Can patients assess the quality of health care?

Patient feedback surveys are increasingly seen as a key component of monitoring and improving the quality of health care.1 Since 2002, all NHS trusts in England have been required to survey a sample of their patients on an annual basis and report the results to their regulator, the Healthcare Commission. General practitioners throughout the United Kingdom can earn extra contractual points and more money if they implement patient surveys. Patients' feedback on individual doctors has been advocated for practice accreditation, clinical governance, assessment of trainees, appraisal, and revalidation. But can patients' really make reliable judgments on the quality of health care?

In this week's BMJ Rao and colleagues point to some potential problems, particularly with regard to patients' assessment of the technical quality of care.2 Using a British adaptation of a US patient questionnaire (the general practice assessment survey (GPAS)3), they found no correlation between patients' evaluations of the quality of technical care and evidence based indicators …