Since the 1960s, health organizations have increasingly shown interest in how patients perceive the quality of their care. The traditional, biomedical approach to health delivery views patients as passive receivers of care, and only evaluates service quality with standardized benchmarks such as medical efficacy. A "democratization of health care services" (Calnan, 1988) has phased out this approach and progressively values patients for their role in evaluating health care quality. When patient preferences are included in the evaluation and design of health services, their overall utilization of services, quality of life, access to care, and medical efficacy improve (Greene, Tuzzio & Cherkin, 2012).