Does a Good Clinical Outcome Equal High Patient Satisfaction?

Evaluating the success of a surgical procedure can be challenging. An orthopedic surgeon may consider a surgery to be successful if the patient's pain levels and activity improved post-operatively and the patient did not suffer any complications. The patient may consider the same surgery a failure if their surgeon was impersonal or their hospital experience was unpleasant. As such, the patient and the surgeon may not have the same indicators of a "successful" surgery. This leads us to explore how a patient's satisfaction with their procedure is correlated with the outcome of the procedure.

Although it has been suggested that improved health outcomes are associated with high patient satisfaction, this relationship has not been universally agreed upon.1-4 As such, the debate continues over the use of patient satisfaction ratings as a marker for quality-of-care and healthcare outcomes.

A patient’s satisfaction can be affected by a variety of factors. These factors may or may not be directly related to their surgery. For example, a hospital undergoing a renovation may cause higher traffic congestion that frustrates patients visiting the hospital. Or, perhaps a hospital experiences low nursing staff levels and patients have to wait longer for their care. These two frustrating scenarios may result in low patient satisfaction scores, despite the patient obtaining a good clinical outcome (e.g. resolution of pain, return to recreational activities). In some cases, a patient with underlying depression may not feel satisfied after surgery, despite a clinical success. Clinical outcomes may not directly correlate with a patient’s overall satisfaction and healthcare systems should be aware of these findings. The opposite is also true. A patient may be highly satisfied with their care, despite suffering a complication (e.g. blood clot), if their treatment team provides the appropriate supportive and follow-up care. By many established healthcare standards, however, a postoperative blood clot would be considered an unfavorable clinical outcome.

Ultimately, achieving a successful clinical outcome may be of utmost importance. However, we cannot assume that, just because the outcome is favorable, the patient is also satisfied with their care. It is important that the surgeon and treatment team realize that patient satisfaction is not directly tied to their clinical outcomes. Surgeons who acknowledge this and implement new strategies to engage their patients and improve the experience for their patients will be leaders among their peers as we transition to a new era of healthcare.