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There's More to Health Than Being Happy: What a Patient Satisfaction Score Really Means


I recently visited an optometrist for my yearly eye exam. I left her office with a new contact lens prescription, a travel-sized bottle of saline solution… and a link to a website where I could leave feedback for my doctor. I had a good experience at the optometry office and was happy to complete the short online survey, but I couldn’t help but notice that none of the evaluation questions had anything to do with my health.

Many doctors, medical offices, and hospitals are searchable and reviewable on Yelp. A Yelper’s one-star review of a hospital in my neighborhood starts off with the sentence, “I have no idea on the quality of medical care here, I'm sure it's fine. However….” A hospital in New Jersey received a negative response to a patient experience survey because “the hospital doesn’t have Splenda.” It seems to me that Yelp reviews and opinions on sweetener options apply to a coffee shop or a restaurant, not a place where I go to receive medical care.

Each year, 1.25 percent of Medicare reimbursements are withheld from hospitals. Hospitals with the highest quality scores earn the money back, with greater payments going to the hospitals with marks at the very top. These scores are calculated from 24 quality measurements, one of which is patient satisfaction.

Unfortunately, satisfied patients aren’t necessarily healthier patients. In fact, a 2012 study found that the patients in the top 25th percentile of satisfaction scores were actually associated with greater health care and prescription costs, in addition to a higher mortality rate. In a 2014 survey of 155 physicians, nearly half of the doctors surveyed believed that the pressure to receive higher patient satisfaction scores encouraged “inappropriate care,” including unnecessary and expensive prescriptions, procedures, tests, and hospital admissions.

Some elements of patient satisfaction are very important, such as emergency room wait time and medical professionals’ bedside manner. However, there’s little overlap between the criteria for a good experience at a restaurant and a good experience at a hospital. The customer may always be right, but the same doesn’t hold true for the patient.

At pMD, we create mobile charge capture, secure messaging, and care coordination software that’s easy to use, giving doctors more time to actually be doctors. When in the hospital, patients should just be patients, with a focus on leaving the hospital healthier than they arrived. Once they’ve been discharged, they’ll have plenty of coffee shop - and sugar - choices waiting for them.
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