Unpacking the concept of patient satisfaction: a feminist analysis

The aim of this paper is to present a feminist critique of the concept of patient satisfaction.

Fiscal restraint, health care restructuring, shifting demographics, biomedical technological advances, and a significant shortage of health care professionals are stretching health care systems across North America to the breaking point. A simultaneous focus on consumerism and health service accountability is placing additional pressure on the system. The concept of patient satisfaction, with roots in the consumer movement of the 1960s, has both practical and political relevance in the current health care system and is commonly used to guide research related to consumer experiences of health care. Because the quality of health care encounters may lead to treatment-seeking delays, patient satisfaction research may be an effective vehicle for addressing this public health issue. However, there is wide agreement that patient satisfaction is an under-theorized concept. Using current conceptualizations of patient satisfaction, we end up all too often producing a checklist approach to 'achieving' patient satisfaction, rather than developing an understanding of the larger issues underlying individual experiences of health care. We focus on the symptoms rather than the problems.

Without further theoretical refinement, the results of research into patient satisfaction are of limited use. To push forward theoretical development we might apply a variety of theoretical lenses to the analysis of both the concept and the results of patient satisfaction research. Feminism, in particular, offers a perspective that may provoke further refinement of patient satisfaction as a concept.

Without a deeper understanding of the values and beliefs (or the worldview) that informs our approaches to researching patient satisfaction, researchers will be reacting to the most obvious indicators and failing to address the underlying issues related to individual experiences of health care.