WHAT IS SATISFACTION FOR THE SURGERY PATIENT?

Abstract

Purpose of the study: Why is a surgery patient satisfied, or not satisfied? What is the basis of the patient’s perception of the surgical result and what criteria does a patient use to decide to undergo surgery and then to consider the result satisfactory or not?

Material and methods: All patients consulting a surgeon in the orthopedic and traumatology surgery department during the month of April 2002 received an anonymous questionnaire. The inclusion criteria were an open orthopedic or traumatologic surgical procedure performed by the consulting surgeon, the last procedure performed being considered. Patient satisfaction being multifactorial, several associated factors were tested: pain, comfort, operating room, personnel, anesthesia.

Results: Twenty-five questionnaires were collected. One questionnaire was eliminated because of missing data. Operations were undertaken for medical reasons, rarely patient comfort. Postoperative patient satisfaction depended on the patient-physician relationship, and secondarily on outcome. Responses to open questions illustrated that the key element was a quality relationship with the physician.

Discussion: This survey had a methodological bias: non-responders often avoid mentioning poor outcome. In this survey, non-responders were non-consulting patients who were not tested. The remarkable fact was that the surgeon was the key to patient satisfaction, more than the result of the operation. The way information was delivered had a primordial importance: the patients expected to be given honest and pertinent information.

Conclusion: The feeling of competence and the information delivered are certainly two of the most important points in the patient-surgeon relationship. They are the cement leading to a confident relationship. Information delivery has a personal aspect which each surgeon must manage honestly. The obligation of information delivery is necessary from a regulatory point of view. But it is most important to keep in mind that the way information is delivered is an important aspect which can be assessed via an internal audit. The British National Health Service has demonstrated the usefulness of such audits and the publication of the results as well as the impact on the clientele.