What do patients want? Technical quality versus functional quality: a literature review for plastic surgeons

While most surgeons are well aware of outcomes studies and quality assessment based on technical quality (TQ) measurements, there has been little attention given in the plastic surgery literature to the discussion of functional quality (FQ)-the process by which a health care service is delivered, as opposed to the actual procedure itself. Most patients judge the quality of their hospital experience based on FQ issues. They use their assessment of FQ to secondarily infer a judgment of the TQ level of a surgeon or facility. Surgeons, conversely, typically rate their own success with purely technical quality measures, paying little attention to FQ. This article reviews the relevant service-quality medical literature and introduces plastic surgeons to the importance of differentiating between TQ and FQ. Important FQ assessment techniques are reviewed. Implications for the plastic surgeon are discussed.