Patient satisfaction surveys offer insight into full scope of care
I can’t believe we’re still bashing patient satisfaction as a valid component—and measure—of healthcare. A June 20 letter (“Tread carefully on measures of patient satisfaction,” p. 26) criticizes satisfaction surveys for focusing on trivia (“a hospital is not a hotel nor a theme park”); encouraging docs to prescribe inappropriate or harmful meds to earn good scores; and yielding subjective data that don’t always mirror technical clinical measures.
Enough of these assumptions and opinions. Let’s focus on facts:
■ The HCAHPS survey (on which CMS reimbursement is partially based) measures communication and empa- thy. There is not a single amenity or “service” item. Patients would much rather have good information about what’s being done to them than 600thread-count sheets.
■ While there appears to be a national tendency to overprescribe some meds and tests, there is no empirical evidence linking such practices largely to docs’ desire to achieve good patient satisfaction scores.
■ Of course patient satisfaction ratings are subjective. That’s because a major component of “care” is subjective. Communication about the illness, its treatment and aftermath; and empathy and accommodation for the stress, discomfort and vulnerability caused by the medical issue and hospitalization—these subjective aspects of care go unrecognized in clinical process and outcome measures. Thus, the disconnect between patient satisfaction and technical measures should not be surprising. They reflect different aspects of care and require distinct concerns and competencies (which are clearly still in short supply).
The sooner we stop survey-bashing, the sooner we can pay necessary attention to the full content of care—not just the technical part.
Irwin Press, Ph.D. Adjunct faculty, Rush University Medical Center Chicago Co-founder, Press Ganey Indianapolis