Do patient satisfaction scores do more harm than good?

Report argues satisfaction not tied to quality of care

A new report from the Hastings Center argues that the health care industry's growing focus on patient satisfaction scores may not lead to higher quality care.

Hospitals are increasingly rewarded financially for high patient satisfaction scores. And CMS has increased their importance in the eyes of consumers by adding satisfaction scores to its Hospital Compare website.

Hospitals struggle to bring up their patient satisfaction scores

However, Stuart Youngner, a professor of bioethics and psychiatry at Case Western Reserve University, and Alexandra Junewicz, a resident in psychiatry at the NYU School of Medicine, argue that patient satisfaction is poorly defined and overemphasized. "'Patient satisfaction' means something different to everyone and bears no clear relationship to the technical quality of health care," they write.

Connection to outcomes

The authors say that patient satisfaction surveys can be inconsistent, depending on the surveyor, and the questions often group satisfaction and health care quality together.

Has the focus on patient satisfaction gone too far?

While the report acknowledges "eliciting the patient's perspective is essential to shared decision-making and important to health care quality," it says providers are going too far by treating patients as consumers. And the authors conclude that patients may receive medically unnecessary treatment as a result.

"Placing such an emphasis on the patient perspective risks giving patient-satisfaction surveys the power to pressure providers to 'satisfy' their patients at all costs," the pair writes.

Youngner and Junewicz also say patient satisfaction surveys are flawed because they require expertise patients do not have. For instance, some questions ask patients to rate physicians on a scale of "best doctor possible" to "worst doctor possible."

Without reform, patient satisfaction surveys may "lead health care astray, undermining the provision of optimum care for all," the report warns (Rice, Modern Healthcare, 6/4 [subscription required]; Budryk, FierceHealthcare, 6/5).

The takeaway: A new report argues patient satisfaction scores are not related to care quality and may be promoting negative behavior on the part of providers.


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