Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Patient satisfaction surveys are worthless. Here’s why.

Skeptical Scalpel, MD
Physician
January 17, 2018
1K Shares
Share
Tweet
Share

For several years, Medicare has tied hospital reimbursement to its definition of quality of care. Poorly performing hospitals can be penalized as much as 2% of their Medicare payments.

As part of Medicare’s assessment of quality, surveys are used to measure patient experience and satisfaction. One of the components of the Medicare survey is pain management, which Medicare describes as follows:

I’m not sure who, if anyone, does Medicare’s copy editing, but that’s the way it looks in a screen grab from the website. The emphasis on “always” controlling pain, which many patients equate with “no pain,” is one reason we have an opioid epidemic.

How valid is patient satisfaction as a measure of quality? Some conflicting research has been done, but a recent paper from JAMA Internal Medicine implies the answer is “probably not valid.”

Researchers from the Department of Family and Community Medicine at the University of California, Davis surveyed 1141 patients immediately after they made 1319 visits to 56 different family doctors; 897 visits involved one or more patient requests with 1441 (85%) fulfilled. The authors did not comment on that percentage, but acquiescing to 85% of patient requests seems quite high.

From 10% to 18% of patient requests for pain medication, referrals, laboratory tests, and new medications other than antibiotics or pain medication were refused and resulted in statistically significant decreases in patient satisfaction of 9 to 20 percentiles after the results were adjusted for numerous patient characteristics known to affect patient satisfaction such as age, sex, race/ethnicity, education, marital status, body mass index, overall self-rated health, mental health status, personality factors, life satisfaction, worry about symptoms, prior visits with the clinician, and my personal favorite—medical skepticism.

Refusals of patient requests for radiology tests, antibiotics, other tests, occurred in 34%, 14%, and 9.5%, respectively, but these denials did not cause significant decreases in patient satisfaction percentiles.

Antibiotics were requested only 107 times — a small sample size, which may account for the lack of association with lower patient satisfaction ratings. The authors suggested clinicians might have more experience denying antibiotic requests because of recent emphasis on this topic.

They felt that a solution to the problem of lower patient satisfaction after denial of requests could be addressed by “targeted clinician training in brief communication techniques to address patient requests.” This training could be based on creating a positive patient experience while denying inappropriate requests such as adopting what they called a “wait and see” approach when a patient asked for something that the clinician did not think was indicated. Whether patients would be satisfied with that strategy is unknown.

Another option the authors did not consider might be to educate the patients about realistic expectations and the costs associated with unnecessary care.

In my opinion, an even better solution would be to abolish patient satisfaction surveys.

“Skeptical Scalpel” is a surgeon who blogs at his self-titled site, Skeptical Scalpel.  This article originally appeared in Physician’s Weekly.

Image credit: Shutterstock.com

Prev

Bad things happen to every doctor

January 17, 2018 Kevin 0
…
Next

A physician cancels his life insurance policy. Here's why.

January 18, 2018 Kevin 3
…

Tagged as: Hospital-Based Medicine

Post navigation

< Previous Post
Bad things happen to every doctor
Next Post >
A physician cancels his life insurance policy. Here's why.

More by Skeptical Scalpel, MD

  • The hospital CEO who made a surgical incision. What happened?

    Skeptical Scalpel, MD
  • Medical error is not the third leading cause of death

    Skeptical Scalpel, MD
  • Should speed-eating contests be banned?

    Skeptical Scalpel, MD

Related Posts

  • Patient satisfaction should not be driven by poorly-designed surveys

    Stephen P. Wood, ACNP-BC
  • Physicians are trapped between patient satisfaction and unnecessary prescribing

    Richard Young, MD
  • Building a bond of trust between patient and physician

    Michele Luckenbaugh
  • More physician responsibility for patient care

    Michael R. McGuire
  • Prescribing medication from a patient’s and physician’s perspective

    Michael Kirsch, MD
  • The triad of health care: patient, nurse, physician

    Michele Luckenbaugh

More in Physician

  • How can there be joy in medicine if there is no joy in Mudville?

    Arthur Lazarus, MD, MBA
  • Physician entrepreneurs offer hope for burned out doctors

    Cindy Rubin, MD
  • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

    Elizabeth Cerceo, MD
  • Raw humanity on night float: inspiring patient encounters and overcoming challenges

    Johnathan Yao, MD, MPH
  • Revolutionizing emergency medicine: Overcoming long-term challenges with innovative solutions for physicians and patients

    Anonymous
  • The pediatric health care system tested to the limits: an inside look at the “at capacity” period during the tripledemic

    Jacqueline Bolt, MD
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

      Kevin Pho, MD | KevinMD
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • How electronic health records preserve patients’ legacies in the words of oncologists

      Marc Braunstein, MD, PhD | Physician
    • Unmasking the brutal reality of gun violence in America: a call to action for unity and meaningful change

      Osmund Agbo, MD | Policy
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • How can there be joy in medicine if there is no joy in Mudville?

      Arthur Lazarus, MD, MBA | Physician
    • Unveiling the intricate link between housing costs and health care

      Harvey Castro, MD, MBA | Policy
    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Uncovering the truth about racial health inequities in America: a book review

      John Paul Mikhaiel, MD | Policy
    • Why electronic health records are failing patients: the dark side of copy and paste [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 21 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • 'Medically Relevant to Saving the Life of Your Patient': What We Heard This Week
  • Want to Solve the Nurse Shortage?
  • Why Are Female Doctors Sued Nearly Half as Often as Male Doctors?
  • What Drug Did FDA Just Approve for COVID?
  • PET Scan for Alzheimer's Dx; Predicting Colon Cancer Survival

Meeting Coverage

  • No Access to Routine Healthcare Biggest Barrier to HPV Vaccination
  • Trial Results Spark Talk of Curing More Metastatic Cervical Cancers
  • Cross-Border Collaboration Improves Survival in Pediatric Leukemia Patients
  • Monoclonal Antibody Reduced Need For Transfusions in Low-Risk MDS
  • Less-Invasive Surgery for Pancreatic Cancer Proves Safe, Effective
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

      Kevin Pho, MD | KevinMD
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • How electronic health records preserve patients’ legacies in the words of oncologists

      Marc Braunstein, MD, PhD | Physician
    • Unmasking the brutal reality of gun violence in America: a call to action for unity and meaningful change

      Osmund Agbo, MD | Policy
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • How can there be joy in medicine if there is no joy in Mudville?

      Arthur Lazarus, MD, MBA | Physician
    • Unveiling the intricate link between housing costs and health care

      Harvey Castro, MD, MBA | Policy
    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Uncovering the truth about racial health inequities in America: a book review

      John Paul Mikhaiel, MD | Policy
    • Why electronic health records are failing patients: the dark side of copy and paste [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Patient satisfaction surveys are worthless. Here’s why.
21 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...