I see a lot of practitioners online justify their treatment choice with the idea of ‘my patients are very happy with it’. But is that reason enough to do it? Do happy patients do better?
The simple answer is… NO!
While you don’t actually want to piss off your patients, using their satisfaction as a marker of a good treatment option is unwise for many reasons. Number one being that a patient’s satisfaction can be influenced by unrealistic expectations or ideas about quick fixes or simple solutions that require limited time or energy invested. Or that they don’t need to change their behaviour to get a good outcome.
To provide the best care you may have to impart uncomfortable truths, or shatter the idea of ‘quick-fixes’, which will have a direct impact on patient satisfaction.
The most prominent example of this is exercise and diet. We know that changing your diet and exercising more is the best advice for many patients, yet how many people are satisfied with this advice?
And we see this in the data as well. Patient’s who were more satisfied with their care had higher health care costs and were more likely to die then their less satisfied counter-parts. (“The cost of satisfaction: a national study of patient satisfaction, health care utilization, expenditures, and mortality.” https://www.ncbi.nlm.nih.gov/pubmed/22331982).
A patient may love getting a massage for their ‘tight calves’ and love coming to see you for it, but that doesn’t mean it is recommended they do so. We know it isn’t the most effective treatment or efficient use of health care.
Now a patient may choose less effective care. The ethical dilemma here is whether they’re making an informed choice. Do they know they’re receiving low value healthcare and what is our role in facilitating a shift to higher value care?
These are difficult questions to answer and do depend on context. However, what we know is that just because a patient likes their treatment, doesn’t mean it is a good treatment.
Remember, those who are happy with treatment are more likely to die.
“The Problem With Satisfied Patients” https://www.theatlantic.com/health/archive/2015/04/the-problem-with-satisfied-patients/390684/