Commentary As physicians, we have always sought ways to evaluate ourselves. We strive both to know that we are providing optimum care for our patients and to satisfy ourselves that we are being the best clinicians we can be. Traditionally, a wide variety of physician-derived outcome measures have been employed to answer these questions. Unfortunately, these instruments have often failed to capture the complex relationship between success, as we define it, and satisfaction, as defined by our patients.
Increasingly, patient satisfaction is assuming a more prominent position in the world of outcomes measurement. With the emergence of online rating sites such as Healthgrades, Angie’s List, and RateMDs, the public evaluation of our practice is, more than ever, a reflection of patient satisfaction. In addition, in the changing landscape of health care, patient satisfaction is becoming increasingly tied to reimbursement. Over the next year, for example, 30% of Medicare payments to hospitals will be based on a patient-satisfaction questionnaire, and patient satisfaction seems certain to play a role in pay-for-performance models.
As the practice environment changes around us, we cannot dismiss the possibility that we could lose control of how our outcomes are measured. Although physician-derived instruments have, to date, failed to fully capture the factors that patients identify as important, we remain in the best position to develop the next generation of more complete measurement tools. We must apply good science to our unique knowledge and experience and take a leadership role in shaping the future of outcomes measurement.
In “Age and Sex Differences Between Patient and Physician-Derived Outcome Measures in the Foot and Ankle,” Dr. Baumhauer and her colleagues demonstrate the type of important work that will begin to shape that future. Starting with an open-ended pilot question and building their survey instrument with use of the patients’ own words, they developed a survey built entirely on factors deemed important by their patients. They then administered their survey to nearly 800 patients over a three-month period to further stratify which of the factors their patients considered to be most important. They further evaluated their data by stratifying by age and sex and, finally, by comparing their rank list with two commonly used physician-derived outcome scales.