Patient satisfaction and health outcomes

Satisfied with your doctor?

The research

The results

What to do?

References

Satisfied with your doctor?

Doctor satisfaction is not always in a patient's best interests. Often, when a doctor gives you a prescription, it will do you more harm than good (after taking into account the side-effects and long-term effects). Did you ask for an antibiotic and get it? Just because you left the surgery with something (a prescription, a medicine, some tests booked) does not necessarily mean that you can expect a better health outcome.

A study (1) showed that those patients who reported being the most satisfied with the services and care provided by their doctors are actually more likely to die than patients who report low levels of satisfaction.

The research

The study examined the patient satisfaction surveys from nearly 52,000 adults. This data came from the national Medical Expenditure Panel Survey (MEPS) between 2000 and 2007. It compared the patient's satisfaction scores with variables including health care utilisation, self-rated health status, health care expenditures, prescription drug expenditures, and future mortality.

The results

People have all sorts of expectations about medical care and what they should get from their doctor. Some patients who get antibiotics from their doctor every time they visit with common cold or flu symptoms may report high levels of satisfaction simply because their doctors did something. In contrast, more competent doctors who refuse inappropriate or harmful medication in the same situation are perceived by some patients as providing a low level of care.

Patient satisfaction and good patient care are two completely different things that appear to have an inverse relationship, based on the study's findings. The study found that those patients who were most satisfied with their doctors had a high correlation with several negative indicators including higher death rates.

Results of the study showed that patients who had the highest satisfaction ratings:

• Spent 9% more on health care and prescription medications than did the least satisfied patients.
• Had a 26% greater risk of death compared to least satisfied patients.
• Perversely, when the sickest patients were excluded from the statistics, the risk of death jumped to 44%. This shows that if you are reasonably healthy, then visiting a doctor is even more risky.

What to do?

The reason for the study's results is that most patients prefer that their doctors do more rather than less, even when doing less actually benefits the patient. (2) Patients may misguidedly feel that they are being well-cared for when they are getting plenty of diagnostic tests. For example, getting too many mammograms may make many women feel empowered against breast cancer, but have actually been shown to cause it. The dangers of excessive x-rays or radioactive traces go without saying. The more a patient is over-tested, the more false diagnoses are likely to occur.

The same is true for pharmaceutical drugs, which many doctors hand out whenever their patients report even the slightest pains or discomforts. Most patients report higher satisfaction from doctors who simply dispense them pills, as opposed to doctors that tell them to get more exercise, take time to relax or slow down, and eat better.

"Make time for your health, and you will gain many additional youthful years. If you have no time to spare, your ill health will take that time anyway." This is the opening sentence in the first chapter of my ebook Grow Youthful.

You are in an empowered position if you have done your own research into your ailment, and have an idea of its real causes and the range of remedies and treatments that are available. Prevention and healing are much more likely if you are willing to take full responsibility and do whatever needs to be done, rather than putting that responsibility on your doctor, who may only have had limited time to talk with you, and who may have limited options (apart from pharmaceuticals) in the surgery.

References

1. Joshua J. Fenton, Anthony F. Jerant, Klea D. Bertakis, Peter Franks. A National Study of Patient Satisfaction, Health Care Utilization, Expenditures, and Mortality. Archives of Internal Medicine. 2012;172(5):405-411.

2. Rachelle Buchbinder, Ian Harris. How Doctors are Betraying their Oath. NewSouth, 2021.