Does a Good Clinical Outcome Equal High Patient Satisfaction?

Evaluating the success of surgery can be challenging. While an orthopedic surgeon would consider surgery to be successful if the patient is active again, the patient may consider the same surgery a failure if their surgeon was impersonal, or their hospital experience was unpleasant. It goes without saying, the patient and the surgeon may not be on the same page.

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 which in turn frustrate patients. Another example is low nursing staff levels, where patients have to wait longer to be cared for. 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). Moreover, a patient with underlying depression may never be satisfied after surgery, despite a clinical success. The clinical outcome does 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 care. By many standards, a postoperative blood clot would be considered an unfavorable clinical outcome.

Yes, at the end of the day, 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. Surgeon’s who acknowledge this and implement new strategies to engage their patients and explore their patient’s desires will be leaders among their peers as we transition to a new era of healthcare.

Kevin Campbell