Dead with a grin on your face

Happy patients are not always better patients.  Patient satisfaction has been a source of debate for a long time.  More and more hospital administration is pushing for better patient satisfaction.  Satisfaction is based more on the patient’s perception of how they were treated not how well they were treated medically.  Many times the medical providers’ pay and job are related to how the patients fill out the survey.  It is kinda like the patient giving their waiter a tip at the restaurant.  It does not necessarily reflect how good the food was, instead it reflects how well I kept your glass full.  I agree that people should not be rude and should keep their patients informed about what is going on.  But what about when the patient gets mad because I will not send them home with narcotics when they are a known drug abuser or when a mom demands her kid get a head CT because he just got hit in the head with a wet noodle despite all the risks of radiation and possibility of cancer?  Just like your car dealer, we are graded on the patient’s satisfaction where anything less than a 5 out of 5 is failing where 5 is outstanding, way above average.  Looking at this grading expectation, it is fundamentally flawed.  By definition, 50% of clinics/doctors/hospitals cannot provide above average care.  So why are they penalized for not being able to do the impossible?  Recently there was a study (link included below) which had an interesting finding. It concluded: “In a nationally representative sample, higher patient satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality.” Go to the actual article for more interesting info.  Looking at it a different way from the same data, people who were not satisfied with their care had less money spent on them, less tests performed, and did better.  This just shows that many times patient satisfaction is bought not earned.  I could do the best thing for the patient and they do great.  But they are still unhappy because they thought they needed a pain medications or a certain test and did not get it.  More is not always better.

The Cost of Satisfaction A National Study of Patient Satisfaction, Health Care Utilization, Expenditures, and Mortality

Arch Intern Med. 2012;172(5):405-411

One comment on “Dead with a grin on your face

  1. Cheryl Bode says:

    Love reading your posts!

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