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Press Ganey CEO Patrick Ryan’s Hidden Relationships

Remember the expose about Press Ganey titled Why Rating Your Doctor is Bad For Your Health by Kai Falkenberg published in Forbes this past January?

Turns out that Press Ganey and its CEO don’t like playing by their own rules. And they may just be trying to hide some interesting relationships from the public to boot.

Let’s first look at one of the documents mentioned in the Forbes article. A July 2002 letter (.pdf) from The Gallup Organization’s Managing Partner Robert Nielsen to Thomas Scully, the administrator of the Centers for Medicare and Medicaid Services (otherwise known by the acronym “CMS”) specifically stated that response rates for mail questionnaires (which Press Ganey uses) are too low. With response rates of 20-40%, Mr. Nielsen admitted that “the standard rules of probability don’t exist.” Mr. Nielsen then noted that “This is a dirty little secret in our industry” and that such a non-response rate “produces bias and produces unreliable metrics.”

In other words, the managing partner of an organization specializing in data collection acknowledged that the same data collection methods Press Ganey uses are biased, do not follow rules of probability, and produce unreliable results. He also acknowledged that the industry knows about these facts, but keeps it “secret” from the public.

When commenting on Ms. Falkenberg’s article, Press Ganey’s CEO, Patrick Ryan’s response was basically that doctors need to “suck it up” – kind of like Press Ganey is doing with its business model, but that was the subject of another post. It shouldn’t matter that the statistics are unreliable and that the methods are biased. Press Ganey customers need to rely on those statistics, anyway.
Think about what a dangerous precedent that sets. Imagine how many people would die in car crashes if car safety study statistics were unreliable. Imagine how many people would die from side effects if drug study statistics were unreliable and kept as a “dirty little secret in our industry”.
That “dirty little secret” is just the industry’s way of saying “we don’t give a rat’s tail about the effects of our product, we just want to make money.”

It doesn’t stop there, though.

After the Forbes article was published, there was a plethora of comments made to Ms. Falkenberg’s investigation. Forbes highlighted several of them in a subsequent issue. (.pdf)
Dr. Patrick Burnside noted that it was “Such a needed article.”
Dr. Robert Solomon remarked that “Many physicians have written about this but are handicapped by Press Ganey’s ad hominem implication that they are just whiners because they don’t like being judged.”
Cleveland Clinic’s Rafid Fadul called the surveys “a meaningless tool used essentially to ratchet down payments to physicians.”
But according to Forbes, the “most heated response” came from Eugene D. Hill III, a managing partner at venture capital firm SV Life Sciences. His response to the article, as published in Forbes, is contained below.

[The] article departed from FORBES’ usual high standard of investigative journalism. One of the principle [sic] unsupported assertions, that patient satisfaction is not correlated with clinical outcome, is refuted by common sense as well as a long history of patient satisfaction research, and most recently by a peer reviewed formal assessment that was published in the Jan. 17, 2013 issue of The New England Journal of Medicine.  It is not surprising that physicians, the understandably biased subjects of evaluation, some of whom have historically resisted both formal quality assessment as well as patient feedback (‘the doctor knows best syndrome’) and some of whom are lacking in interpersonal skills/bedside manner, might be less than willing to accept negative feedback.  To  criticize the evaluation service vendors is akin to shooting the messenger. In an age characterized by excessive reliance on diagnostic testing versus physical examination and patient
interview, an overreliance on ineffective therapies such as antibiotics for viral infections that propagate drug resistance, and an epidemic of prescription painkiller abuse, it is unconscionable for physicians to suggest they must offer `Vicodin goody bags’ to patients as an attempt to improve survey results. If true, as reported in your article, such actions only reinforce the necessity of more formal assessment of our highly inefficient and error-prone health care nonsystem. Incentive compensation based upon patient satisfaction is a minuscule (1%) portion of provider payment, an important point the FORBES article neglects to mention, leaving it to the reader to infer that the percentage is far greater. Medical services exist for the benefit of the patient, not the reverse; hence, bringing patients into the evaluation process is not only appropriate, it is essential.  FORBES’  readership deserves a higher standard of objective reporting and less sensationalistic journalism about this crucially important and pervasive subject.”

Forbes disclosed no conflicts of interest in Mr. Hill’s letter. Just some venture capitalist with too much time on his hands who became upset after reading investigative journalism.

The first thing I asked myself after reading that impassioned response was: “Self, why did a venture capitalist with no dog in this fight write a scathing criticism of an expose about a patient satisfaction company?”

Why indeed.

The author of the letter, Eugene Dubose Hill III, is in his 60s. But Eugene Dubose Hill III has a son named Eugene David Hill who is in his late 20s.
Anyone care to guess where Eugene David Hill works? If you believe his LinkedIn page, Eugene David Hill has been working at … Press Ganey Associates since October 2012. In case Eugene Jr. tries to remove his LinkedIn profile, a screenshot can be found here.

So daddy got mad and wrote a mean letter when someone criticized junior’s company. How sweet. Eugene Dubose says that Forbes readers demand more “objectivity” and yet his own relationships to Press Ganey were conveniently not disclosed? Reeeeeeeaaalllly.

That’s not all, though.

Eugene Senior has done some lecturing. One of his lectures back in February 2003 was on “Entrepreneurship” at the Wharton School of Business.
Anyone care to guess who was on the panel with Eugene Senior?
None other than Press Ganey’s current CEO, Patrick Ryan.

A little more research shows that according to Dun & Bradstreet, Patrick T Ryan, the CEO of Press Ganey, is also the President of SV Life Sciences – Mr. Hill’s venture capital firm. According to Bloomberg Businessweek, Patrick T Ryan was previously a venture partner at SV Life Sciences Advisers. And he’s currently an adviser to Medco. Yeah, that Medco.
You can have all kinds of fun exploring the incestuous relationships between Patrick T Ryan and Eugene D Hill on MarketVisual.com. Just punch in one of their names and see how the other always seems to pop up.

Now I understand why SV Life Sciences managing partner Eugene Dubose Hill III would write a letter of complaint about a medical patient satisfaction article. I can only wonder why the relationships weren’t disclosed. If that happened in a medical setting, it would be considered unethical and cause for reprimand. Here? Meh. Not so much.

Oh, and one other thing.

Did anyone happen to notice how much Mr. Ryan’s “approval rating” on Glassdoor.com had a sudden spike? Heck, he’s at 50% positive approval rating now. That’s like the first percentile when compared with patient satisfaction rankings, but heck, it’s better than the 24% mark he used to have.
His sudden jump in approval is despite many posts describing how the company favors nepotism and how Mr. Ryan and his pals have “killed the company.” One former employee even wrote that there was a “campaign of positive reviews” to improve Press Ganey’s image, but that Press Ganey is still a “toxic environment.”

The thing is that, just like anyone can answer Press Ganey surveys, anyone can log into the Glassdoor.com system and rate Mr. Ryan and his company. Glassdoor.com doesn’t verify who is making the posts. Patrick Ryan could be paying people from his SV Life Sciences venture capital firm to log in and give him positive ratings for all we know. Or maybe he’s logging in himself over and over again create posts telling everyone how good he thinks he is.
Wouldn’t it suck if a bunch of employees or former employees went to the Glassdoor site and rated him poorly? If you happen to work at Press Ganey now or happened to work there in the past, the link to rate Press Ganey and Mr. Ryan on Glassdoor.com is here.

Seems that Mr. Ryan has no problem telling other people to “suck it up,” but he has trouble covering up his own shortcomings as a manager and following his own advice when people rate him poorly – and a lot of people are doing so.

Uh oh.

Now I wonder if Eugene Dubose will write me a nasty letter, too.

 

13 comments

  1. Heh. Love when stuff comes back to bite the “non-leaders” who think they’re doing a great job. In the Army the best leaders did: Lead by example.” I live and die by that motto and one other: To be a leader is to do the uncomfortable thing.

  2. I’m shocked, shocked I say, to discover that anyone who could advocate using their tripe as “data” would be involved in such blatant books-cooking and underhanded incestuous money-grubbing and log-rolling.

    Dig a little deeper, Dr. Whitecoat, and I’ll lay you odds that somewhere at the other end of Press-Ganey you’ll find a few folks with ties to the folks that wrote Obamacare into being as law.

    A quick cross-reference of Ryan and Dubose with donor campaign contributions, and to whom, would be in order too, if we had a media worthy of the name.

  3. The patient satisfaction survey hysteria will end. Nothing this corrupt and this expensive and this demoralizing and damaging to patients and this unnecessary can survive. It will collapse under its own weight and unwieldiness. There are a very small group of individuals that are making boatloads of money from this con (see above article) and the only way this scam will be exposed will be through investigative journalism and legislation and grass-roots efforts, such as the petition you will find when you go to nopatientsatisfactionsurveys.com. Last week Pennsylvania ACEP approved the first resolution to formally identify patient satisfaction surveys as flawed and damaging and unfair to clinicians. The resolution will go before the entire national ACEP college of delegates in October at the annual Scientific Seminar in Seattle. Every emergency physician, nurse, PA and medical student needs to let their delegates know how angry and disgusted and fed up we are with the patient satisfaction con-job and Press-Ganey bullying.

    • “Nothing this corrupt and this expensive and this demoralizing and damaging to patients and this unnecessary can survive.”

      What makes you so sure of this? It wouldn’t be the first expensive, demoralizing, damaging and unnecessary thing to outlive its life expectancy.

    • Nothing this corrupt and this expensive and this demoralizing and damaging to patients and this unnecessary can survive.

      Clearly you’re completely unfamiliar with the British National Health System. Or the VA. Or JCAHO. Or…

      Nevermind.

  4. “A quick cross-reference of Ryan and Dubose with donor campaign contributions, and to whom, would be in order too, if we had a media worthy of the name.”

    OpenSecrets is your friend. You’d have to look up not just individual contributions, of course, but via any companies, limited entities, or other organizations they might own or control. Plus, if they donate to PACs (political action committees), then you have to find out where the PACs funneled that money. It’s a little fiddly, but it can be done and you don’t /need/ to be a journalist to do it. In fact it probably helps if you’re not.

    We just can’t depend anymore on a media which will report on political things “without fear or favor” like they used to at least try to do. The old media is dead. So be your own media. Whitecoat looks to have made a great start of it already.

  5. Look up “Kathryn Ryan” on LinkedIn. Also from Boston, went from intern to director… Guess who her dad is?

  6. As a patient who gets these Press Ganey surveys all the time, what in your opinion is the best thing to do? Fortunately, I have been highly satisfied with the quality of care given by my internist, dermatologist, etc. and I realize hospitals/medical groups use these to make (sometimes stupid) decisions about goals, improvements and whatnot. Obviously, I’ve been honest but are there things/categories that tend to hold more weight?

    So…what can little ole layperson like me do for a PG survey that really benefits my providers who are awesome? I’ve been told that giving all high marks makes the results outliers, thus not reliable data (a nurse said this). I mean, if these surveys are stupid yet admins use them, why not help us who want to help you get better grades :)? Yeah, yeah ethics…

  7. Your truthful answers are like pouring milk in a bowl of sewage to make it taste better.

    Your best choice is to throw anything from Press Ganey in the trash. Treat their attempts to elicit a response from you as you would a letter from a Nigerian attempting to gain your assistance in releasing a stray $30,000,000 from the Bank Of Lagos.

    If you liked your care, send a personal letter to the hospital CEO and doctor’s group(s) involved, and mention the caregivers who most impressed you by name. CC them, so the Powers That Be can’t “forget” about that recognition down the road. (They will otherwise.)

  8. Hahah, thanks!

    In my personal letters, I will be sure to include my SSN and my bank account #, you know…just in case.

    (Seriously though, thanks for the info. The Powers That Be tend to only hear the bad stuff. I figure, why not make sure they know how great their clinicians are?)

  9. May interest everyone to know that former bosses and colleagues of Mr Ryan have called him ‘bullish’, ‘arrogant beyond compare’, and using ‘intimidation tactics’ with employees….Surprisingly enough with customers too! Any of this ring true with the indirect intimidation that Dr WhiteCoat has received here?!!

    This also explains the glassdoor CEO spike in approval ratings, where employees have been ‘encouraged to contribute’ to save the honour of the company.

    The current sad state of affairs has led to employees leaving hand over fist and the management receiving a roasting through the same glassdoor survey…Can Mr Ryan and his cronies spell….BACKFIRE?

  10. Darren Black was a Managing Partner at SV Life Sciences for 10 years until August 2013. His brother, Jonathan Black, is COO of Press Ganey.

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