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)
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
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)
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
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)
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
|
|
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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