Are Contented Patients the Best to Be Milked as We Juggle Our Making Money vs Improving Health Agendas?

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One reads everywhere, even in these pages, that satisfied patients have better outcomes.  Indeed, health care leaders are hearing from all kinds of vendors and consultants how they need to improve patient satisfaction.

But is it really true that “satisfied with treatment” means “in better health”?  Certainly there is plausibility in such a link: how we feel affects the body as well as the mind.

woman and cowThere is an analogy, too, in organizational development, the so-called “contented cows” theory.   And there is considerable research evidence that employee engagement improves organizational outcomes, although that is not the whole story. (Then again the claim that contented cows give better milk is perhaps no more than an advertising slogan.)

Likewise, there are many studies showing that patient satisfaction leads to better outcomes.  But there are others that demonstrate the opposite.  For example, a 2012 JAMA Internal Medicine article (“The Cost of Satisfaction”) reports that “in a nationally representative sample, 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.”

Many have questioned how well patients can evaluate their own care.  A Johns Hopkins report is entitled “Patient Satisfaction With Hospital Stay Does Not Reflect Quality Of Surgical Care.”

Moreover there is much evidence that, just as teachers are concentrating on improving test scores rather than real learning, doctors are becoming more attentive to Press Ganey ratings than patient’s actual needs.  As one doctor has noted, “Practicing physicians have learned — from reimbursement systems, the medical liability environment, and clinical performance scorekeepers — that they will be rewarded for excess and penalized if they risk not doing enough.”  When it comes to our health, we are all inclined to think that nothing less than the best will do and no amount of tests and care is too much.

Another JAMA article puts it this way: patient satisfaction and patient care are necessary but not equal.  It explains research showing why more satisfied patients were actually worse off medically as the result of doctors and hospitals treating patients as consumers.

Our increasingly money-oriented healthcare system tends to produce happy patients who are like customers who are happy about their store purchase whether it was actually in their best interest or not.  Make customers happy and they will come back more.  The result can be a preference in spending on hospital television sets over, say, nurse staffing.

Satisfied patients, we are told, are “like money in the bank”.   Indeed, Cleveland Clinic (which we have praised here many times) says that it wants not satisfied patients, but “raving fans”.

We have suggested that the quest for an ideal healthcare organization should start with questions:  Maybe the first one to ask should be, “Are we in this for health or for the money?”  We invite workers in the field to ask that question in their organization and report to us what answers they get.

Jim Murphy has a solo consulting practice called Management 3000, focusing on jim murphyorganizational development and change management. Formerly he led the Massachusetts Bay Organizational Development Learning Group, was Human Resources Director for the City of Boston Assessing Department, and served as a consultant with the Boston Management Consortium.  His consulting practice includes management coaching as well as research and writing on employee relationships, leadership, healthcare and collaborative practices.  Having produced newsletters for several organizations  and being a frequent content writer for the”Confident Voices in Healthcare” blog, he is interested in writing and research opportunities, as we all consulting and coaching. www.manage2001.com   jim@manage2001.com

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4 Responses to Are Contented Patients the Best to Be Milked as We Juggle Our Making Money vs Improving Health Agendas?

  1. Pingback: Seven Questions About Seven Ways to Increase Patient Satisfaction

  2. Jane Pavey King says:

    I think the bigger picture we are missing is that insuramce companies & supposed nonprofit hospital fight for money the patient and the staff esp nursing they cut back many times to the morbitity & mortality of patients. People who become the helpless victims of corporate greed try to set it right. That’s what you are trying to do with the limited power that you have…. so are the payors (not the insurance companies. Watch sick for profit sometime) . The problem is that you cannot legislate or regulate morality or just plan doing the right thing. and as all these disjointed forces andven powetful groups try to fix corporations that in there leadership employ people in positions of power who have greed not just profit as their goal they look at the laws &regulations &any other attempts to get them to do what is aright as a letter of the law &not a spirit of the law situation. &they do their best to wriggle out of actually doing it they know its wrong while on the outside the pretend to comply but they take no real steps to change. hospital staff. Try ing to keep their jobs I have heard say to patients please don’t complain about me or Iwill get fired so they improve pt satisfactions by firing & intimidating staff…. that’s not why magnet hospitals started nor is it there goal. It was mentioned that maybe them plagiarizing your work was possibly showing you were having the desired effect… All is see within that action is the same old people in positions of power trying again to appear as if they have the right goals on they outside while on the inside still trying towriggle out of actually doing it.Why did they steal it cuz they couldn’t write because it really isn’t how they feel it is not their goal but they have to maintain the facade.

    or Iwill g

    • Jane Pavey King says:

      Sorry typed it on my phone && it won’t let me see what I’m typing so can’t even effectively edit it btw still couldnt find who did it 🙁 not that it matters its just that some are lazier about their facade than others but it’s just that end of the tv season cliff hanger thing going on & you’ve got me sucked in… I can see why they stole it…. your cander is captivating…. you made them look really good probably got a raise…. keep pulling it out into the light…..keep on keeping them honest….tear those facades down… that’s really what Jesus would do!

  3. Pingback: Watch What You Write & Publish– You May Be Surprised Where You Find It

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