SUFFERING FROM A TOOTHACHE, a South Carolina woman headed to her local emergency room a few months ago. The doctor there responded by administering Dilaudid, a powerful intramuscular narcotic typically reserved for cancer-related pain. Why, his nurse queried, was he killing a flea with a sledgehammer? Afraid of malpractice? No, the doc replied, Press Ganey. "My scores last month were low."
Press who? The little-known company has become a hated target of hospital physicians, outstripping even trial lawyers. Utter its name in an emergency room and you'll likely unleash a cloud of four-letter words. Based in South Bend, Ind., Press Ganey is the nation's leading provider of patient satisfaction surveys, the Yelp equivalent for hospitals and doctors, and a central component of health care reform. Over the past decade the government has fully embraced the "patient is always right" model--these surveys focus on areas like waiting times, pain management and communication skills--betting that increased customer satisfaction will improve the quality of care and reduce costs. There's some evidence they have. An ObamaCare initiative adds extra teeth, to the tune of $850 million, reducing Medicare reimbursement fees for hospitals with less-than-stellar scores.
Catering to Patients Can Be Harmful to Their Health
Accordingly, hospitals kowtow to Press Ganey. In November nearly 2,000 administrators spent $1,100 or more each to attend Press Ganey's glittery client conference--a closed-to-the-public affair in Washington, D.C., with keynotes by Jeb Bush and astronaut Mark Kelly and his wife, former congresswoman Gabby Giffords. Press Ganey is helping hospitals fulfill their mandated obligation. Some have taken an extra step, tying physicians' compensation to their ratings.
That may sound like a good thing. Why shouldn't you grade the quality of your medical care, the way that you pass judgments on other services, whether hotel stays via TripAdvisor or contractors via Angie's List?
The short reason: The current system might just kill you. Many doctors, in order to get high ratings (and a higher salary), overprescribe and overtest, just to "satisfy" patients, who probably aren't qualified to judge their care. And there's a financial cost, as flawed survey methods and the decisions they induce, produce billions more in waste. It's a case of good intentions gone badly awry--and it's only getting worse."
"most satisfied patients=more likely to die."

"But what exactly are Press Ganey and its two main rivals, the Gallup polling company and the publicly traded National Research Corp., measuring? Customers know what they want when they review spaghetti carbonara for Zagat. But giving patients exactly what they want, versus what the doctor thinks is right, can be very bad medicine. Last February researchers at UC Davis, using data from nearly 52,000 adults, found that the most satisfied patients spent the most on health care and prescription drugs. They were 12% more likely to be admitted to the hospital and accounted for 9% more in total health care costs. Strikingly, they were also the ones more likely to die."

"Vicki Frantz Jackson 4 years ago
This article raises legitimate concerns. I am an RN at on psychiatric unit in a hospital. Same thing is being incorporated into our system. Whether it works in a medical unit, I won’t speak to that, but psychiatric? no way! Doctors end up prescribing narcotics to already addicted psychiatric patients who are coming into the hospital claiming to be suicidal only to be prescribed the pain pills they can’t afford off the street and can’t get a doctor to prescribe for them on the outside. These are patients who are clearly not in pain as they flint around the unit socializing with others like they are on a cruise ship. Many psychiatric patients are unhappy and they are not in a frame of mind to do anything but complain. My specific area gets a lot of personality disorders who thrive on chaos, try to create chaos, split staff, push limits, disobey rules. When they don’t get away with their childish antics, when they are confronted on their behavior and how it is impeding their ability to get along in the “world” they can become angry and punitive. Punitive especially when asked about patient satisfaction. It’s their chance to seek revenge because they don’t want to change their misguided and maladjusted ways of coping with the world’s stresses. We end up allowing them to get away with anything and the unit begins to resemble a playroom where wild and misbehaved 2 year olds have taken control of their caregivers. Sounds good in theory, does not work in real life. In fact, like the article says, it ends up impeding getting the care the patient actually needs."