Death By Patient Satisfaction

Check this out. What you will see is a great, tongue in cheek piece by an ER doctor who is obviously “up to here” with “customer satisfaction” applied to U.S. healthcare. The strategy of business optimization through “CSAT,” as she points out, was readily grasped by various medical institutions in the U.S. that were trying to be profitable, or at least to survive. Adding fuel to that fire, along came Obama and the Feds who took away substantial hunks of reimbursement $$$ from institutions where surveys did not indicate that patients were not, you guessed it, satisfied.  

The result? Absurdity! But most poignantly, a major force behind the opioid crisis. A patient that wants pain killers gets them, right? Otherwise he won’t be “satisfied.”

Bottom Line. And so it goes. The goofiness of gauging the quality of medical care by the level of resultant patient satisfaction seems to me to be sufficiently obvious that eliminating these stupid metrics from the U.S. healthcare scene shouldn’t even require a second thought. But it obviously does. AND. My partner in psychological crime at ThinkGen, Dr. Neale Martin, regularly cites research that indicates that even in non-medical areas, like consumer packaged goods, CSAT predicts neither repurchase behavior nor virtually anything else of any importance.  

Will anybody ever wake up to the craziness of what is going on in CSAT-based medical care?

Stay tuned!


  • Richard, thank you for sharing Dr. Rada Jones’ dispiriting article on how an obsession with patient satisfaction is compromising the quality of patient care in the ER. And I agree that there are always going to be some patients who prioritize the variety of candy bars offered by the ER’s vending machine over what kind of care they receive but I prefer to think they’re in the minority. What about the questions that comprise these patient satisfaction surveys? Yes, it’s important that doctors in the hospital where you’re staying treat you with “courtesy and respect” as Medicare’s HCAHPS survey asks patients but what about getting the diagnosis and treatment right? As someone who had a hospital stay where they got the diagnosis wrong but somehow still got the treatment right, I would put that at the very top of the list. Why is that missing from inpatient and outpatient satisfaction surveys (except which has Accurate Diagnosis as one of the items patients are asked to rate)?

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