Patient Satisfaction

A great Perspective in the Journal of the American Medical Association discusses patient satisfaction and patient-centered care.   (JAMA Perspective)  Patient satisfaction is a key component in value-based purchasing and pay-for-performance programs and patient-centered care is deemed to be an important aspect of health care quality, revolving around understanding patient values and preferences and respecting those in care decisions.  As the Perspective points out, there can be a tension in these concepts.  Patient satisfaction derives from more generalized customer satisfaction doctrines and practices and largely measures results against expectations.  In reality, customers are often not capable of judging the more technical aspects of a product or service and instead make judgments based on surface aspects such as friendliness.  This is especially true in health care, where few people have that much medical training.

Patient satisfaction, however, is not that clearly linked to actual good clinical outcomes.  Often patients are satisfied when they get all the care they might imagine, which costs more and doesn’t necessarily correlate with good care.  Patient-centered care also can create problems if the patient’s preferences are inconsistent with prudent use of medical resources or endanger the patient in some way.  Rewarding high patient satisfaction scores might encourage providers to use excessive amounts of care, without really delivering better health care or health.  While we want patients to be satisfied, and that state of mind may itself improve health, it is more important to ensure appropriate use of medical resources and have truly better clinical results.