Keeping Patients Happy Hurts Outcomes as Costs Rise
Patients are more satisfied when doctors give them what they want, though it’s not always the best treatment strategy, a study suggests.
Healthy outcomes didn’t correlate with satisfaction in a study that surveyed more than 50,000 people nationally from 2000 to 2007. Patients who were the most satisfied spent more on care and medicine, compared with the least content, according to the report published today in the Archives of Internal Medicine. They also were 26 percent more likely to die.
Patient satisfaction is increasingly used as a metric for quality of care, boosting doctor pay and health insurer loyalty, the researchers said. Doctors are paid for each service they provide, so they aren’t encouraged to consider whether a service is necessary, said Joshua Fenton, the study’s lead author.
“We may be encouraging spending money on health care that ultimately is harmful to our population,” Fenton, an assistant professor of family and community medicine at the University of California, Davis, said in a telephone interview. “In our system, so much focus is on consumption, which can mean treatment with more risk than benefit.”
Doctors urged to make patients more satisfied may not bring up topics that challenge or disturb them, such as substance abuse, the researchers wrote in the study. The physicians also may fail to emphasize the risks when patients ask for tests that are medically unnecessary, the authors wrote.
“Patients do make requests of physicians, and physicians often honor those requests,” Fenton said. “Satisfaction is not linked to quality of care.”
Those patients who were most satisfied among four groups ranked by satisfaction spent about 9 percent more on health care and prescription drugs. While use of emergency rooms was lower for the group, inpatient admissions were higher, the researchers found.
To contact the reporter on this story: Sarah Frier in New York at sfrier1@bloomberg.net;
To contact the editor responsible for this story: Reg Gale at rgale5@bloomberg.net
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