Drs. Simul Parikh and Matt Spraker host health care quality experts radiation oncologist Dr. Marsha Haley and MROQC program manager Melissa Mietzel, MS for a discussion about everyone's favorite topic: patient satisfaction scores!We begin with a discussion of Marsha's recent graduate work, a systemic review of whether patient satisfaction measures such as Press-Gainey and CAHPS are related to quality outcomes. You may be shocked to learn that the evidence is limited. Matt bravely shares his patient sat scores and then we discuss how games like "top box scoring" and low sample sizes make these instruments frustrating to use for continuous quality improvement. What's worse, Goodhart's law inevitability degrades the value of the surveys and some studies even suggest that they may impact practices such as pain management. Yet, the future is bright! We move on to discuss patient reported outcomes as a better solution to measuring care quality. Melissa, who has helped implement robust collection of PROs across 26 radiation oncology clinics, teaches us the ways of implementation across MROQC.We close the show with Simul putting Marsha and Melissa through a Pennsylvania and Michigan themed Accelerators Lightning Round! Episode art generously donated by Dr. Danielle Cunningham.