Should patient satisfaction influence physician compensation?

One bane of emergency physicians are patient satisfaction scores, which some hospitals use in part to determine physician salaries.

Often times, if patients are denied, say, opioid medications, they’re more likely to give low scores, which the hospital administration can then use to penalize doctors. Of course, this creates an incentive to give patients everything they want, sometimes to the detriment of good medicine.

But Shadowfax, an emergency physician-administrator, delves deeper into how his group uses these scores, and finds that, in most cases, low scores were correlated with valid patient complaints. Long waiting times and whether the medical staff listened to patients, for instance.

He goes on to detail his hospital’s turnaround, which required cooperation with hospital administration: “There may be a need for additional resources: If the ER is so understaffed that nurses can barely provide safe patient care, it’s going to be hard for them to spend time getting warm blankets. If half the beds are full of boarded patients, then wait times will remain long and scores will never improve.”

In order to improve, there has to be some kind of quantitative yardstick, and patient satisfaction scores provide one way for doctors and hospitals to measure year to year gains. But it’s an imperfect tool, and as such, should only be used in conjunction with other means of evaluation.