(Not ME/CFS-specific) "Patient Satisfaction Is Overrated"

[Dolphin]

More a general issue in health than specific to ME/CFS but I find it an interesting topic:

Patient Satisfaction Is Overrated

William Sonnenberg, MD

March 06, 2014

http://www.medscape.com/viewarticle/821288

 

[Dolphin]

I highlighted the following on another thread before:

Patient satisfaction with anaesthesia care: what is patient satisfaction, how should it be measured, and what is the evidence for assuring high patient satisfaction?

Best Pract Res Clin Anaesthesiol. 2006 Jun;20(2):331-46.

Heidegger T, Saal D, Nuebling M.

Source: Department of Anaesthesiology, Cantonal Hospital St Gallen, Rorschacherstrasse 95, 9007 St Gallen, Switzerland. thomas.heidegger@kssg.ch

Abstract

Patient satisfaction is a part of outcome quality.

Many theories of satisfaction include patients' expectation.

One definition of satisfaction is therefore the degree of congruence between expectation and accomplishment.

The involvement of patients as well as experts is therefore an important step in the development of an instrument to measure patient satisfaction.

Results of single-item ratings or overall satisfaction surveys are over-optimistic and do not represent the true indication of care.

The construction of highly standardized (psychometric) questionnaires should include elements of content validity, criterion and construct validity, reliability and practicability.

Based on the few available studies in anaesthesia, patient satisfaction is primarily determined by information and communication.

There is great potential for improvement in this area.

However, we do not know the best way to continuously improve patient satisfaction with anaesthesia care, or to what extent decisions should be shared between the anaesthetist and the patient.

PMID: 16850781
[PubMed - indexed for MEDLINE]

Extract:

In the case of patient satisfaction, most studies [14,40] have shown that questions simply relating to overall satisfaction are not adequate: first, because they lead to highly skewed distributions with over-estimation of satisfaction; patients are notoriously satisfied (strong ceiling effects) when asked in a general way only, but we know that they will report deficits beyond this when we ask in a more concrete manner. And second, such overall satisfaction questions do not help in formulating improvement strategies; one only knows that 97% of the patients are satisfied and 3% are dissatisfied, but not what should be improved.

14. Fung D & Cohen MM. Measuring patient satisfaction with anaesthesia care: a review of current methodology. Anesthesia and Analgesia 1998; 87: 10891098.
40. Jenkinson C, Coulter A, Bruster S et al. Patients experiences and satisfaction with health care: results of a questionnaire study of specific aspects of care. Quality and Safety in Health Care 2002; 11: 335339.

The PACE Trial investigators have sometimes referred to the relatively high satisfaction ratings they obtained.

 

[Snow Leopard]

The question isn't really whether "satisfaction" is important, but whether this can be captured properly with a few questions in a questionnaire at a single point in time...

 

[Hope123]

More a general issue in health than specific to ME/CFS but I find it an interesting topic:

http://www.medscape.com/viewarticle/821288

One of my former bosses is an expert on surveys and outcomes. He told me that satisfaction surveys are skewed as the act of simply asking patients (or customers) about their satisfaction is often enough to increase satisfaction in and of itself. [This is a great marketing technique in fact.]

Another problem with satisfaction in the healthcare field is unless the survey is well put together, satisfaction may have nothing to do with quality of medical care. Patients have and do judge satisfaction based on factors as disparate as having to pay for parking, whether the receptionist treats them politely, and how clean/ stylish the waiting room is.

In fact, several years ago, researchers showed that patients were willing to switch docs based on higher parking rates at one facility and indeed, I saw this happen in the place I used to practice. We'd get "spillover" patients from the big city to our north because our parking was free and our city branch charged for parking.

So for an overall pic, satisfaction is worth look at but not if the question is about quality of medical care, which it is being used as a measure for in some instances now in the US.

Here's one post from Hopkins: http://www.hopkinsmedicine.org/news...tay_does_not_reflect_quality_of_surgical_care

And for those interested, the New England Journal of Medicine had a recent article last year on this topic.

 

[Esther12]

Also, I was perfectly satisfied with my medical care at first... virus knocks you about, but nothing to worry about as gradually increasing exercise reconditions body and teaches brain that the fatigue is not a real problem that needs to be paid attention to... it was only after finding that this didn't work for me my satisfaction dropped... and it was only years later, on reading more medical papers and seeing how vile and manipulative this initial 'management' was that I was truly able to assess my satisfaction with their care.

 

[Dolphin]

Also, I was perfectly satisfied with my medical care at first... virus knocks you about, but nothing to worry about as gradually increasing exercise reconditions body and teaches brain that the fatigue is not a real problem that needs to be paid attention to... it was only after finding that this didn't work for me my satisfaction dropped... and it was only years later, on reading more medical papers and seeing how vile and manipulative this initial 'management' was that I was truly able to assess my satisfaction with their care.

Yes, good points.
When medicine is privately paid for on an appointment-by-appointment basis, as happens with a lot of systems, or with complementary medicine, people will generally (not always) need to feel satisfied or they won't keep paying. But it's not a true picture of long-term satisfaction with treatment.

 

[Esther12]

Yes, good points.
When medicine is privately paid for on an appointment-by-appointment basis, as happens with a lot of systems, or with complementary medicine, people will generally (not always) need to feel satisfied or they won't keep paying. But it's not a true picture of long-term satisfaction with treatment.

This also creates incentives to provide 'treatments' able to provide certain types of emotional, short-term 'satisfaction', regardless of whether they really serve to improve people's health.