Incentives to increase patient satisfaction:
Are we doing more harm than good?
Jan Frost
Beachnut University

Incentives to increase patient satisfaction: are we doing more harm than good? Over the past several years, a growing trend in health care has been to adopt a consumer-oriented philosophy to provided patient-centered care and maximize patient satisfaction. This focus on the patient experience has led to substantial increase in peer-reviewed literature using patient satisfaction as a metric (Lee, Tu, & Chong, 2008). The Ontario government, under the Excellent Care for All Act 2010, has legislated that all hospitals perform yearly surveys of patient satisfaction and use the results to guide their quality-improvement plans. These plans are used to determine quality improvement targets; by law, executive compensation must be linked to the achievement of those targets. In the United States, The Affordable Care Act includes the provision that up to 1% of Medicare reimbursements be redirected from hospitals with low satisfaction scores to those with high scores (Geiger, 2012). The push to deliver patients who report being satisfied is changing how the principle of patient autonomy is interpreted; self-determination (the patient’s right to accept or reject proposed treatments). The struggle between true patient-centered care (patient engagement within the process of evidence based medicine) and patient-directed medicine is readily apparent in the internet age where patients increasingly have specific requests for care based on their own information gathering, which may not be evidence-based or clinically warranted. In attempts to increase patient satisfaction, we may be establishing frameworks that actually cause harm (Detsky & Shaul, 2013). HFMA will roll out new initiatives intended to create transparency and build bridges