What price patient satisfaction?

Several years ago, Richard Angelo, a nurse, was convicted of killing several of his patients. He was so well liked that he was able to poison at least 35 of them over several years before hospital administrators realized he was the murderer. Unfortunately, you cannot judge your health care providers by their bedside manners. Indeed, a recent JAMA study reveals that higher patient satisfaction is linked to greater drug and medical spending and higher death rates.

This study suggests that new Medicare payment incentive systems that reward doctors and nurses for high patient satisfaction ratings might end up hurting patients. These incentives may lead providers to behave against their patients’ interests. They might, for example, fail to discuss all health care options with patients thinking that it will make them happier. Or, they might overtreat their patients, providing them with unnecessary procedures they request.

A new study from the Hastings Center finds that a focus on patient satisfaction could hurt efforts to improve quality of patient care. The report notes that there are three ways to define patient satisfaction: 1. The patient received the care that he or she requested regardless of whether it was needed; 2. The patient felt that the doctors communicated effectively and looked after the patient’s comfort; and 3. The patient received needed care that improved the patient’s health outcomes. The first two definitions have no relation to whether the care provided improved the patient’s health.

Of course, patient-centered care that is evidence-based can also lead to patient satisfaction. But, at this time, the satisfaction data does not distinguish between this care and care that is not patient-centered that leads to patient satisfaction.

In sum, you may not want to give great weight to patient satisfaction data in choosing a hospital or a doctor or a nursing home. For sure, be aware that there is no clear link between patient satisfaction and good health outcomes.