Evaluating Health Care Appropriateness Means Putting a Value on its Goodness: The Role of Expectations and Trust

The measurement and evaluation of healthcare services continues to be challenged when the appropriateness of the services is its focus. Good outcomes do not mean the services were needed or that the process of delivering care was efficient. Further, patient and family satisfaction with the care episode is influenced by the promises the healthcare system in general and physicians in particular made to the patients. As such, physicians have the dual role of educating patients while they are managing their health status changes. Eventually, it is a question of accountability about the processes and outcomes of the care, which are expected to both demonstrate the social responsibilities of health care professionals and gauge the expectations of patients, families, and communities. The purpose of this article is to explore the determinants of what and why patients expect from healthcare and caring. Within the concept of accountability, the role of physicians as educators rather than exclusively healers of disease is explored. Evaluating Health Care Appropriateness Means Putting a Value on its Goodness: The Role of Expectations and Trust