How patients judge what makes ‘excellent’ health care

Alice Walton looks at a new study of 374 breast cancer patients, finding that the women’s opinions of care received didn’t necessarily line up with the quality of care provided:

Just over half of the women (55 percent) said they received “excellent” care. But most women — 88 percent — actually got care that was considered in line with the best current treatment guidelines.

The process of obtaining medical treatment had a great influence on how satisfied patients were. Many women (60 percent) who said they got excellent care also said the process of getting the care was excellent; but only about 16 percent of women who said they got less-than-excellent care said the process of getting the care was excellent. This suggests that the ease or difficulty of obtaining the treatment in the first place has a big impact on one’s experience of the whole process.

The way the women felt they were treated by medical personnel also affected the total experience. Women who said they got “excellent” care were more likely to say they had good communication with their doctor, knew which person to go to with questions, and received excellent care by the medical staff in general. Importantly, they also felt less mistrust of the medical system overall.

There are, perhaps, two ways to read this study. One is the conclusion that Walton draws, that “patients aren’t great at figuring out if they got excellent care.” We mix up extraneous factors with the one thing that really matters: The eventual, medical outcome.

The other way, however, would be to question whether the medical outcome is, in fact, the best metric to judge the quality of care provided. These women’s responses suggest that it isn’t: Patients put value on a high-quality treatment experience that includes open communication and ease of service. This could be especially true for a more invasive treatment such as the chemotherapy provided to the women in this study.