Patient satisfaction efforts may have a "nocebo effect" on some patients, since many enter hospitals expecting a negative experience and can actually feel worse after treatment, according to a Huffington Post report written by two physicians and public health advocates.
The nocebo effect is the reversal of the placebo effect, where neutral sugar pills can induce positive outcomes just because the person expects a positive response. Under the nocebo effect, patients may feel dispirited in hospitals because they expected things like poor bedside manner from physicians, poor sleep quality or limited visiting hours.
Even if patients' surgery or treatment is successful, they may perceive their stay to be much worse. This can severely undermine a hospital's patient satisfaction or HCAHPS scores, which will harm their Medicare reimbursement when Value-Based Purchasing goes into effect in Oct. 2012.
In the report, Matthew Erlich, MD, and Lloyd Sederer, MD, recommend hospitals and physicians limit the nocebo effect through the following steps:
1. Enhance the patient experience. Care routines should be designed around the patient and family, not employees and providers. Ask patients if they understand concepts, if they have questions and if they or their families have any concerns. Optimism and hope can also "inform positive outcomes," according to the report, so providers should do their best to provide it.
2. Establish partnerships in care. A physician-patient partnership in the patient's care can serve as a cure to the nocebo effect. Patient preferences should inform clinical decisions.
3. Think of Disney World. Hospitals and theme parks aren't very comparable, but physicians and hospital employees should focus on communication, warmth, respect, optimism and responding to patient needs quickly. Walt Disney was the master of this with his organization, the report said.
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The nocebo effect is the reversal of the placebo effect, where neutral sugar pills can induce positive outcomes just because the person expects a positive response. Under the nocebo effect, patients may feel dispirited in hospitals because they expected things like poor bedside manner from physicians, poor sleep quality or limited visiting hours.
Even if patients' surgery or treatment is successful, they may perceive their stay to be much worse. This can severely undermine a hospital's patient satisfaction or HCAHPS scores, which will harm their Medicare reimbursement when Value-Based Purchasing goes into effect in Oct. 2012.
In the report, Matthew Erlich, MD, and Lloyd Sederer, MD, recommend hospitals and physicians limit the nocebo effect through the following steps:
1. Enhance the patient experience. Care routines should be designed around the patient and family, not employees and providers. Ask patients if they understand concepts, if they have questions and if they or their families have any concerns. Optimism and hope can also "inform positive outcomes," according to the report, so providers should do their best to provide it.
2. Establish partnerships in care. A physician-patient partnership in the patient's care can serve as a cure to the nocebo effect. Patient preferences should inform clinical decisions.
3. Think of Disney World. Hospitals and theme parks aren't very comparable, but physicians and hospital employees should focus on communication, warmth, respect, optimism and responding to patient needs quickly. Walt Disney was the master of this with his organization, the report said.
Related Articles on Patient Satisfaction:
The Perfect 10: Hospital Officials Scramble to Ace Patient Satisfaction ScoresU of Chicago Medical Center Devotes Institute to Patient-Physician Relationships With $42M Donation
Survey Shows Physicians Often Fail to Ask Patients About Expectations