Mixed Messages on Patient Satisfaction

This article appears in the August 2012 issue of HealthLeaders magazine.

Does high patient satisfaction equal a good patient experience? Healthcare leaders are usually of two minds about HCAHPS scores. The attention that their organizations must now give to obtaining high marks from patients smacks too much of car sales, where salespeople have to hustle for every transaction to be marked "excellent" in order to get paid. Healthcare increasingly looks to hotels and airlines for models of customer service (as detailed in our cover story).

But hospitals aren't hotels. By now you've probably heard about the study by UC Davis Health System researchers showing that the most satisfied patients also have higher hospitalization and mortality rates and rack up higher healthcare bills. That's the worst of perverse incentives. The researchers speculated that caregivers for these patients may be acceding too much to patient expectations—for tests, prescriptions, and the like—and avoiding unpleasant subjects such as weight loss or substance abuse.