In 2013 Hospital Impact published my post “The hidden costs of incentivizing patient satisfaction“.
In this piece I shared the following quote from a physician working within the broken healthcare system …
– “If a portion of my compensation is based on patient satisfaction then to maximize my reimbursement I must provide to my patients everything they want. And if that means services they don’t actually need, be it an antibiotic or x-ray, so be it. If I say no they are mad (unsatisfied) and it will cost me money. These are the rules of engagement the system has created and thus these are the engagement rules I will follow.”
And I concluded …
– To honor our commitment to improving the health of our patients, families and communities, we must be mindful of the complexity of the system, understand the unintended consequences, and focus on those things that bring physicians and patients closer–and rail against anything that hurts the physician-patient relationship.
So I was thrilled to see the article “Bioethicists say patient-satisfaction surveys could lead to bad medicine” by Sabriya Rice in Modern Healthcare this week in which she shares:
– “The bioethicists also worry that focusing on patient satisfaction as an independent goal has made it “ripe for commercialization” and resulted in a boom of profit-making businesses.”
– “… many have questioned whether focusing on those priorities will lead to improvements in patient outcomes such as lower mortality and lower readmission rates or result in unintended consequences.”
With unintended consequences defined as …
– “Pressure to tell patients what they want to hear and accede to unreasonable requests may increase the provision of unnecessary care,” and ultimately “lead healthcare astray, undermining the provision of optimum care for all.”
As healthcare leaders we must remember surveys are simply tools and within the complex adaptive nature of the healthcare system we must focus on both intended and unintended consequences of the reliance on these tools.
We must ensure we are developing healthcare models which optimize these tools without being solely dependent on them.
And most importantly … we must focus on ensuring authentic connection and relationship between patients (and families) and their clinicians which allow for the development of trust and the telling and hearing of the patient’s whole story. Only then will we truly understand the patient’s experience and satisfaction level through their lens and truly be able to act upon it together with our patients.