I recently read an interesting article about how inserting an element of competition to the health care system might improve customer service. Proponents of this notion often suggest that compensating physicians based on patient ratings would help to push health care models into the 21st century, drive “poor performers” out of the system, encourage more patient-centred care, and would ultimately improve the quality and efficiency of care.
It seems to me this is based on the mistaken assumption that good customer service equals quality care and a good customer service rating is a basis on which to build a compensation model. If patients are highly satisfied with their care experience (short or no wait times; lovely people behind the front desk; – generally a lovely outing), they would give the physician higher ratings and referrals to neighbours and friends, etc. Competition on the patient experience scale would result in a flow of patients to the “best” providers, a basis on which to reward the best physicians with enhanced compensation, and pressure on all providers to put more effort into ensuring their patients are happy. It’s a tempting argument.
Certainly there is no excuse for treating patients badly. Rude staff, long wait times, less than pleasant waiting rooms, or rushed medical exams do not engender confidence in the system. Keeping patients happy, through polite and respectful dialogue, respect for their time and clean and comfortable waiting rooms should be a no-brainer. Simple courtesy demands a minimal level of service.
But let’s not confuse patient satisfaction with the quality of care. There are too many other factors that must be considered. To suggest that physician compensation should be linked to patient ratings and rankings, or to a popularity score, equates happy patients with healthy patients. Not necessarily a truism.
Patient satisfaction scores might be one component of quality. But we need to be clear about how much weight we attach to that and what other components of quality need to be included in our assessment.
Yes, we may rank our most popular retailers on customer service, low prices and short lineups. But let’s not mistake those features for product quality. Not in retail, and certainly not in medical care.
