As part of an Obama­care initiative meant to reward quality care, the Centers for Medicare and Medicaid Services (CMS) is allocating some $1.5 billion in Medicare payments to hospitals based on criteria that include patient-­satisfaction surveys. Among the questions: “During this hospital stay, how often did the hospital staff do everything they could to help you with your pain?” And: “How often was your pain well controlled?”

In a 2014 survey published in Patient Preference and Adherence, over 48% of doctors reported prescribing inappropriate narcotic pain medication because of patient-­satisfaction questions. One doctor wrote that drug seekers “are well aware of the patient satisfaction scores and how they can use these threats and complaints to obtain narcotics.”