Hospitable harm: When patient experience efforts compromise clinical integrity.

Abstract

Efforts to improve patients' hospital experience can reduce uncertainty and indignity, but they can also create "hospitable harm" when pressure for smoother encounters encourages low-value care, preferential access, or compromises in safety, stewardship, or equity. This Perspective introduces the Experience-Integrity Matrix as a conceptual model for examining such initiatives. One axis asks whether an initiative makes care more reliable and dignified for patients; the other asks whether it aligns with clinical integrity. The four quadrants indicate what leaders should scale, repair, decline, or redesign. The article also distinguishes experience from satisfaction and hospitality, examines the economic and organizational pressures that favor accommodation over value, and outlines practical responses: review initiatives before launch, make only commitments with clear ownership and measures, support clinicians who decline low-value requests, and monitor whether improvements are equitable and sustainable. The aim is humane, reliable care without purchasing goodwill at the expense of integrity.