Satisfied Patients = Poor Outcomes???

For those who haven't seen it yet, there was an interesting article distributed in a recent Daily Briefing from The Advisory Board..the gist of the article is that some recent research has shown that higher patient satisfaction scores are actually linked to poorer clinical outcomes.  My first thought was that this can't be correct, but after thinking it over I can understand how this could be the case - however, it seems to me that there may be a fundamental flaw in the causal link hypothesized by the research.  While both clinical outcomes and patient satisfaction are desirable features in any healthcare facility, it is certainly possible to have one without the other (we've all seen institutions that are delivering quality care in facilities that don't live up to patient expectations)...I think more than anything this research points out how disengaged most patients are from their own healthcare experience - to the point that "creature comforts" can trump quality of care.  Somewhere in all of this is a proper balance, and hopefully as healthcare facilities designers we can help find it.  What do you think?

--Kent