Patient Satisfaction: Who Really Matters?

In Editorial, Opinion by Shahbaz SyedLeave a Comment

Does patient satisfaction matter? If you’re a healthcare administrator you’re likely to believe so, as demonstrated by patient satisfaction surveys, hospital greeters and increased vigilance on ensuring enhanced patient satisfaction at all levels of healthcare.

While well intentioned, the premise behind this sentiment may be misguided. There is an idea that enhanced patient satisfaction correlates to better patient care, however, we’re merely muting more deeply seeded issues. By employing measures to enhance patient satisfaction, hospital administers are creating an illusion of better care. If a patient feels that they’re being attended to – they are more likely to view the hospital in a beneficial light.

We’re often taught in residency and medical school that the number one reason for lawsuits and complaints is a lack of communication and dissatisfaction with the physician. I always facetiously interpreted this to suggest you could make many mistakes as a physician, so long as you were nice about it. I use this exaggerated analogy to suggest that efforts to enhance patient satisfaction could be viewed in the same light.

I’d instead, like to argue that a more important element to delivering excellent patient care is healthcare worker satisfaction.

Healthcare worker satisfaction

Regardless of what you do for a living, your mood on any given day may directly reflect your passion or desire for work that day (for instance, we all know Garfield hates Monday’s). The same holds true for healthcare providers, if you have a sick child, going through a divorce, or are simply having a bad day – your work is likely to suffer.

On a more microscopic level, my mood and happiness on any given shift in the emergency department has a strong correlation to my nurses. If I am working with happy, energetic nurses – I am more likely to have a good day. By the same token, if my nurses (or any other hospital staff for that matter) are burnt out or overworked– it negatively impacts my mood and performance.

Being an emergency physician requires a significant amount of patience and tolerance, and while I would love to say that I am always maximally empathetic and a good listener; I am not yet conceded enough to know I have good days and bad days. Anecdotally, I know when I am energetic and excited about my workplace environment, I find myself more engaged, empathetic and caring.

This problem isn’t unique to me, the emergency department, or the hospital I work at – this is a global healthcare issue. Budget cuts and resource scarcity is an expectation in any realm of healthcare, and as a result we need to practice medicine within particular constraints. Unfortunately, the first cuts are often made to allied health professionals, and we therefore see nursing shortages and a lack of support staff (social workers, porters, geriatric nurses etc.) and this is directly having a negative impact upon patient care. Not only are we feeling the burden from a lack of services within/out of hospital, but this strain is also felt on everyone in the healthcare system.

When my nursing collogues are having a bad day because they’re short staffed, running off their feet and feeling under-appreciated – I too, am likely to have a stressful, unsatisfying day at the office. I know I am not alone in this sentiment, as the environment one works in plays a significant role one’s job satisfaction.

Beyond Healthcare

I want to step outside of medicine for a moment, and take a look an economic look at Google. The technology giant consistently ranks in the top end for employee satisfaction, and there is good evidence to suggest that this is directly correlated to employee satisfaction. There have been multiple independent studies that have demonstrated a strong correlation between employee happiness and productivity; both in terms of quality and quantity. Dr. Jane Dutton, PhD, professor of business administration and psychology at the University of Michigan has studied this extensively, and has suggested that; “having positive relationships at work is seen as a major predictor of employee engagement, and that’s a major driver of customer engagement.” We often lose sight of the fact that the hospital is ultimately a workplace, and so it is important to remember that these same principles apply.


I’m not here to argue that patient satisfaction isn’t important, it is – and will continue to be a metric by which administration will consider a benchmark. However, satisfaction is derived from individual experiences as the patient traverses the healthcare system. When hospital workers are unhappy, this has a negative impact upon a patient’s perception of their care and the hospital environment they are in. Therefore, I would suggest that to ultimately achieve excellent patient satisfaction and optimized patient centered care, we must redirect our focus upon those providing to these patients.

Utilizing patient satisfaction as a marker for patient care is unfortunately shortsighted and is merely putting a band aid on a much larger problem. It is akin to giving blood to a bleeding patient, it will keep them alive for a while, but ultimately you need to stop the bleeding to give that patient an opportunity to survive. By the same token, its time to re-evaluate how we treat healthcare employees, and provide the necessary support to allow them to do their jobs happily and efficiently. If you influence this level of healthcare provision, you will ultimately see the highly touted increase in patient satisfaction.


  1. Dutton J, Heaphy E. 2005. Embodying Social Interactions: Integrating Physiology into the Study of Connections and Relationships at Work. Working Paper. Stephen M. Ross School of Business at the University of Michigan.
  2. Oswald A, Proto E, Sgori D. 2014. Happiness and Productivity. Institute for the study of Labor.

Shahbaz Syed

FRCPC Emergency Medicine Physician at the University of Ottawa, with a fellowship in Digital Scholarship, and an special interest in rational resource utilization. Additionally, holds a role as editor for CanadiEM, and is the junior social media editor for CJEM.
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Frontdoor 2 Healthcare

Frontdoor2Healthcare, founded by Dr. Edmund Kwok in 2012, provides editorial and commentary on issues affecting Canadian healthcare from the emergency department’s “front door” perspective. Frontdoor posts allow for open sharing of the diverse opinions and perspectives of emergency physicians from across the country.

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