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The Paradox of Patient Satisfaction - the Less Satisfaction the Better!

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"Satisfaction guaranteed (or take your love back)" sang Harold Melvyn with gusto during my halycon days as a disco DJ.

I am not sure the crowds would have boogied with quite as much gusto if Harold and his Blue Notes had been crooning "Satisfaction guaranteed (at your own risk)".

Yet that seems to be the message the health care industry has us dancing to, according to data just published in the Archives of Internal Medicine.

Those patients who are most satisfied with what their doctors provide are more likely "to be hospitalized, accumulate more health-care and drug expenditures, and have higher death rates than patients who are less satisfied with their care", according to a UC Davis newsletter on the study.

And this was not because they started out sicker. The figures indicate the reverse. On average, the more satisfied patients started out with better physical and mental health than those less satisfied. In addition, even among patients who were healthier there was "a stronger association" between high satisfaction and an increased risk of dying.

Which could hardly be described as a satisfying outcome to those seeking better health!

The study's lead author Dr Joshua Fenton points out: "Patient satisfaction is a widely emphasized indicator of health-care quality, but our study calls into question whether increased patient satisfaction, as currently measured and used, is a wise goal in and of itself".

He goes on to explain how time constraints and use of incentives encourage and reward physicians for pandering to choices "which may expose patients to risks without benefits".

The desire of the vast majority of physicians is doubtless to get their patients the most helpful care. And Fenton reasonably suggests that it is success in accomplishing that goal which should became the measure of "patient satisfaction".

But is that single adjustment to the status quo sufficient? Beyond such careful consideration of how to improve the provision of medical care, are doctors also struggling with a challenge common to every materially based system - namely the ordering of cause and effect?

The materialistic approach to life says "when I get what I want then I will be satisfied" and then pushes to achieve that.

A God-focused approach says "I am created whole and complete and by coming alive to that fact I will find myself better attuned to recognise and experience what I really need".

That's a model articulated by Jesus. He said seek "the kingdom of God" first and then you will find that you have the "other things you need".

This wasn't a call to a monastic life nor a request to invest hope in an afterlife of future rewards. He was pinpointing the need to exchange a more chaotic matter-focused consciousness for a divinely ordered one in the here and now of everyday life. In other words, by gaining an inner assurance that all is well spiritually the present availability of good becomes evidenced practically.

What might that mean in terms of health care?

What if "patient satisfaction" were not viewed as an attitude towards medicine but as a quality of mind that is medicinal itself?

Surveys over the years have indicated that qualities which make up a satisfied mind - such as love, kindness and forgiveness - tend towards health. On the other hand things like fear, bitterness and resentment steer us in the opposite direction. That means we can improve our health outcomes by more habitually nurturing the kind of thinking shown as foundational to the well-being we seek.

That has proved of value to me in dealing with sickness since finding a more spiritual groove towards the tail-end of those disco days.

Fenton recommends that the reason patients are considered satisfied should be changed. It should be "because their physicians guide them toward the best care and not merely because they provide tests or treatments that may do more harm than good".

Could that "best care" include attending to the deeper need we each have to feel unconditionally at peace within ourselves?

If so, it is likely that patient demand for tests and treatments - which can "do more harm than good" - will lessen, to the benefit of the patients in question.

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