Because of the high status of survey research and its ubiquity (everyone asks everyone about everything continuously and worldwide) most in the quality management field these days ask customers/citizens questions (what they like, don’t like, how products and programs could be improved, etc.). trying to identify their preferences, and then conclude, as one practitioner put it: “consumer preference is the foundation of quality”. This is not correct. Deming, Juran, and the precious few other quality management thinkers and practitioners not addicted to survey research, have made it quite clear that quality products—not consumer preferences—are the foundation of quality. Quality products meet objective, measurable, criteria; in the case of, say, healthcare, the criteria or standards of physicians, hospital administrators, and other specialists in the healthcare profession; people like Donald Berwick (appointed to head up critical aspects of the Obama administration’s healthcare reform effort) and Janusz Godyn, M.D, who wrote in a recent Quality Progress article that the quality of a product “is the objective measure of the outcome and the objective evaluation of the most effective ways to achieve the best outcome. This . . . should be scored by professional experts based on the current knowledge”. Whereas quality products are objective phenomena produced by specialists, preferences are subjective phenomena produced by socialization in all its variations, including schooling, peer pressure, advertising, and political propaganda. Consequently, most consumers/citizens, in this instance, are unlikely to prefer or choose the healthcare they actually need. Patients in hospitals and citizens trying to decide which healthcare insurance policy to purchase don’t know how to diagnose and treat their illnesses nor do they know the best way to deliver or implement healthcare policies, or the best way to pay for the care they need. Consumers of healthcare will receive the healthcare they need only when they receive quality healthcare. Only quality healthcare—which is true for all quality products—has, in Juran’s words, “fitness for use”; that is, that is, fits consumers’/citizens’ needs.
Concerning survey research, see my book, The Problem with Survey Research.