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Are patient experience and happiness the same thing?

Patient satisfaction is undoubtedly a much debated topic in the health practitioner world. It is an obviously complicated and complex issue that elicits many different opinions, many of them very passionate ones. The passion over the topic is understandable as healthcare is currently undergoing massive changes, including tying a larger percentage of doctor pay directly to patient satisfaction.  There has been a recent influx of articles suggesting that patient satisfaction doesn’t work, that it is holding back advances in care, and that it is even tied to higher death rates (a handful of articles have referred to a study showing higher patient satisfaction was correlated with higher mortality rates. Thankfully correlation isn’t causation; otherwise a doctor’s goal would be to provide poor care).

Of course, patient satisfaction is far from perfect. Therefore, we should try to improve it as opposed to damn it. At its core, patient satisfaction attempts to measure the patient’s overall experience.  One way to improve patient satisfaction is to understand what it is NOT (or should not be). Patient satisfaction (or experience) is not patient happiness. Though, happiness is part of the overall experience.

Dr. David Tilstra makes a great point in a recent article differentiating patient experience and patient happiness:

“Patient experience is not to be confused with patient happiness. We are not Disney World: We are a health care delivery system. Everything we do will not make people happy, but they still can be satisfied and can have a good experience with their health care.”

An unhappy patient doesn’t necessarily always make for an unsatisfied one – a hospital is not a restaurant. At the same time, patient happiness is still part of the overall experience. Dr. Tilstra goes on to explain that by correctly prioritizing the levels of care provided, the patient experience is improved. The three levels of prioritized care Dr. Tilstra outlines are: patient safety, providing high quality care, and delivery of care. All three contribute to a patient’s overall experience. The last level – how care is delivered – is usually associated with patient happiness. Therefore, patient happiness is a part of the equation, but at the bottom of the three priorities.

The point is not to sacrifice safety and quality of care in the name of patient happiness – in other words, making sure the patient is happy at all costs is never in the patient’s best interest. With the large amount of significance placed on patient satisfaction it is easy to lose focus on the most important part of the equation: providing high quality care (sometimes at the expense of patient happiness). I am convinced that if a health system focuses on patient safety and quality care, the patient will have a positive experience. The goal is to perform all three priorities of care exceptionally, but remember that (the first) two outta three ain’t bad.

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