Monday, January 5, 2015

Patient Satisfaction. What happened to, "First, do no harm?"

Remember this study from 2012?  

The Cost of Satisfaction: A National Study of Patient Satisfaction, Health Care Utilization, Expenditures, and Mortality.

The conclusion:  "In a nationally representative sample, higher patient satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality."

Yet we continue to use patient satisfaction scores.

What happened to, Primum non nocere? First, do no harm. 

During B-school, I learned that what gets measured, gets done.  But what if the thing we are measuring is causing harm to our patients?

I get it though. I love to see happy patients who say, "Thank you!" It makes me feel good about my career. 

But I don't what that measured, especially if it's causing harm! 
If doctors are paid to please patients, how does an MD tell his patient to lose weight, quit smoking, eat right, and that antibiotics are unnecessary for their URI?

The solution is simple. 

D/C patient satisfaction scores.