Why Patient Satisfaction Metrics Are Failing Healthcare
Joshua Tamayo-Sarver, MD, PhD, FACEP, FAMIA
A few years ago, I found myself watching a report (https://www.linkedin.com/posts/ericbrickermd_love-hate-hospitalsystems-activity-7167840837157019648-EiAg?utm_source=share&utm_medium=member_desktop&rcm=ACoAAA0vFnYBqCa-qlqXvvTVNNJ1eRpUa8Gj2d8) on patient satisfaction with their physicians that should have been reassuring but instead left me deeply unsettled. It was a patient satisfaction survey for a group of physicians, and even the lowest-ranked doctors, those in the bottom 10%, had 70% of their patients rating them a perfect five out of five. On paper, this looked like a triumph. But when juxtaposed with the overwhelming sentiment from patients that the healthcare system as a whole was broken, the disconnect was glaring. How could individual physicians be rated so highly while the system they operate within is universally criticized? This paradox is emblematic of a deeper issue: patient satisfaction metrics are not telling us what we need to know.
The Problem with Measuring “Satisfaction”
Patient satisfaction surveys have become ubiquitous in healthcare, often driving decisions about care delivery, physician incentives, and even hospital funding. While these surveys might seem like a logical way to assess quality, they are fundamentally flawed for several reasons:
1. Misaligned Goals: Satisfaction metrics often prioritize how patients feel about their interactions with providers rather than whether their healthcare needs were met. This focus on likability over efficacy creates a system where bedside manner can overshadow clinical outcomes.
2. The Halo Effect: Patients tend to rate individual providers highly, even if their overall experience with the healthcare system is negative. This phenomenon — where patients separate their feelings about doctors from their frustrations with systemic inefficiencies — renders satisfaction scores almost meaningless as a measure of systemic performance.
3. Perverse Incentives: In an effort to boost satisfaction scores, healthcare organizations may implement changes that prioritize superficial improvements (like shorter wait times or more comfortable facilities) over substantive reforms that address deeper issues such as accessibility or care coordination.
A Better Way to Measure Success
If patient satisfaction surveys aren’t cutting it, what should replace them? The answer lies in shifting our focus from how satisfied patients are to whether their needs were met. This approach requires asking different questions — ones that probe the outcomes patients were seeking and whether the healthcare system helped them achieve those outcomes.
Here’s how we can reframe our metrics:
• Ask About Goals: Instead of asking patients how happy they were with their visit, ask them what they were trying to accomplish and whether they succeeded.
• Identify Barriers: Follow up by asking what obstacles prevented them from achieving their goals and what could have helped them overcome those barriers.
• Focus on Systemic Solutions: Use this data to identify patterns and implement changes that address recurring issues across the system.
This shift would allow us to design healthcare systems around meeting patient needs rather than chasing higher satisfaction scores.
Lessons Learned from Misguided Metrics
Reflecting on my own experiences as both a physician and an innovator in healthcare technology, I’ve seen firsthand how misplaced priorities can derail progress. For example:
• Care vs. Connection: Efforts to improve patient satisfaction often emphasize building rapport between providers and patients. While this is important, it shouldn’t come at the expense of addressing clinical needs or systemic inefficiencies.
• Data Blind Spots: Satisfaction surveys rarely capture actionable insights about what patients actually need from the healthcare system. As a result, we end up optimizing for metrics that don’t align with meaningful improvements.
These lessons underscore the importance of redefining success in healthcare — not as a measure of popularity but as evidence of impact.
A Call to Action
The time has come for healthcare leaders to stop chasing satisfaction scores and start focusing on what really matters: meeting patient needs and improving outcomes. This shift won’t be easy, it requires rethinking entrenched practices and challenging longstanding assumptions, but it’s essential if we want to build a healthcare system that truly serves its purpose.
Let’s stop asking patients if they like us and start asking them how we can help them achieve their goals. Only then can we transform our broken system into one that delivers meaningful care for everyone.
Dr. Joshua Tamayo-Sarver, MD, PhD, FACEP, FAMIA, develops and deploys technology solutions in the healthcare ecosystem as a clinician, business leader, software engineer, statistician, and social justice researcher. As the Vice President of Innovation at Inflect Health and Vituity, his unique formula of skills has helped develop over 35 solutions and scale multiple new healthcare products, including the first AI occult sepsis tool with FDA breakthrough designation. Dr. Tamayo-Sarver oversees corporate venture, internal incubation, and advisory services for AI-driven healthcare solutions, blending consumerism and clinical quality to fit the delicate balance of patient desire, user experience and quality medical care. A Harvard graduate, he holds degrees in biochemistry, epidemiology, and biostatistics, as well as a medical degree from Case Western Reserve University. He is a Mentor in the Emergence Program at Stanford University.
