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A unicorn is a mythical creature. It does not exist.  

Which brings me to Press Ganey scores.  

For those of you entirely immune to the numeric patient satisfaction benchmarks, Press Ganey is eponymous with HCAHPS scores mandated by CMS. HCAHPS was initially rolled out to allow comparisons between institutions providing inpatient care. How satisfied are patients receiving care at those institutions. Like any federal mandate, it grew. Patient satisfaction surveys are now ubiquitous. They are now tailored to rate individual physician practices; emergency departments, urgent care centers, and dialysis units.  

Broadly, I think information gained related to patient feedback can be useful.  

But there are three important caveats. 

There must be a meaningful sample size to draw conclusions. 

The feedback must be gathered close in time to when services were rendered. 

Detailed comments are more important than numeric scores. 

I’ve been on a search for the single physician who is a fan of Press Ganey scores. I exclude those who have a connection to the company. I exclude those who work in administration (where scores are used to determine how much the institution is reimbursed). I’m just looking for that physician who says these scores are meaningful to them. And they find the scores to be constructive criticism allowing them to improve their service.  

Candidly, I’ve not found that unicorn yet. I’ll keep looking. 

Here are the beefs I HAVE heard in my quest. 

Most patients throw letters from Press Ganey in the trash. The surveys are not filled out. The “n” is too low.  

Most patient who receive emails from Press Ganey press the delete button. The “n” remains low. 

If a patient does complain, by the time their response is collated, too much time has gone by. It’s hard to do proper service recovery when there’s a giant chasm between when the patient was seen and when their response was received. 

Many physicians believe we are teaching to the test; that patient perception of how care is delivered is valued more than the actual care itself. As to whether there is merit to that claim, I cannot say. But that is a strong perception. Put differently, if a doctor is generous with pain medication or provides requested antibiotics for viral infections, the fact that that patient is satisfied seems to matter more than data related safety and clinical outcomes.  

Every doctor will at some point become a patient. When you become a patient, you will want care to be delivered with respect. You will want to be treated by dignity. So, there is merit to doing our best to learn about how we deliver care. I’m just not convinced the best way to do that is by chasing unicorns.  

What do you think? Click here to quickly join the conversation and share your thoughts with us below.


Jeffrey Segal, MD, JD

Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

Dr. Segal received his M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.

Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.

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