I appreciate all patient surveys, which I review periodically. Although surveys are anonymous, I can usually identify the patient and the circumstances resulting in a poor score. I always look back and ponder if I or my staff could have done things differently. Sometimes the answer is yes, and we reach out to the patient to apologize and make things right. At other times, however, poor rating is the result of a disconnect between patient expectation and my belief of what constitutes appropriate medical care. I accept that there will be patients who will not like the diagnosis, treatment, prognosis, or simply the way how our office is run. I firmly believe that practicing medicine solely based on patient satisfaction will ultimately cause harm to my patients. I encourage you to read 'The Cost of Satisfation' http://archinte.jamanetwork.com/article.aspx?articleid=1108766 which provides a different perspective of survey scores.