The era of the independent surgeon is drawing to a close. More and more patients will be cared for by surgeons whose economic and surgical lives are directly influenced by the corporate entities that employ them. What, if any, impact will this dramatic shift in the surgeon’s professional world have on the access and quality of surgery practiced in the future? It remains to be seen, but there is a reason the American Medical Association (AMA) specifically addressed this shift in 2012 with new guidelines for physicians selling their practices. Tellingly, the AMA stated that “patients should be told whenever a hospital provides financial incentives that encourage, discourage, or restrict referrals or treatment options.” The AMA statement continued: “Physicians should always make treatment and referral decisions based on the interests of their patients.” Isn’t this how physicians and surgeons already practice, and have for hundreds of years? Or is it?

As a patient, should you know who your surgeon works for before agreeing to an operation? If you’re interested in a dinosaur’s perspective, the answer is “Yes!”

What do you think about Dr. Ruggieris view of the future?

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