Dying to be Satisfied

I read an interesting article the other day about a correlation between very high patient satisfaction scores and poor patient outcomes.  Meaning that there seems to be a link between people who rate their experience at a hospital as super great and things not going so great for them.  Sounds odd on the surface.  But the researchers conclusions had to do with the fact that what people want isn't always what is good for them, and if you give it to them anyways, they may be happy with you for it and pay the price.

For example.  Antibiotics don't treat viral infections. Like the majority of cases of bronchitis. But if you come to the ER and have even what sounds like it's most likely viral bronchitis, you're going home with a script for antibiotics. Why?  You came all that way, you waited in the waiting room, you told us in great detail how miserable you are, and you are not going to be happy with a doctor who tells you to keep on taking over the counters for symptom relief, which you were already doing before you incurred a 150$ ER copay.  And you will mark a low box for customer satisfaction, even though you were treated appropriately.  But if your doctor gives you a prescription, your trip feels vindicated. You have bronchitis for crying out loud and now you will finally be treated and cured with the magic pills. Oh, and get a yeast infection. Oh, and contribute to antibiotic resistant mega-bugs.  But you will be marking the high box for how satisfied you were with your care.

It makes me think a lot about parenting.  A parent's job is to teach a child what is good for them because they don't know it themselves yet.  The parents knows more about how the world really works and what their kid needs to do to survive and thrive.  If my kids were filling out surveys about how satisfied they are with my parenting, you can bet they'd be checking more top boxes if I pushed bedtime back, allowed some jelly beans for breakfast and oreos for lunch and made all milk the chocolate variety, and if I never made them share their toys or pick up after themselves.  And then they'd turn into tired, overweight, diabetic, entitled, lazy shmucks. But in the process of becoming such, their parent satisfaction scores would soar.  What if we allowed that to drive how we parent our kids?

Not that patients are like children.  But they come to medical professionals because we know stuff about medicine and the body that the average person doesn't know.  And we are responsible to use that knowledge to help people get what they really need - even when they are convinced it's something else.  Even when they storm that they are not getting the care they deserve because you won't treat something with a medicine that won't work anyway or expose them to radiation that they really don't need even though they think they do and will feel like you were very thorough for doing it.  Even when doing the right thing will result in people being less satisfied with you.  Because a lot of times that's the way it goes.  Take Good Friday.