Customer Satisfaction and Medical Care
A recent local news article ranked area hospitals using a customer satisfaction survey and found the smallest hospitals ranked at the top and the largest regional hospital at the bottom. Based on the newspaper article you would think that in an emergency you should head to the smaller hospital. Unfortunately the article ignored a simple fact about customer satisfaction and good medical care: they have nothing in common.
Well that’s not completely true. A 2012 JAMA study looked at patient satisfaction and found 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.” So making your patients happy may be lethal.
The hospital ranked highest happens to be the area’s largest employer, and the second highest hospital, the second largest employer. In rural communities if you don’t work at one of these hospitals chances are you know somebody who does. This fact alone could explain the high satisfaction scores.
But when you’ve been in a motorcycle accident or are having chest pain are you going to the hospital for a social outing? Numerous studies find larger hospitals have better outcomes than smaller ones. This is one reason why, when I was thrown from a dirt bike into the hard red clay last November I skipped the local hospital ranked highest in customer satisfaction and went straight to the large hospital ranked at the bottom. In metrics that matter such as positive outcomes and quality of care that hospital ranks as one of the state’s best, so it was worth driving the distance in extreme pain.
As large health care systems take over small independent hospitals and practices, many of the same tools and metrics used by corporations to judge how they are doing will be applied to medicine. A satisfaction survey makes sense if you are staying at a hotel or have made an online purchase. But when you are sick or injured all that matters is the competence of the staff treating you, and that is something that will not be captured in a customer satisfaction survey.
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