Brand New Day HMO: May 2019

Feature Image

Table – Report Marketing Features

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Aspect		Note
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Feature Image		Mark A
Blog(s)		P4D & BND
Blogger Titles		Behavioral Health Doctor a Consumer Satisfaction Report by Keith Torkelson (201905) & MSG
Keywords		External Quality Review – Satisfaction – Behavioral Health Doctor
Dedicated To		Mark A
In Memory Of		“Road Kill” Mark

Last Reviewed: 20190520-M:

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In Memory Of...
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Table – Social Media Aspects


Aspect		Note

Google Plus Info		April 2019 Google Plus option taken away by Google
Pinterest Workings		Very little impact so far 3 Links
Facebook Workings		Improved readership yet taking care with crossovers
Twitter Workings		Can’t get our links to take Attempt 3 Links
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Last Reviewed: 20190520-M:

Partners

Abstract – Executive Summary

This paper primarily considers Keith “Buster” Torkelson and his burgeoning partnership with Rimal B Bera MD (RBB). RBB is Buster’s new and improved Behavioral Health Doctor. We selected approximately seven (7) assessment tools to gauge their association. In total we apply Buster’s lived experiences with four (4) Behavioral Health Doctors (BHDs). Today is Monday May 20, 2019. To date Buster has met face-to-face with RBB in his offices six (6) times. As is often usual for us in our reports we consider objective results up front. We are Mentalation Solutions Group (MSG) and I am Avey Asus. Applying online consumer satisfaction data on April 4, 2019 we found that RBB has a pooled Star Equivalent (SE) rating of 2.9 Stars (5.0 Stars being Superior). Next on April 25, 2019 using an alternate method we compared RBB with his colleague Bum Soo Lee MD (BSL). RBB earned 2.3 Stars whereas BSL earned 3.9 Stars. Next we considered Buster’s self-score about stress using a common stress measure. On May 19, 2019 (SUN) Buster scored 266 out of 1466 for his Social Readjustment (Stress) Rating. We applied our Great Doctor Screening tool to BSL and RBB. BSL scored 4.6 Stars whereas RBB scored 4.6 then 4.3 Stars. While addressing our Doctor Good Quality Screener we found RBB earns a 4.4.

On Recommending Rimal B Bera MD

We chose to compare RBB with our all-time best BHD doctor David Dobos. We gave doctor Dobos 5.0 Stars. While adjusting for our Dobos experiences we uncovered a relatively sound Correction Factor of 1.111. We rated a few BHDs past and present for their Antagonisms. Doctor Arnold P Deutsch MD earned 0.00% whereas RBB earned the high of 38.9%. Using another satisfaction assessment (UCMG) that we applied on May 19, 2019 (Sunday) we found about ourselves and RBB a 2.9 Star Satisfaction. Last we apply an assessment tool that we rarely use the Hare Psychopathy Checklist. Our findings indicate that RBB may have some “Pathy” features. In sum we would not globally recommend doctor Rimal B Bera MD to our friends or family for services. Congratulations if you reached here. Read on you may find the details intriguing. (Avey Asus, 201905)

List of Tables (T) – Figures – Matrices – Etc

T – Report Marketing Features

List of Tables (T) – Figures – Matrices – Etc

List of Acronyms

T - Associated Assessments (Eliminations)

Figure Key Performance

T – Legend for Behavioral Health Doctors

T – Appointment & Key Event Register (Timeline)

Figure - Objective Up Front

Matrix - Pooled Calculation – Data Date: 20190414-SUN – Rimal B Bera MD

Figure – Sample Satisfaction Metadata

Figure - Donald L Dungworth (SciMed & PhD) Principle

T - Presenting Problems – Responsibility Assignment Matrix (RAM)

Matrix – Balanced Scorecard - Summary

Figure – 20190519-SUN: Readjustment Results for “Buster”

Matrix - AUAMED Great Doctor Screener (7 Item)

Matrix – Doctor Good Quality Screener (10 Item)

Matrix - 20160414: Patient Ratings – David Dobos MD – VITALS Patient Ratings Model

Matrix – Antagonist Checklist

T – Legend for Antagonist Checklist – Level of Antagonism

Figure – UCMC Client Satisfaction

Table(s) – Applied Satisfaction Survey Findings - Reporting

Matrix - Hare Psychopath (12 Item Screener)

Figure – Authority to Assess

Figure – One Health

List of Acronyms – Satisfaction Paper

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Acronym	Meaning
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ADC	A Dobos Correction
BEA	BHD Encounter Assessment
BHD	Behavioral Health Doctor
CCCHC	Central City Community Health Center
DLD	Donald L Dungworth (A Mentor)
EQR	External Quality Review
HPC	Hare Psychopathy Checklist
HRA	Health Risk Assessment
JAN	A Director & Overseer
LCU	Life Change Unit(s)
MMG	Medication Management Group
MSG	Mentalation Solutions Group
OCD	Obsessive Compulsive Disorder
P4D	Psychiatry for Dummies
PCL	Psychopathy Checklist
QOL	Quality Of Life
R	Retroactive
R&L	Referral & Linkage
RAM	Responsibility Assignment Matrix
REN	Rest Exercise and Nutrition
RT	Real Time
S4E	Standard for Excellence
SE	Star Equivalent
TBP	The Bera Partnership
TRC	Tork Reconstruction Company
UCD	University of California @ Davis
UCMG	Universal Care Medical Group

Last Reviewed: 20190517-F:

Table - Associated Assessments (Eliminations)

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Instrument	Note	Applied Here	Note
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AUAMED Great Doctor Screener	7 Item	X
Doctor Good Quality Screener	10 Item	X
Healthgrades	8 Items		Stayed
Impact of a BHD on Consumer Satisfaction Antagonist Checklist Build	9 Item	X
Measures of Consumer Satisfaction	14 Item	X
Measures of Provider Satisfaction ProQOL Build	30 Item		Stayed
Psychopath Assessment	12 Items	X
Pursuit (A Balanced Scorecard)	25 Item Beta	X
Vitals	7 Item	X
Vitals Plus	6 + 18 Items		Stayed
When to Kill Project	6 Items		Stayed
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Last Reviewed: 20190517-F:

Key Performance Metadata

Table – Legend for Behavioral Health Doctors

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Character	Code	Translation	Carried Score (%)
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BSL	R	Bum Soo Lee MD Retroactive	5.6
APD	R	Arnold P Deutsch MD Retroactive	0.0
RPS	R	Ravinder P Singh MD Retroactive	30.6
RBB	RT	Rimal B Bera MD Real Time	38.9
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Last Reviewed: 20190519-SUN:

Date of Appointments

MSG_Psychiatry_Referral_Bera_18032002_Part-IV

Table – Appointment & Key Event Register (Timeline)

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Time Stamp	Key Event	Satisfied

20171024-TU	Base Referral (R&L)	Close five years with Bum Soo Lee Satisfied
20180103-W	Linkage 1 (Referral Part I)	Yes
20180411-W	Linkage 2 (Referral Part II)	Yes

20180509-W	Charter Bera Standalone	In Consideration
20180718-W	Linkage 3 (Referral Part III)	SoSo
20180718-W	Graduate from Linkage Phase
20181010-W	Wrap up first year	Partnership “Stable”
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20190109-W	The Consensus Appointment
20190308-F	Major meeting with JAN	Spend an hour with us Very Satisfied
20190403-W	The Crash Appointment	Treatment Appointment Charter P4D Study
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20190703-W	The Recovery Appointment Would like a checklist from doctor	System Restore V Reconfigure
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Last Update: 20190517-F:

Figure - Objective Up Front

Compare to Current Stars

Assess_Vitals_Plus_Bera_RBB_19040301_Appt-2019-02

Objective

Matrix - Pooled Calculation – Data Date: 20190414-SUN – Rimal B Bera MD

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Rating Service	Rating	Reviews Votes	CALCS	Note

Healthgrades	2.0	4	8.0
Vitals	3.1	12	37.2
WebMD	3.0	16	48.0
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SUM		32	93.2
CALC			93.2/32
Star Equivalents =			2.9
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Figure – Sample Satisfaction Metadata

FYI – A Mentor

Figure - Donald L Dungworth (SciMed & PhD) Principle

“He received his veterinary degree from the University of Liverpool in 1956 followed by a residency in pathology at the Ontario Veterinary College, Guelph, Ontario, Canada. In 1957, Donald L Dungworth (DLD) entered a Ph.D. program in the School of Veterinary Medicine at UCD. He received his Ph.D. in 1961.”

“You don’t have to do everything superbly”

DLD Circa 1987

Table - Presenting Problems – Responsibility Assignment Matrix (RAM)

Resource Leveling

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Problem	Self	PCP	BHD
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Accountability			X
Agent		X	X
Clozapine Contingency	X		X
Consumer Perception	X	X	X
COPD	X	X
Coping	X		X
Environments	X	X	X
Grieving	X
Host	X
Housing	X
MSE			X
Objective Stars Score		X	X
P4D	X		X
QOL	X
Quality Assurance	X	X	X
Readership	X
Restoril			X
Sleep	X		X
Smoking Cigarettes	X	X
Time Spent		X	X
Unilateral Partnership		X	X
Vital Plus Issue		X	X
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Designed: 20190519-SUN: Last Reviewed:

Matrix – Balanced Scorecard - Summary

Tailored Pursuit (A Balanced Scorecard) – 25 Item Summary (Comparative)

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	Component	BSL-R	RBB-RT	Note
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	Part I of II	8.75/12	7.25/15
	Part II of II	6.25/7	4.00/10
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	CALC	15.0/19	11.25/25
	BHD Encounter Assessment (BEA) Score =	78.9%	45.0%

	Star Equivalents =	3.9	2.3
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Date of Evaluation: 20190425-TH: After 3 Week Cooldown Period: Date of Key Encounter: 20190403-W: R = Retroactive | RT = Real Time

20190403-W:

The Crash Appointment Tantrum

Metadata > Assess_Vitals_Plus_Bera_RBB_19040301_Appt-2019-02

Matrix

Tailored Pursuit (A Balanced Scorecard) – 25 Item Part I of II (Comparative)

Individualized

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##	Pursuit	BSL	RBB	Note
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01	20190403-W: Not a Crash Appointment Tantrum	NA	0.00
02	Bedside Manner	1.00	0.25
03	Cognitive Assessment	0.75	0.25
04	Dementia Speaking In Public	NA	0.25
05	No Dualistic Treatment	0.00	1.00
06	Family Involvement	0.50	0.25
07	Not putting us in Harm’s Way	0.25	1.00
08	Medication - The Clozapine Fix	0.75	0.00
09	Medication Clozapine	0.75	1.00
10	Medication Lithium	1.00	1.00
11	Medication Lorazepam	1.00	0.00
12	Medication Management	0.75	0.75
13	Meeting of the Minds	NA	0.50
14	Minded Medication	1.00	0.50
15	OCD Smoking	1.00	0.50
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	Carry	8.75/12	7.25/15
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Date of Evaluation: 20190425-TH: After 3 Week Cooldown Period: Date of Key Encounter: 20190403-W:

On Weighting – Lesson Learned

We here at TRC and MSG have been quantifying using Health & Human Services (HHS) assessments since the year 2000. At times when we go to make our scoring algorithms we get scores that do not reflect well reality. One of the factors that skew our results is “Weighting”. A good “Fix” for weighting items heavier is to replicate them in the list.

Special Interest - Considering Stress

FYI - Holmes- Rahe Stress Inventory - The American Institute of Stress

https://www.stress.org/holmes-rahe-stress-inventory

Apr 10, 2019 - The Holmes-Rahe Stress Inventory (Form)

https://www.stress.org/wp-content/uploads/2019/04/stress-inventory-1.pdf

Online Version

https://www.stress.org/test/the-holmes-rahe-life-stress-inventory

The Holmes-Rahe Life Stress Inventory (43 Item)

Instructions

“Mark down the point value of each of these life events that has happened to you during the previous year. Then, add up all your points to calculate your final score.”

20190519-SUN: What Does Your Score Mean?

Results for “Buster”

Figure – 20190519-SUN: Readjustment Results for “Buster”

Interpretation

According to the Holmes-Rahe statistical prediction model

150 points or less	A relatively low amount of life change and a low susceptibility to stress-induced health breakdown
150 to 300 points	50% chance of health breakdown in the next 2 years
300 points or more	80% chance of health breakdown in the next 2 years

"Please note that The American Institute of Stress does not own the Holmes-Rahe Stress Inventory and cannot give permission for reprinting or publication."

Matrix - Tailored Pursuit (A Balanced Scorecard) – 25 Item Part II of II (Comparative)

Individualized

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##	Pursuit	BSL	RBB	Note
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16	Practice Policy & Procedures Written	0.50	0.00
17	Practice Policy & Procedures Oral	1.00	1.00
18	Public Health	NA	0.50
19	Restoril Experiment	0.75	0.00
20	Risk Management	1.00	0.50
21	Sample Case Jonathan Effectiveness	NA	0.00
22	Situational Awareness	1.00	0.25
23	Special Interests John Henry Foundation (JHF)	NA	0.50
24	Targeted Evaluation	1.00	1.00
25 (10)	Time Spent (Due Rigor)	1.00	0.25
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	Part 16-25 (10) - Carry	6.25/7	4.00/10
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Date of Evaluation: 20190425-TH: After 3 Week Cooldown Period: Date of Key Encounter: 20190403-W:

Crash Appointment Notation – Med Management

Near the end of our six (6) minute Crash Appointment we addressed time spent with RBB. We said we only worked for seven minutes. We said that when we bought into the Medical Model for Behavioral Health we thought that medication was important enough to take time and spend time about its’ nuances. We said that at one point we were paying privately for a one hour (50 minute) session. We said that our private pay BHD (APD) felt that it takes time to manage medication appropriately. We said: So you think APD was wrong in spending an hour with us? RBB states: “This is in how I choose to run my practice”.

Through Put and Efficiency

RBB also indicated that he served an overburdening caseload. Doctor Dobos our most promising BHD had a system to manage medication issues in “Batch”. He orchestrated a Monday and Friday Medication Management Group (MMG). Buster believes it lasted at least one hour. Doctor Dobos’ patients would assessable in a group room. Almost immediately doctor Dobos’ Med Nurse would join the group. Then she went about the group usually of about ten (10) people and solicited about medication needs. Each person would weigh in. She would take the requests to doctor Dobos and near the end of the hour the Med Nurse would return with the appropriate prescriptions. At peak efficiency he could handle ten people in a half hour. That is three (3) minutes per person.

FYI – Links

Why is it difficult to be a doctor? - KevinMD.com

https://www.kevinmd.com/blog/2018/04/why-is-it-difficult-to-be-a-doctor.html

Apr 30, 2018 - Trying to get information from people who don't want to give it to you ... That kind of responsibility is very stressful, it's a good thing, but it's hard.

What qualities make a good doctor?

Here, MDLinx provides perspective on the most common qualities of a good doctor.

https://www.mdlinx.com/internal-medicine/article/2631

Special Topic – Exemplary MDs

Matrix - AUAMED Great Doctor Screener (7 Item)

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#	Quality	2012-2017 BSL-Retro	2018-RT RBB	2019-TD RBB
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1	Compassion	1.00	1.00	1.00
2	Strong Work Ethic	1.00	1.00	0.75
3	Professionalism	1.00	1.00	0,75
4	Knowledge	0.75	0.75	0.75
5	Confidence	1.00	1.00	1.00
6	Humility	1.00	1.00	0.75
7	Passion	0.75	0.75	1.00
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	CALC	6.50/7	6.50/7	6.00/7
	Percent Good Doctor =	92.9	92.9	85.7
	Star Equivalents =	4.6	4.6	4.3
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Date Scored: 20190520-M:

FYI - Strong Work Ethic

https://www.auamed.org/blog/7-essential-qualities-physician-2/

“Having a strong work ethic means you dedicate 100% of yourself to your work every day, regardless of how tired you are or what is going on in your personal life. While this quality will help you succeed in any field, it is especially essential to the practice of medicine. Every day brings a new challenge. Even if you don’t know what those challenges will be, you’ll have to be ready to face them. Preparation is time consuming, but you must put in the effort if you want to succeed.”

Matrix – Doctor Good Quality Screener (10 Item)

Underpinning for Satisfaction – A Dobos Correction (ADC)

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##	Quality	20190517-F Proven-RT RBB MD	2001-R Dobos MD	Note
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01	Compassion	1.00	1.00
02	Understanding	0.50	1.00
03	Empathy	1.00	1.00
04	Honesty	0.75	1.00
05	Competence	1.00	1.00
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06	Commitment	1.00	1.00
07	Humanity	1.00	1.00
08	Courage	1.00	1.00
09	Respect	0.75	1.00
10	Optimism	0.75	1.00
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	CALC	8.75/10	10.0/10
	Good Doctor Score =	87.5%	100.0%
	SE =	4.4	5.0
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Last Reviewed: 2019019-SUN:

Standard for Excellence (S4E)

We have written and published at least a couple of reports about our experiences with doctor David Dobos MD. After methodical evaluation across some odd ten (10) Behavioral Health Doctors (BHDs) we found doctor Dobos our Standard for Excellence (S4E). A FAV feature about doctor Dobos’ Practice was that he was good at taking care of business. He worked hard in the beginning so we could be more efficient as time progressed. At one point we mentioned our work with doctor Dobos to his boss at the time doctor David Chandler MD. Doctor Chandler replied saying: He (doctor Dobos) is a hard worker and good doctor.

Matrix - 20160414: Patient Ratings – David Dobos MD – VITALS Patient Ratings Model

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##	Service Element	Objective (6 Responses)	Our Response 20160414 Retro
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01	Ease of Appointment	3.1	4.5
02	Promptness	4.0	4.5
03	Courteous Staff	3.4	4.5
04	Accurate Diagnosis	3.4	4.5
05	Bedside Manner	3.4	4.5
06	Spends Time with Me	3.9	5.0
07	Follows Up After Visit	3.4	4.0
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	AVG (Stars) =	24.6/7 = 3.5	31.5/7 = 4.5
	Score MAX =	35.0	35.0
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Last Reviewed: 2019019-SUN:

Correction Factor

After some odd three (3) years of ferreting we have come up with our first Correction Factor. If doctor Dobos is our best Behavioral Health Doctor (BHD) ever then it only makes sense to adjust some of the scores we have about him up to 5.0 when appropriate. Back in 2016 we calculated for him 4.5 Stars. It seemed in tune since six other people reviewed him yielding an average stars score of 3.5. To adjust for discrepancies we have started to upgrade doctor Dobos to 5.0 stars. Considering a 7 Item Vitals basic assessment we find for him a Correction Factor (5.0 / 4.5 - 7 Item Strength) = 1.111. Now where appropriated we may calibrate using 1.111 as a multiplier.

Matrix – Antagonist Checklist

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##	SynoTerm	BSL-R	APD-R	RPS-R	RBB-RT	Note
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01	Adversary	0.00	0.00	0.50	0.00
	Competitor	0.00	0.00	0.00	0.50
	Contender	0.00	0.00	0.00	0.00
	Enemy	0.00	0.00	0.25	0.00
05	Foe	0.00	0.00	0.75	1.00
	Nemesis	0.00	0.00	0.50	1.00
	Opponent	0.00	0.00	0.50	0.50
	Opposition	0.50	0.00	0.25	0.50
09	Rival	0.00	0.00	0.00	0.00
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	CALC	0.50/9	0.00/9	2.75/9	3.50/9
	Antagonist Rating =	5.6%	0.0%	30.6%	38.9%
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Date Scored: 20190502-TH: Last Reviewed: 20190519-SUN:

Table – Legend for Antagonist Checklist – Level of Antagonism

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Character	Code	Translation	Carried Score (%)
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BSL	R	Bum Soo Lee MD Retroactive	5.6
APD	R	Arnold P Deutsch MD Retroactive	0.0
RPS	R	Ravinder P Singh MD Retroactive	30.6
RBB	RT	Rimal B Bera MD Real Time	38.9
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Last Reviewed: 20190519-SUN:

Shared with:

10_Satisfaction_Evaluation_RBB_Bera_19041006_Develop

Date Scored: 20190519-SUN

Assessment: Universal Care Medical Group (UCMG) Client Satisfaction

Concentration: 20190403-W (Crash) Appointment

Figure – UCMC Client Satisfaction

Associated Document

Metadata > BND_CCCHC_RBB_Bera_19051901_Satisfaction

Universal Care Medical Group (UCMG) Client Satisfaction

Instructions:

“Please rate the following items about you work with Brand New Day using the scale to the following scale. If an item does not apply to you, please enter DA for Doesn’t Apply. For each question, enter a grade that best answers the question. Thank you for helping!”

UCMG - Grades

4 for Excellent

3 for Very Good

2 for Good

1 for Poor/Failing

DA for Doesn’t Apply

Table(s) – Applied Satisfaction Survey Findings - Reporting