Patient Satisfaction Is No Simple Equation

Sure enough, the nurses on the colorectal floor (and my wife) were diligent in making sure I was getting out of bed, walking, and doing all the things necessary to get my injured colon to work properly again. This included a minimization of my pain medications. Yes, I was a grumpy patient. I hurt, and moving around just hurt more. I didn’t want to get up regularly. I didn’t want my deep vein thrombosis prophylaxis shots; those really hurt, too. At the time, my patient satisfaction level was low. In retrospect, it was exactly what I needed to get the best outcome.

I am happy to report that I am back to my good health – but what about my patient satisfaction through this ordeal?

I would have been "happier" if I’d gone to the VIP floor. If I’d told the nurses on that floor to "come back later" for my necessary walk, they would have acquiesced. The VIP floor would likely have given me all the pain medication I wanted – regardless of the potential effect on my colon motility.

As a physician, I can reflect on my experience and recognize that doing what is easy for our patients is not necessarily in their best interest. To maximize value, we have to do what is right for them and it will not always align with their overall satisfaction. Patient satisfaction is important, and we must continue to track and measure how well we interact with our patients. We must improve how we manage expectations. But it is a mistake to link patient satisfaction with hospital and physician reimbursement.

High-value care is not simply giving our patients what they want when they want it.

Dr. Michota is the director of academic affairs in the department of hospital medicine at the Cleveland Clinic. He reports having no relevant conflicts of interest.