Why Poor Communication — Not Poor Care — Often Drives Dissatisfaction

Many cases of dissatisfaction do not stem from what was done medically, but from what was understood.

When expectations are set unrealistically — or not set at all — patients may interpret normal variation, recovery time, or residual symptoms as failure. This is especially likely when explanations are rushed, delegated without alignment, or overly reassuring¹.

Research has consistently shown that communication quality strongly influences satisfaction, complaints, and trust, independent of clinical outcome².

Good care delivered without clear communication can still feel disappointing. Conversely, outcomes that fall short of hopes are often better tolerated when expectations were discussed openly from the start.

Communication does not change reality — but it shapes how reality is experienced.

This is why communication is not an optional extra in healthcare. It is a core clinical skill.

References

1. Cleary PD. The increasing importance of patient surveys in assessing health care quality. BMJ. 1999;319(7212):720–721.
2. Hickson GB, Clayton EW, Githens PB, Sloan FA. Factors that prompted families to file medical malpractice claims. Pediatrics. 1992;89(2):336–341.

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