ARE WE AS GOOD AS WE THINK IN PREDICTING OUR PATIENT SATISFACTION?

Purpose:

Patient’s satisfaction after hip or knee arthroplasty can be very different from surgeon’s satisfaction or objective clinical and radiologic findings. Up to 20% of patients after knee replacement are not satisfied with the procedure. An experienced arthroplasty surgeon often has a feeling that he can predict the success of planned surgery, based on his assessment of patient’s personality. This study was conducted to examine the ability to predict satisfaction by the treating orthopaedic surgeon and other health care providers.

Method(s):

40 arthroplasty surgeons were asked to what degree they can preoperatively predict their patient satisfaction one year after a hip or a knee arthroplasty. The prediction was done using the Visual Analogue Scale (VAS).

Then, 219 consecutive patients scheduled for arthroplasty (118 hip and 101 knee) completed the study. Each patient filled Pain Visual Analogue Scale and Oxford hip or knee score before and year after the surgery. Assessment of satisfaction (actual and predicted) was again performed using the Visual Analogue Scale. It was predicted by the referring surgeon and the patient during the clinic visit and treating physician, physiotherapist and 2-3 nurses during hospitalization. A year postoperatively the satisfaction was assessed by patient and his surgeon (who also tried to “guess” patient’s satisfaction). All assessors were blinded to others.

Result(s):

Arthroplasty surgeons felt that they can predict postoperative patient satisfaction in 90% for hip and 70% for knee arhroplasty. However, no significant correlation was found between predicted patient satisfaction (by the patient himself, the treating orthopaedic surgeon or other health care provider) and the actual patient satisfaction one year after the procedure.

Conclusion(s):

Arthroplasty surgeons strongly feel that they can predict patient satisfaction when they refer the patient to surgery. This study shows that our ability to predict patient satisfaction based on superficial impression of patient’s personality is very low or non-existent. Medical decisions based on these impressions are misleading and should be avoided.