Maybe the best way to start this literature review is the old saying that success is a measure as

decided by others, whereas satisfaction is a measure as decided by you. And there was a study that

came out in February of 2020, which I don't think most hospice or nurses or whoever are going to

be too surprised about,

but it was kind of nice to see that what we think is actually true,

which is patient satisfaction scores really don't have much to do with medical quality nor mortality rates

and much more had to do with amenities and hospitality

experiences. So things like hallway noise or being in a private room, how fast nurses and doctors

and CNAs respond to requests. Those things were much more important

in patient satisfaction than medical quality or mortality rates. And this study was based on CMS data

from 3,000 U.S. hospitals. So I think we can trust the data, and basically this is a very old idea

just showing itself once again, meaning even Mahatma Gandhi once said,

satisfaction lies in the effort, not in the attainment. Full effort is full victory.

And not surprisingly, patients don't really know mortality

rates or how smart their doctor is. What they do notice is how long it takes when they push the call

button or how cold their food is if it's been sitting out in the hallway for an hour and a half

before it gets to them.

All right, so moving along, there was a study at a JAMA, which spoke to me personally, because my residents often tell me,

boy, you order a lot less consults than a lot of the other teaching physicians and physicians that we train under.

For example, someone comes in with a

creatin of 8. If I don't think it's ATN or something that we're definitely going to need dialysis for

quickly, I will try and reverse that on my own without nephrology and usually will succeed.

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