Tread carefully on measures for patient satisfaction

Regarding the recent online commentary “Yelp CEO says online reviews could beat 'gold standard' healthcare measures," patients' perceptions of their care do have value, and their complaints can be drivers for systemic change. A key word is “perception.” And reality for many people is their perception.

Platforms such as Yelp can be a good source of information on physicians and hospitals. And now Medicare is tying reimbursement to patient-satisfaction surveys. Personally, I have misgivings about placing so much emphasis on making patients happy. A hospital is not a hotel nor a theme park.

Many of these ratings are clearly subjective. Certain hospitals with superior scores in clinical measures and outcomes suffer from bad patient reviews. A person can have a great clinical outcome but perhaps clash with the person at the front desk. Maybe a person really wanted 60 tabs of Vicodin but only got 800mg ibuprofen. So they give a bad review.

We need to tread carefully with patient-satisfaction measurements regardless of where and how they're collected.

Steve Sisko

Healthcare data, technology and services consultant Gilbert, Ariz.

Regarding the June 13 commentary “Growth in evidence-based care offers best hope to eliminate medical errors," I am really quite tired of hearing that providers must practice evidence-based care. First, evidence is mixed on many fronts. Second, patients often demand care even when a provider knows it isn't indicated or useful. Oh, and third, we have a fee-for-service system that makes it virtually impossible to practice evidence-based care.

Until the payment system changes, there is no point in jawboning providers to practice evidence-based medicine. The reward for practicing that kind of care today is that providers have better outcomes, lower costs—and they go out of business. What a wonderful plan.

Steve Williams

Grand Rapids, Mich.