As we focus on quality, patient satisfaction continues to be a prominent measure of healthcare experience. In fact, higher patient satisfaction scores seem to correlate with desirable health outcomes. However, the issue arises concerning whether the current clinical care standard does in fact, accurately reflect clinical performance, and does it support efforts to improve the patient experience?
A recent discovery found that efforts to increase the average patient experience scores could be more effective and less counterproductive when evaluated as a measure of physician performance. One study even discovered that those patients with higher satisfaction scores had higher costs of care. This latter point is compelling in the age of consumerism. But suppose we adhere to the marketing dynamic that the customer is always correct. In that case, this dictum can lead to higher costs and, more importantly, possible harm due to non-evidence-based treatments or diagnostic procedures.
It’s crucial to manage the polarity of patient experience and health outcomes on an individual patient level. Because physicians are now being “graded” on both measurements, one must balance the patient experience within the context of evidence-based medicine. Two components are at play, the first being, what we are measuring and the second, is the conversations we have with those we treat. A patient satisfaction question concerning access is the availability of an appointment, and this question assumes a requirement to deliver care in a physical location. Merely the nature of the question leads one to believe that this is the correct way to receive care. However, from a true clinical perspective, the question is more accurately, “Did you promptly receive the care you needed in a timely manner?” This adjustment of view allows other methods of engagement outside in-person visits.
Additionally, managing expectations and conversing in meaningful conversations at the time of care may be incredibly impactful. Asking “what is your greatest worry,” and answering that question early on will likely lead to higher scoring.
Regardless of how we solve the problem, we must constantly evaluate whether the questionnaire we provide fits the intended purpose. Moreover, when an implemented model has been shown not to drive the wanted results, it’s necessary to reevaluate the model for enhancements or abandonment. Unquestionably, we are blessed to serve others in their times of need, and it’s prudent that their experience is multifactorial and worth balancing with their clinical needs.