Patient input in their treatment should be valued by doctors

Thanks all who responded to my recent USA Today piece, Patient-satisfaction surveys have drawbacks.

But in a letter published in the paper yesterday, a reader from Oklahoma City was quite unhappy with my take.

Mark R. Heaton writes, somewhat angrily:

Dr. Kevin Pho’s recent opinion piece was not only arrogant but also grossly naive.

His basic premise was twofold:

• Doctors know best and should therefore ignore patient feedback regarding possible tests and treatments.

• Patient-satisfaction surveys should not affect doctors’ pay.

Frankly, it comes as no surprise that Pho’s arrogance regarding patient feedback (about the patient’s own care) would translate directly to poor patient-satisfaction scores and lower pay for the doctor.

Welcome to the real world, doctor.

No profession is 100% fail-safe (after all, it is called medical “practice” for a reason).

Even the world’s best surgeons should not presume they are qualified to start swinging a scalpel at someone without first considering all the feedback from the patient regarding his care.

The patient will be the only one living with the outcome of a prescribed treatment, so the doctor should at least respectfully consider tests and treatment options that patients would like to discuss.

If the concepts of a free market and customer service are so offensive to Pho, then I recommend he consider changing professions.

Thanks for the response Mark, I appreciate it. I’m going to overlook the ad hominem attacks, chalking it up to your rightful frustration with our health system.

Upon re-reading my column, you’ll find that I indeed support patient feedback, and in fact, wrote that it’s essential to improving physician practice: “Gauging patient sentiment with satisfaction scores is a useful way to point out deficiencies and improve the patient experience,” and, “Satisfaction scores give patients a needed voice to express their concerns, which can help medical professionals improve their patient relations.”

So when you say that I believe “doctors know best and should therefore ignore patient feedback regarding possible tests and treatments,” that’s simply wrong.

I continue to believe, however, that it’s a mistake to tie a doctor’s salary to how well he scores on patient surveys. Multiple studies, which are cited in the piece, show that there is little correlation tying quality care with high satisfaction scores.  Giving a financial motive to “treat to the satisfaction score,” doesn’t necessarily promote the best medical care.

But when you write, “the doctor should at least respectfully consider tests and treatment options that patients would like to discuss,” I absolutely agree with that. Decisions shared between both the doctor and patient form the basis of an ideal relationship. Discussions like these take time, which is in short supply as doctors are pressured to see more patients during the day.

Moving forward, it’s imperative that health reformers recognize that time needs to be better valued, in order to better utilize patients’ input in their own health.

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