Why Disappointment Often Results From Unmet Expectations — and Why Clear Expectations Are Essential

Many cases of dissatisfaction arise not from poor care, but from unmet or unspoken expectations.

Expectations strongly influence how outcomes are perceived. Even when treatment is clinically successful, a result can feel disappointing if it differs from what was imagined¹.

Before treatment, discussions should address:

• Likely improvement — not perfection
• Possible residual symptoms or limitations
• Realistic recovery timelines
• Areas of uncertainty and trade-offs

Questions that help align expectations

• “What improvement is realistic for someone like me?”
• “What symptoms might remain, and how long will recovery take?”

Research shows that good pre-treatment communication reduces dissatisfaction, complaints, and decisional regret independent of the objective outcome².

Setting realistic expectations is not pessimism. It is responsible medicine that protects trust and supports better long-term satisfaction.

References

1. Bowling A, Rowe G, Lambert N, et al. Quality of life and satisfaction following cataract surgery. Br J Ophthalmol. 2005;89(8):921–927.
2. Street RL, Makoul G, Arora NK, Epstein RM. How does communication heal? Pathways linking clinician–patient communication to health outcomes. Patient Educ Couns. 2009;74(3):295–301.