In Response.

Abstract

We thank Dr Anwari1 for his thoughtful reading of our article2 and agree with his observations regarding the potentially powerful role of customer reviews in today’s marketplace. We also agree that due to social aspects of the physician–patient relationship, patient consumers of health care services differ from consumers of other goods and patient customers are likely incentivized to not anger physicians to whom they entrust their health care. Finally, we agree that our “snapshot” of patient satisfaction in a large private group practice may not fully describe overall satisfaction with providers in that practice due to response bias. Nevertheless, we believe that our observations have potential value for the anesthesiologist seeking to measure patient satisfaction with his/her care. We found (as we hypothesized) that some factors not under direct anesthesiologist control such as increased age and nighttime or inpatient surgery meaningfully affected satisfaction.2 We also identified opportunities to improve. The lowest ranked questions in our survey related to whether the anesthesiologist spent enough time with the patient before and after surgery. Whether better care, salesmanship, or advertising, we would argue that spending more time with the patient improves care and satisfaction both. We agree that our response rate was low. To address that issue, we examined clinical characteristics of nonresponders and found that they were more likely to be older and male, have a higher American Society of Anesthesiologists (ASA) physical status, have undergone inpatient or nighttime surgery, and not have received general anesthesia. Based on our findings, we suggested (as Dr Anwari does) that nonresponders were likely to be less satisfied.2 Despite the many limitations of our analysis, we continue to believe that measuring patient satisfaction is an important aspect of anesthesia care and a positive investment. Improving patient satisfaction is a worthy goal in itself and a business differentiator in winning and retaining hospital contracts for anesthesia services. We recognize that unscrupulous entities may “sell” products not clearly in the patient’s best interest to improve satisfaction, but note that this problem has existed since the time of Maimonides.3 Our observations have changed our personal practices, and we believe that measuring patient satisfaction may do so for other anesthesiologists focused on delivering the best patient experience possible. Anastasia Pozdnyakova, BSPritzker School of MedicineChicago, IllinoisAvery Tung, MDDepartment of Anesthesia and Critical CareUniversity of ChicagoChicago, Illinois[email protected]Richard Dutton, MD, MBAUnited States Anesthesia PartnersFt Lauderdale, FloridaAnum Wazir, BSTexas A&M School of MedicineBryan, TexasDavid B. Glick, MD, MBADepartment of Anesthesia and Critical CareUniversity of ChicagoChicago, Illinois