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To the Editor: In his Editorial about the relationship between patient complaints and malpractice risk, Dr Sage¹ supports the familiar contention the patient is always right. However, this argument may not be helpful in addressing concerns about medical malpractice litigation.

It seems to me that patient satisfaction is rarely correlated with the actual quality of care that physicians render. Sage alludes to this fact in a vignette about an incompetent yet beloved physician in his past. To be sure, my patients would prefer that I encourage their smoking and advocate increased consumption of alcohol. Their satisfaction with my care would be high. Would Sage have me change my practice in this way to comply with his axiom of customer service?

One of Sage's citations further refutes his contention that physicians can insulate themselves from malpractice suits by being more attentive to patient complaints. Brennan et al² found that the incidence . . . [Full Text of this Article]