-
Feature Picture
-
-
Right Hand Treatment Results 1 Day After
Source Document
Assess_Vitals_18091905_Laquer DERM
-
Charter Info
-
Blog > Brand New Day
-
Post Title
Doctor Vivian Laquer – Dermatologist
- Comparative Review by MSG and Keith Torkelson MS (2018)
-
Google + Information
Vitals-Plus MSG Assessment
Instrument – Applied to Vivian Laquer MD – Fountain Valley Dermatologist – By
KE Torkelson (MS-Pathology) – Context of Annual Christmas Report Card (MSG,
2018)
-
Partners For This Study
-
-
Abstract – Summary
The client of interest in this
expedited study is Keith Torkelson MS.
We are Mentalation Solutions Group (MSG). The primary subject of this study is Doctor
Vivian Laquer (V_L MD) working in the capacity as a Dermatologist. As the end of this year (2018) approaches we
thought that our review of the practice that V_L works about would be our usual
and customary high rating. We saw V_L
yesterday, September 19, 2018 (Wednesday).
Our visit was anything but positive.
We are taking this opportunity to deliver an External Quality Review
(EQR) report within 2 days. In other
words two (2) days from the time we collected our encounter information till
finishing our publication. Let us see
how thing measure up.
-
Impression Doctor Vivian Laquer
MD
It looks like V_L is doctor TQNs’
partner. TQN historically is one of our
better doctors. It would appear from our
cursory search on-line that Doctor V_L has no Rate Your Doctor data on
file. Last year we pooled Dr. TQN’s
online data. Because TQN’s data is in
scope we include it here. We came up
with an Objective Rate Your Doctor result 2017 for TQN. For TQN the total number of votes (129) across
three rating sites averaged 3.3 Stars. For
the Service Window about 2018 we saw three different TQN associates: Melody,
Crystal, and Darin. We believe they are
Physician’s Assistants (PAs). We awarded all of them a Quick Star Score (Q*S) of
4.5 with 5.0 being best. While applying
our MSG Vitals Plus Tool TQN earned 4.6 Stars whereas his partner Vivian Laquer
MD earned 1.5 Stars. One online
commenter shared this: “Doctor Laquer's his daughter very rude: Just awful and
rude”. In the translation this for us at
MSG is very close to a 1.0 or worse rating.
We only saw V_L once this year. Again,
the service date was 20180919-W. Let’s
look into this matter a bit further – shall we?
-
List of Tables – Matrices –
Figures
-
Figure - Graph First Method (GFM)
Table - Objective Rate Your Doctor Data (2017 Legacy Data)
Matrix – Service Encounter
Tracker - Dermatology - Updated: 20180920
20180919-W: Charting Vivian
Laquer Notes – Issues
Figure - 20180919-W: Freeze Times
– Incidences – Repeating Ourselves
Figure – Freeze Times
Legacy Link -
Positive Control
Appendices
Table – Conditions
– Specialties – Procedures A-J – Compare Nguyen & Laquer
Appendix – Table - Professional Language - List of algae |
Britannica.com
Matrix - Vitals-Plus Method – Combined Scores – Dermatology
Comparisons
Matrix - Vitals Standard Elements
– Courtesy of Vitals
Matrix - Vitals-Plus Elements
(Quality and Satisfaction)
-
Figure - Graph First Method (GFM)
-
Interpreting Our Stars Graph
Years ago now we discussed quality control and Online Rate Your Doctor
scores with Dr. TQN. Each year we only
had high rating for him. We were proud
to hand deliver his MSG Christmas Report Card (MSG-CRC) to him. As we delved online for objective material we
were at a loss as to why people were rating TQN, e.g. average 3.3 Stars,
harshly. We investigated his PA
associates. We gave them high
scores. Then yesterday we meet Dr.
Vivian Laquer (V_L). Our first
impression was she suffers below average Bedside Manner. The Red Area in the graph appears to be Dr.
V_L’s domain. Actually for us she spent
more time avoiding work than continuing to chip away with our well established
Treatment Plan.
-
Positivism
We were ready to share and
publish a positive report for this year about Dr. TQN’s operation. We focus on strengths. This is the reason why we call the outcome
measure for our Vitals Plus Tool a Super Satisfaction Score (MSG-SSS). We quickly reviewed and updated our Service
Encounter Tracker (SET). We here at MSG
have applied our Vitals Plus Tool (VPT) between 50 and 75 times. Our VPT for us is reaching maturity. Our VPT is one of MSG’s most widely applied
assessment tools. In developing our VPT
we took Vitals standard 7-Item Screener and extended with 18 more Items. This makes for a total of 25 Items. Again, our VPT assessment for all practical
purposes is for us Matured. Typically we
hand deliver our Super Satisfaction Score (SSS AKA Triple S) reports to our
highest performers.
-
Table - Objective Rate Your Doctor Data (TQN 2017 Legacy Data)
-
|
|||||
Rating Site
|
# Reviews or Votes
|
Average
Stars
|
Weighing
Reversal
|
Average Across All
|
|
-
|
|||||
Yelp-01
|
35
|
3.5
|
122.5
|
||
Yelp-02
|
21
|
4.0
|
84.0
|
||
Heathgrades
|
14
|
2.7
|
37.8
|
||
Vitals
|
59
|
3.0
|
177.0
|
||
-
|
|||||
Sums
|
129 (*)
|
421.3/129
|
3.3
|
||
Website Testimonials
|
4
|
5.0
|
|||
-
|
All data gathered Sunday June 18, 2017 for Doctor TQN – Dermatologist –
Last Reviewed: 20180920-TH:
-
(*) Landmark Achievement
In the arena of Rate Your Doctor, Doctors in Orange County rarely get 100
reviews. This number of reviews is a
remarkable achievement. One day we might
project the number of 5.0 Stars Rating Votes it will take to get the Average
Rating over 4.0. It looks like somewhere
around 100.
-
From: [Metadata]
> BND_9.1.1_Specialists_17061803_Dermatology V2018
-
Matrix – Service Encounter Tracker - Dermatology - Updated:
20180920
-
|
||||||
Appt Date
|
Q*M
|
QGM
|
Vitals + Plus
|
Note(s)
|
||
-
|
||||||
20180110-W
Melody
|
4.5
|
90%
3.6 = A-
|
NNFI
|
|||
-
|
||||||
20180221-W
Crystal
|
4.5
|
90%
3.6 = A-
|
NNFI
|
|||
20180404-W
Darin
|
4.5
|
90%
3.6 = A-
|
NNFI
|
|||
20180516-W
Crystal
|
4.5
|
90%
3.6 = A-
|
NNFI
|
|||
20180627-W
Melody
|
4.5
|
90%
3.6 = A-
|
NNFI
|
|||
-
|
||||||
20180919-W
Vivian
|
2.0
|
C
|
7.0/23
30.4
1.5
|
Addressed Graphically
|
||
-
|
||||||
Multiple
High & Byes
TQN
|
5.0
|
A
|
21/23
91.3%
4.6
|
Compare with 3.3 Objective
|
||
-
|
Matrix – Service Encounter Tracker - Dermatology - Updated:
20180920: Q*M = Quick Star Method - QGM = Quick Grade Method – NNFI = No Need
For It
-
Slight Variance
We give all TQN associates the same “A- Grade” because we
saw no value in picking about tiny details.
All Melody, Darin, and Crystal have excellent Bedside Manner. We would recommend them to our family and
friends.
-
20180919-W: Charting Vivian
Laquer Notes – Issues
Now let’s get down to our
charting of this key encounter.
Everything was on track until being called into the first exam room on
the left. Normally we get what we call
Team TQN. We had no idea that the
service profile would change. We sat
down as usual and the Electronic Health Record specialist asked us routine
questions such as presenting problems or changes in medication. She seemed too polite. Then she left. Leaving us alone in the room is not
usual. In enters Doctor Laquer. She says I’m Doctor Laquer. We immediately say to ourselves: This person could
use some work on bedside manner. She
says something to the tune of: What’s going on?
We reply the routine has been tackling our skin lesions head to
toe. She begins freezing the top of our
head. She froze about ten spots in less
than 5 seconds. We say OK we may have a
freeze time issue here. Then she altered
the Treatment Plan by spending more time saying she would not freeze this or
that. We got to our right hand. She froze about five (5) spots in less than
five (5) seconds.
-
“All I See Are Black Dots”
On our left leg we put Sharpie
Map Marks (SMMs) as we had in the past.
She was the first one who said all I see are Black Dots. Today, now, is less than 36 hours later. Our freeze spots look almost healed. [REFERENCE RT HAND PICTURE]. Last, let us discuss the language
barrier. We looked online for the
conditions that TQN and V_L were experts at.
Doctor V_L kept calling our lesions benign age spots. Whether the lesion was pigmented or not is
was a benign skin lesion. The she said:
“If it does not bother you we won’t treat it”.
The reason we mapped areas with the black sharpie is because those areas
bothered us. In the end we fell
backwards on the Treatment Plan. We
think we have found a “Mole” that is driving down TQN’s Stars scores and
operational quality.
-
Which Hand Was Treated?
Which Hand Was Treated?
Hands Less Than 48 Hours After Laquer MD Treated One of Them
(Photo Taken 20180921-F)
Figure - 20180919-W: Freeze Times – Incidences – Repeating
Ourselves
-
Figure – Freeze Times
Metadata > 11_Ghlth_Derm_TX_16062502_Freeze-Times
-
20160625: We here at MSG) were
wondering. Why “when Doctor Nguyen
freezes us it is most effective. We
think it is because he sprays each spot longer (See number 4 – 15 second
minimum for the OraSure System)”. With
Dr. Laquer see address all freeze points in less than 15 seconds.
Step 4 - Freeze Times
-
What Others Are Saying About You
We encountered a problem when we
tried to access online objective Rate Your Doctor results for Doctor Vivian
Laquer. We could not find any online
ratings for her. Yet using the search
query “rate doctor vivian laquer” we found her information embedded in doctor
TQN’s.
-
Associated Document (Metadata)
> Checklist_Dermatology_Conditions_18092001_Notes_Laquer
-
Dr. Vivian Laquer, MD - Fountain
Valley, CA
20180919-W: Dr. Vivian Laquer, MD
is a family medicine specialist in Fountain Valley, CA. She specializes in
family medicine - 7 Conditions Treated
Comment: Chance she is not a
Dermatologist.
-
Sample of Embedded Information
Dr. Tien Q Nguyen MD (TQN) Reviews
| Garden Grove, CA | Vitals.com
20180919-W: Rating: 3 - 61 votes
(Vitals Update)
Dr. Tien Q Nguyen is a highly
rated dermatologist in Garden Grove, CA with over ... These doctors will
evaluate any abnormality, blemish or lesion on the skin in… Dr. Tien Q Nguyen
has 13-expertises
-
Self-verified patient of Dr. Tien
Q Nguyen - Posted on August 22nd, 2012
“Do NOT go here...I had very bad
experience from my first visit to Tien Nguyen MD in Irvine, aslo [SPELL ERROR
RETAINED] the doctor Laquer's his daughter very rude. Just awful and rude.”
-
Healthgrades Update
Dr. Tien Nguyen, MD - Healthgrades
20180919-W: Rating: 3 - 16
reviews
Jul 8, 2018 - Dr. Tien Nguyen, MD
is a dermatologist in Fountain Valley, CA - Dr. Nguyen's percentages are based
on the rate of treatment – 36-Conditions Treated. [EMBEDDED] “Dr. Laquer is the most caring
doctor I have ever met.”
-
On Mixed Messages – Always Error
“Dr. Laquer is the most caring
doctor I have ever met.”
Well next let us address doctor
level & principal comparison. The
statement “most caring doctor I have ever met” is what we call and Always
Error. Dr. Laquer is very unlikely for
us to ever rise to the top. In other
word V_L MD will probably not improve without customer service training.
-
Table – Balanced Scorecard Professional Comparative
Metadata > Assess_Comparative_Review_Health_18092001_Balanced
-
|
||||
Agent of Fortune
Character
|
QGM
20170621-W
|
Special
|
QGM
20180920-TH
|
|
-
|
||||
Tien Q Nguyen
|
A
|
Dermatology
|
A
|
|
Walk on Back Gals of Westminster
“5 Star Massage”
|
A-
|
Pain Management
|
A
|
|
Bum Soo Lee
|
A
|
Behavioral Health
|
Referred to Bera
|
|
Kamara Ya
|
A
|
Yoga/Pilates
|
A-
|
|
Chester D Mojica
|
B
|
Primary Care Physician
|
A-
|
|
Misc. Dentist
|
B
|
Dentistry
|
A-
|
|
-
|
||||
Ann Inman
|
A
|
Optometry
|
B+
|
|
James D Boyce
|
A-
|
Ophthalmology
|
B+
|
|
Rimal B Bera
|
Not Seen
|
Behavioral Health
|
B
|
|
-
|
||||
Vivian Laquer
|
Not Seen
|
Dermatology
|
C-
|
|
Acupuncturist
|
Future
|
Treat Iatrogenic
|
Future
|
|
Chiropractor
|
Future
|
Touch up dislocations
|
Future
|
|
Physical Therapist
|
Future
|
Future
|
||
First Review: 20170621-W: Final
for Fall Quarter (2018) – Last Update: 20180921-F: QGM = Quick Grade Method
-
Legacy Link – Sample of Positivistic
Evaluation (MSG, 2017)
Saturday, November 18, 2017
MSG Vitals-Plus Assessment Instrument – Applied to Central
City Community Health Center – By KE Torkelson (MS-Pathology) – Context of
Annual Christmas Report Card (MSG, 2017)
Satisfaction Survey for Health and Human Services Founded on
Vitals dot Com (MSG, 2017).
[VERY GOOD SHORT REPORT]
-
Legacy Link –
Sample of Positivistic Evaluation (MSG, 2017)
Saturday, November 18, 2017
MSG Vitals-Plus Assessment
Instrument – Applied to Central City Community Health Center – By KE Torkelson
(MS-Pathology) – Context of Annual Christmas Report Card (MSG, 2017)
Satisfaction Survey for Health
and Human Services Founded on Vitals dot Com (MSG, 2017).
[VERY GOOD SHORT REPORT]
-
Appendix
Table – Conditions – Specialties –
Procedures A-J – Compare Nguyen & Laquer
Parent Document > Checklist_Dermatology_Conditions_18092001_Notes_Laquer
-
|
|||
ProCode
|
Condition
|
Addressed
By Team TQN
2013-2018
|
|
-
|
|||
TQN
|
Acne (Acne Vulgaris)
|
||
TQN
|
Acne Rosacea
|
||
TQN
|
Actinic Keratosis
|
X
|
|
LQ
|
Actinic Keratosis
|
||
TQN
|
Allergic Reaction
|
||
TQN
|
Atopic Dermatitis (Eczema)
|
||
TQN
|
Autoimmune Diseases
|
||
TQN
|
Basal Cell
|
||
TQN
|
Basal Cell Carcinoma
|
X
|
|
TQN
|
Benign Tumor
|
X
|
|
TQN
|
Birthmark
|
||
TQN
|
Cancer
|
||
TQN
|
Candidiasis of Skin and Nails
|
||
TQN
|
Cellulitis
|
||
TQN
|
Dermatitis
|
X
|
|
LQ
|
Dermatitis
|
||
TQN
|
Dermatitis Due to Drugs
|
||
TQN
|
Eczema and Contact Dermatitis Due to Metals
|
||
TQN
|
Erythema Multiforme
|
||
TQN
|
Excision
|
X
|
|
TQN
|
Folliculitis
|
||
TQN
|
Fungal Infections
|
||
TQN
|
Fungal Nail Infection
|
||
TQN
|
Hair Loss
|
||
TQN
|
Herpes Simplex Infection
|
||
TQN
|
Hives
|
||
TQN
|
Impetigo
|
X
|
|
LQ
|
Impetigo
|
||
TQN
|
Intertrigo
|
||
LQ
|
Itchy Skin
|
X
|
|
Table – Conditions – Specialties –
Procedures A-J – Compare Nguyen & Laquer
-
-
Appendix
Table – Conditions – Specialties –
Procedures K-Z – Compare Nguyen & Laquer
ProCode
|
Condition
|
Addressed
By Team TQN
2013-2018
|
|
TQN
|
Keloid Scar
|
||
TQN
|
Lichen Planus
|
||
TQN
|
Lipomas
|
||
TQN
|
Melanoma
|
X
|
|
TQN
|
Mole
|
||
TQN
|
Moles (Benign Skin Lesions)
|
||
LQ
|
Moles (Benign Skin Lesions)
|
||
TQN
|
Psoriasis
|
||
TQN
|
Rash
|
||
TQN
|
Ringworm
|
||
TQN
|
Rosacea
|
||
TQN
|
Seborrheic Dermatitis
|
||
LQ
|
Seborrheic Dermatitis
|
||
TQN
|
Seborrheic Keratosis
|
||
TQN
|
Skin Biopsy
|
X
|
|
TQN
|
Skin Cancer
|
X
|
|
TQN
|
Skin Discoloration
|
X
|
|
TQN
|
Skin Infections
|
X
|
|
LQ
|
Skin Infections
|
||
TQN
|
Squamous Cell Carcinoma
|
X
|
|
TQN
|
Vascular Malformations
|
||
TQN
|
Warts
|
||
-
|
Table – Conditions – Specialties – Procedures K-Z – Compare
Nguyen & Laquer
-
Closing Comments - Professional
Language – AVEY’s Part
I am the AVEY construct. I am part of MSG. “We don’t share this much but Keith AKA
Buster our Principal here at MSG earned his Master’s Degree at UC Davis in
Pathology. A few instructors made it
clear that they demand more of the graduates than the medical students. Systemically Keith was focused on learning
histopathology of the GI Tract. In order
to do accomplish his goals he enrolled and completed Systems Pathology. He had a week on the Histopathology of the
Integumentary System. In this new age of
medicine where the client is a near equal partner in health care, getting to
know your client is most helpful. It is
an insult to Intelligence to expect that your client cannot manage scientific
nomenclature and classification. We are
tired of having people speak Dermatologic jargon. What follows is one of Keith’s after grad
school memorization challenges (Circa 2001 – Botany). For the Algae Lab Practical each student was
required to know about 100 variants of Algae.
[SEE SHORT LIST BELOW]. One might
assume that Doctor V_L is classification challenged. She classifies most all variations in lesions
as Old Age Spots!” (AVEY, 2018)
-
Query – Google Images
“microscopic presentations of old age spots”
Old Age Spots and Microscopic Presentation are not
complimentary.
[INSERT SAMPLES OF IMAGE HITS ABOUT QUERY]
-
No Hits for Age Spots
-
Appendix – Table - Professional Language – Example List of
algae | Britannica.com
-
Division Chlorophyta
(green algae)
-
|
|||||
Level
|
Category
|
Know Micro
& Spelling
|
|||
-
|
|||||
Genus
|
Acetabularia
(mermaid’s wine glass)
|
||||
Class
|
Charophyceae
|
||||
Order
|
Desmidiales
(desmids)
|
X
About 20 types
|
|||
Order
|
Charales
(stoneworts)
|
||||
Genus
|
Chlamydomonas
|
||||
Genus
|
Chlorella
|
X
|
|||
Genus
|
Cladophora
|
||||
Genus
|
Codium
|
||||
Genus
|
Hydrodictyon
(water net)
|
X
|
|||
Genus
|
Oedogonium
|
X
|
|||
Genus
|
Pediastrum
|
X
|
|||
Genus
|
Pleurococcus
|
||||
Genus
|
Scenedesmus
|
||||
Genus
|
Spirogyra
|
X
|
|||
Genus
|
Ulothrix
|
X
|
|||
Genus
|
Ulva (sea lettuce)
|
||||
Genus
|
Volvox
|
X
|
|||
-
|
-
Other Divisions
-
Rhodophyta (red
algae)
Dinoflagellata
(Pyrrophyta)
Cryptophyta
Chromophyta
•class Phaeophyceae
(brown algae)
-
Appendix
Matrix - Vitals-Plus
Method – Combined Scores – Dermatology Comparisons
20180919-W: Super Satisfaction Score (SSS) = 100%
-
|
|||||
Patient Ratings
Service Experience Element
|
20180919-W
Vivian
Laquer MD
|
TQN
2018
|
Sample CALC
|
||
-
|
|||||
Items = 7
|
2.0/5
40%
|
6.0/6
100%
|
Sum/# Scored
4.5/5
|
||
Items = 18
|
5.0/17
29.4%
|
15.0/17
88.2%
|
Sum/ # Scored
13.5/15
|
||
Items = 25
|
7.0/23
30.4
|
21/23
91.3%
|
Sum/# Scored
18.0/20
|
||
Star Equivalents
(5.0 Stars is the Best)
|
1.5
|
4.6
|
4.50
|
||
With Bonus
IF – THEN
Add 1 to Numerator
|
20/20
100%
|
(18+1)/20 * 100 =
95.0%
|
|||
Indications of Satisfaction: Actual Data from 20180919-W:
Encounters
-
Reports Applied For:
11_GHlth_Rate_Your_F2F_18021001_STR
-
Prior Impressions were Excellent
Direct Sharing Stayed this Year
-
Scoring Vitals Plus
Binary Scoring Method (BSM)
P-Pass (1.0) | So-So (0.5) | F-Fail (0.0)
-
Matrix - Vitals Standard Elements – Courtesy of Vitals
-
|
-
|
||||
Item
#
|
Patient Ratings
Service Element
|
20180919-W
Vivian
Laquer
|
TQN
2018
|
Sample
CALC
|
|
-
|
-
|
||||
01
|
Ease of Appointment
|
0.5
|
1.0
|
1.0
|
|
02
|
Promptness
|
0.5
|
1.0
|
1.0
|
|
03
|
Courteous Staff
|
0.5
|
1.0
|
1.0
|
|
04
|
Accurate Diagnosis
|
0.5
|
1.0
|
X
|
|
05
|
Bedside Manner
|
0.0
|
1.0
|
1.0
|
|
06
|
Spends Time w Me
|
0.0
|
1.0
|
0.5
|
|
07
|
Follows Up After Visit
|
NA
|
NA
|
X
|
|
-
|
|||||
Items = 7 (MAX)
|
2.0/5
40%
|
6.0/6
100%
|
Sum/#Scored
5.0/5*100
|
||
-
|
|||||
-
|
Vitals Method - Indications of Satisfaction: Actual Data
from 20180919-W: Encounters
-
Matrix - Vitals-Plus Elements (Quality and Satisfaction)
Item
#
|
Patient Ratings
Service Element
|
20180919-W
Vivian
Laquer
|
TQN
2018
|
Sample
CALC
|
|
01
|
Accountability
|
0.0
|
1.0
|
1.0
|
|
02
|
Clozapine Awareness
|
0.0
|
0.5
|
1.0
|
|
03
|
Doctor’s Orders
|
0.0
|
1.0
|
0.5
|
|
04
|
Error Free
|
0.5
|
1.0
|
1.0
|
|
05
|
Guidance
|
0.5
|
1.0
|
X
|
|
06
|
Paper Trail
(E-Paper Trail)
|
0.5
|
1.0
|
1.0
|
|
07
|
Pharmacy
|
0.5
|
1.0
|
X
|
|
08
|
Phone Support
|
NA
|
NA
|
X
|
|
09
|
Promotes Recovery
|
0.5
|
1.0
|
1.0
|
|
10
|
Satisfaction Survey Offered
|
0.0
|
0.0
|
0.0
|
|
11
|
Scheduling
|
0.0
|
1.0
|
1.0
|
|
12
|
Situational Awareness
|
0.0
|
1.0
|
1.0
|
|
13
|
Timeliness
|
0.5
|
1.0
|
1.0
|
|
14
|
TimeSpent
|
0.5
|
1.0
|
1.0
|
|
15
|
Values Consumer
(Member-Account)
|
0.0
|
1.0
|
1.0
|
|
16
|
Values Consumers Time
|
0.5
|
1.0
|
1.0
|
|
17
|
Healthful Environment
|
1.0
|
1.0
|
1.0
|
|
18
|
Agent of Remedy
|
0.0
|
0.5
|
1.0
|
|
Items = 18 (MAX)
|
5.0/17
29.4%
|
15.0/17
88.2%
|
Sum/# Scored
13.5/15*100
|
||
Sustain or Improvement Bonus
|
1.0
|
||||
Vitals-Plus – Last Revision: 20170926-TU: (Theta Version)
Indications of Satisfaction: Actual Data from 20180919-W: Encounters
-
End
-
Images @ The End
-
Our sister sets us up with a peel kit
-
-
Friend with Unmet Dermatologic Needs
Look at his right forearm
He may die too young
-
Head with Fluorouracil Topical Cream
-
Quest for the Perfect Lotion
-
This Is The End
Promote WorldWafers
-30-
