Patient Satisfaction

There is a lot of talk these days about patient satisfaction. For several years, hospitals have been mandated by CMS to survey their discharged patients about their experiences. The results have been publicly reported and payments are tied to performance. This approach, including the use of a federally mandated standard questionnaire and the linking of payment by CMS to scores, is also planned for physician practices. These policies, which are being adopted by private insurers as well as government payers, have been credited with forcing hospitals and doctors to be more attentive to “customer service.”

It is hard to argue against the need for better service, and for better attention to patients’ comfort, and these programs seem to be working (registration required). But a couple of things about this whole approach leave me feeling more sad than inspired.

First, I think it is sad that it literally took an act of Congress for us to pay attention to what our patients think about us, and to how well we treat them. How did that happen for a profession dedicated to relieving suffering and curing illness?

Second, I really don’t like talking about “satisfaction.” Maybe it is just semantics, but satisfaction seems like such a low bar. We may be satisfied with our hotel rooms or our new cars, but why aren’t we striving for something more profound in our interactions with patients? I would want to know if my patients feel cared for, respected, or comforted.

If you want to be inspired by physicians who didn’t need a survey or a threatened pay cut to get them to pay attention to their patients’ needs, watch this.  And remember the immortal word of Francis Weld Peabody, that “the secret of the care of the patient is in caring for the patient.”

5 thoughts on “Patient Satisfaction

  1. It is inspiring to see these outstandingly dedicated and caring physicians who have been able to keep the focus on their patients. Thank you for recognizing their accomplishments.

    1. I am in full agreement with Dr. Nash on this. Healthcare has lingered for a few years in the hotelier model, which held up Ritz Carlton as the organization to emulate, and consciously conflated the role of “patient” and “customer.” It is significant that the former term derives from the Latin word for “suffering.”

      Our obligations to patients are trivialized and our professional sense of self eroded by suggesting that the physician-patient relationship is indistinguishable from that between a shoe salesman and a customer or waiter and a patron. Some see this objection as a reflection of physician arrogance – in truth, it insists on the higher standard to which we committed when we joined the ranks of this noble profession.

      Fortunately, thought leaders are speaking more and more about “empathy based care” as a framework for understanding the real center of the “satisfaction” issue. We can hope that a rebirth of humanism in healthcare will lead us out of the labyrinth.

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