Friday, May 13, 2016

Dr David M Dobos, MD Kaiser Psychiatrist in Aliso Viejo, CA – Doctor On Call - Stats by TheDAG and Keith E Torkelson, MS



20160513-F: Charter Information – Standards (From RENHEW)
20160513-F: Blog Keeping
Date Chartered – May 13, 2016-F (Actual as expected before deadline)
Means/Method – Blogger/Post (Gallery First Method)

20160513-F: Title
Dr David M Dobos, MD Kaiser Psychiatrist in Aliso Viejo, CA – Doctor On Call - Stats by TheDAG and Keith E Torkelson, MS

Test Subject - Dr. David M Dobos MD (Psychiatrist)
Photo – So far none online (unavailable)

Doctors On Call – Dobos (DOC01) & BSL (DOC02)
Development Stage - Beta Testing Around MSG’s Datic Division

Principle Author – TheDAG for MSG

Dobos' Introduction Link

http://the-torkel-saga-2059.blogspot.com/2016/06/keith-e-torkelson-ms-introduces-dr.html

Primary Assessments (MSG)
Doctors’ On Call Assessment Tools - Doctor Tech Assessments - Accountability and Transparency

20160528-TH: Executive Summary – Abstract
This study and report is about our real world experience with one of our, if not he best, psychiatrist – Dr. David M Dobos of SoCal Kaiser Permanente. Referencing Vitals online Rate Your Doctor Experience data: Three others rated Dr. Dobos services at a 3.5 out of 5 stars. Doctor Dobos was (Circa 2000) and is a practicing Kaiser psychiatrist. For this year (2016), the Centers for Medicare & Medicaid Services (CMS) awarded Kaiser 5 Stars with 5 being the best. Vitals stars are not the same as CMS Stars with the latter involving way more data points for its calculation. Using the Vitals method we scored our service experience with Dr. Dobos a 4.5 out of 5 stars. There is no evidence on-line as of May 26, 2016 that Dr. Dobos has reported on any of his successes for self-performance (cure rates, savings with medications, hospitalization diversions, etc,). Some doctors are now reporting that depression is now more curable than ever. We use our Results Up Front Method (RUFM) in this report.

Applying Lessons Learned
We chose RUF because it is to be presented and a post in our Blog and not a refereed paper. For this study we created some assessment tools: Doctor On Call to further flesh out our service experience, an Addressing Transparency Tool, and two assessments to investigate Dr. Dobos in relationship to technology. Doctor Dobos outscores our current psychiatrist (BSL-Control) about all but one of the assessment tools. Our current psychiatrist (BSL) is a contractor about a program that CMS rates with only 3 stars. If we don’t get time to pursue this Doctor On Call endeavor we state that Dr. Dobos’ colleague Dr. David Royce Chandler was one of our worst psychiatrists. With the lessons learned here we hope to hire a superior psychiatrist to succeed our current one. We also hope to give any new psychiatrist a heads up as to our expectations. Key to our expectations is not to experiment on us. We are still deciding whether to publish the assessments (Betas) we wrote for this study.

Community Partners
20160515-SUN: Shared with AMIN-0011


 
 
 
 
 
Method
Partner
Note
-
 
 
 
 
Advocate for Peer Specialists in Behavioral Health
Californian Mark Leno
(M_L)
Senate Bill 614
 
Experimented & Experiments on Humans
Dr. Himasiri K. De Silva, MD
(HKDS)
Unsuccessful biochemical lobotomies
(Per APD, MD)
 
Homeless Representative
(OC - May 2016)
FV Tech Guy
Hope and Innovation
 
Housing Specialist
Donald L Bren
(DLB)
MHSA Funding
 
Inappropriately Served & Over-served
Kelly Thomas
(K_T)
Died Young while being served and protected
 
Man of Peace Methodologies
(Grace & Role Modeling)
Peter Brian Gabriel
(PBG)
Promoted awareness of Stephen Bantu “Biko”
 
 
 
 
 
Promising Practices Psychiatry
Clayton Chau, MD (C_C)
Consumer-survivor
 
Technique of the Quarter
Antonio Egas Moniz (AEM)
Pre-Frontal Lobotomy
 
Writer for “The Resistance”
Daryl Steinberg
(D_S)
Mental Health Services Act
 
HomeyGee’s
(EAK)
Promise for the future
 
 
 
 


20160515-SUN: Table – Maturing with our Community Partners (AMIN & Dobos, 2016)

Results Up Front Method (RUFM – Stars and VITALs - Combined Table)


-
 
 
Assessment
Dobos and Kaiser
Legacy
BSL and GBDP
Current
-
 
 
Obj – CMS Stars (Program)
5 (Out of 5 = Best)
3 (Out of 5 = Best)
 
 
 
Obj – Online Patient Ratings of Doctors
VITALS
3.5/5 (3 Responses)
VITALS
Unavailable
MSG Subj – Using VITALS Model (20160507)
4.5/5 (1 Response)
4.0/5 (1 Response)
 
 
 
Obj – Doctor Self Report
0 - No Evidence Found
0 - No Evidence Found
 
 
 


Current Data as Of 20160507: Table (OBJ) – Results Up Front (RUF) – Featuring Objective Measurements – Comparing Dobos with an in scope control (BSL) - Both psychiatrists.

Table (OBJ) Legend

BSL = Ciphered
CMS = Centers for Medicare & Medicaid Services
GBDP = GB DEATH Program
MSG = Mentalation Solutions Group
Obj = Objective
RUF = Results Up Front
RUFM = Results Up Front Method
Subj = Subjective

Why We Cipher?
Our professor, Gary Michael Zager, for Introduction to Health & Human Services taught us ethical principals. One was called a Dual Relationship. Mr. Zager says (2012) not to destroy a therapeutic relationship if it exists or existed. We are seeing BSL right now and would like to avoid burning this bridge. Thus BSL and GBDP are ciphers for a person and a program.

An FYI: Acronym List - Centers for Medicare & Medicaid Services (About 1000 of them)

https://www.cms.gov/apps/acronyms/listall.asp?Letter=ALL

Features of a Superior Psychiatrist

Table (MDOC) Legend

% = One hundred percent is best
A&TPS = Accountability & Transparency Progress Score
ASSS = Appropriate Services Subjective Score
ATT = Addressing Transparency Tool
COTS = Commercial-of-the-shelf
S&DE = Strengths & Deficits Evaluation

TPS = Transparency Progress Score


 
 
 
 
AcroCode
Assessment
Dobos and Kaiser
Legacy
[% (Items)]
BSL and GBDP
Current
[% (Items)]
 
 
 
 
MDOCAT
HWS
Doctor On Call Assessment Tool (Beta) – High Weight Screener
83 (12)
17  (12)
MDOCAT
LW
Doctor On Call Assessment Tool
(Beta) – Low Weight Fleshing
58 (13)
17 (15)
 
 
 
 
ATT
 
Addressing Transparency Tool
Yields TPS
71 (11)
30 (10)
A&T
Edmonton
Accountability and Transparency – COTS (The Edmonton)
Yields A&TPS
68 (34)
40 (44)
 
 
 
 
S&DE
Strengths & Deficits Evaluation
Yields ASSS
Strengths (#28) > Deficits (#4)
(*) Prediction
Strengths = Deficits
 
 
 
 


Data Current as of 20160510-TU: RUFM – Table (MDOC) - Rating the Doctors On Call -Subjective from Lived and Real World Experience

ATT Control = Edmonton Commercial-off-the-shelf (COTS) Tool
[PDF] - Accountability and Transparency Board Self-Assessment - Charity Central
(4 pages – Tool itself “The Edmonton” & A&T-Edmonton)

http://www.charitycentral.ca/docs/selfdiag-ecl-en.pdf

As a self-assessment, these questions help clarify for you where your agency are going.
(*) - Held over for being out of scope at this time

IT Features for a Superior Psychiatrist

TCMS = Teckno Case Management Score (Yield)


 
 
 
 
AcroCode
Assessment
Dobos and Kaiser
Legacy
[% (Items)]
BSL and GBDP
Current
[% (Items)]
 
 
 
 
MDTAT-HWS
Doctor Teck Assessment Tool – High Weight Screener
Yields TCMS-HW
83 (12)
10 (12)
 
MDTAT-LW
Doctor Teck Assistance Tool – Low Weight
Yields TCMS-LW
31 (16)
 
32 (17)
 
 
-
 
 


Data Current as of 20160510-TU: Table (TCMS) - RUFM – Rating the Doctor On Call’s Technological Prowess -Subjective from Lived Experience

Prosumer Rates Psychiatrist(s)

Table (TCMS) Legend

 
 
AcroCodes
Translation
-
 
MDTAT-HWS
Doctor Teckno Assessment Tool – High Weight Screener
MDTAT-LW
Doctor Teckno Assistance Tool – Low Weight
 
 
TCMS
Teckno Case Management Score (Yield)
TDCMA
Teckno Driven Case Management Assessment
TDCMA-P-HWS
TDCMA – Provider Version – High Weight Screener
TDCMA-P-LW
TDCMA – Provider Version – Low Weight
 
 


20160527-F: Table – Legend for Teckno Assessments

Statement of Intent (General for all MDOCAs)
20160602-TH: Statement of Intent
A major intent is for MSG to gain confidence about its’ External Quality Review (EQR) and sharing process. We try to share lived experience while applying MSG’s Harm Reduction Policy. We are shopping early for a new (superior) psychiatrist in order to prevent preventable losses (AKA an episode).

Predictions Using Stars - Performance Distribution


-Implied Perfection
A CMS Stars score of 5 implies perfection yet that is not the case. Scores are rounded. In the graph the area of green represents the program and staff keepers. The area in yellow represents the needs improvement - program and staff elements. The area in red implies elements that might best be replaced. As we look closer at the distribution it needs a bit of tweaking to better reflect reality. The point is: What is the true difference between a 5 Star (Kaiser) and a 3 Star (GBDP) program? How can one be used to help the other?

Gallery First (Then Embed)
-

"It's Only at the Turning Point
When You Find Out How to Fight"

Oly_091215_CTP_007
Consumer Paraprofessional Training Graduation 2009
Chau and Correa
A TorkMark Photo




Man of PEACE
-



Strengths and Deficits - Four by Four Method
Dobos Service Model (Circa 2000)
Search if you may - “doctor david dobos psychiatrist”

20160418: Strengths – A ListerLista

 
-
 
 
Rank
Service and Supports Element
20160418
 
 
-
Retro Circa 2000
 
 
 
 
 
01
We met our performance challenge together
YES
 
02
Superior medication management system
YES
 
03
Weekly medication adjustments PRN
YES
 
04
Medication Management Position (MMP)
“Sometimes the patient knows how to manage their medication best” (Dobos)
YES
 
 
 
 
 

As of 20160418 - Table for Doctor Dobos’ Strengths (Of a SuperTotal = 18) – Scored by Client

20160418: Deficits – A ListerLista (MSG - ConMan)

 
-
 
 
Rank
Shortfalls and Deficits
20160418
 
 
 
Retro Circa 2000
 
 
 
 
 
01
Educated me about Clozapine
NO
 
02
Analyzed and determined root causes
NO
 
03
Felt secure that his office could manage all my behavioral health needs (keeping risk factors at bay)
NO
 
04
Reliability of relationship
NOT LONG
TERM
 
 
 
 
 

As of 20160418 – Table for Doctor Dobos’ Deficits (SuperTotal = 4) – Scored by Client


Keith Torkelson An Evaluators Error Rate
Applying Course Work (Approximately 10%)
-

20160418-M: Strengths – ListerLista - More Strengths

 
 
 
 
Rank
Service and Supports Element
20160418
 
 
-
Retro Circa 2000
 
 
 
 
 
05
Appropriate dress
YES
 
 
 
 
 
06
Authored letters when I requested
YES
 
 
Bought into my goals
YES
 
 
Few assumptions
YES
 
 
Gentle and calming
YES
 
10
Grief work effective (Both my mom and dad died)
YES
 
 
 
 
 
11
“Seeking new clients” - Would I go back?
Probably Not
 
 
Took the most thorough history of any of my psychiatrists (Handwritten – 40 minute intake)
YES
 
 
Agreement on a working diagnosis
YES
 
14
Did my symptoms improve
YES
 
 
 
 
 
 
 
 
 

As of 20160418 - Table for Doctor Dobos’ Remaining Strengths (Of a SuperTotal = 18) – Scored by Client As of 20160418



ALN Deron
Sample of Memory (File) Fragmentation Collage
By&4 TheDag
Refrag by Keith Torkelson



Kelly-Thomas- Dying
Inappropriately (Over) Served by the
Fullerton Police - Status Beaten & Died Young


"Wise Up Janet Weiss"
Keith Torkelson Graduates From
30 days of Intensive 2012
LG_040412_1353



TheDag's Doctor Shopping
Bera and the John Henry Foundation Captured 20150304
A Doctor On Call





15_Auto_MD_Hx
Capture 2015070806_De Silva 02



LGG3_012216_0916
ReTV Stan Lee
A Source 4 Lunic Captured by LittleTork



Team Genesis (1974)








The Way We Were
Memories 1989
An Appropriate Inappropriate Treatment
ECT Plus (Captured by LittleTork)



Steve Biko and Peter Gabriel Captured 20160513
As Performed by Keith Torkelson Died Young


Once Thought Promising
Lobotomy Un-splitting The Split


#999


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