AMA Journal of Ethics^®

Reporting of post-CABG mortality rates has resulted in a decrease in in-hospital mortality, and non-outcome-based measures of care quality show promise of improving patient satisfaction.

The belief persists that patient satisfaction surveys are more responsive to friendliness and expensive facilities than clinician interaction, but there is evidence to the contrary.

When a patient requests an unfamiliar treatment, the physician should not hesitate to research it before giving a categorical reply about its safety or efficacy.

Web-based physician rating sites are part of a multi-decade cultural shift in the relationship between physicians, patients, and society. But a system in which “patient’s orders” reign is just as lopsided as one that puts “doctor’s orders” in the driver’s seat.

Measuring outcomes alone is not the answer. There should be a way to reward the doctor for educating a patient about lifestyle modifications and then documenting that the care provided followed patient preferences.