Abstract
OBJECTIVE: To measure and compare patient satisfaction with care in resident and attending physician internal medicine ambulatory care clinics.
DESIGN: A cross-sectional survey using a questionnaire derived from the Visit-Specific Satisfaction Questionnaire (VSQ) and Patient Satisfaction Index (PSI) distributed from March 1998 to May 1998.
SETTING: Four clinics based at a university teaching hospital and the associated Veterans’ Affairs (VA) hospital.
PARTICIPANTS: Two hundred eighty-eight patients of 76 resident and 25 attending physicians.
RESULTS: Patients of resident physicians at the university site were more likely to be African American, male, have lower socioeconomic status and have lower physical and mental health scores on the Short Form-12 than patients of university attendings. Patients of resident and attending physicians at the VA site were similar. In multivariate analyses, patients of university attending physicians were more likely to be highly satisfied than patients of university residents on the VSQ-Physician (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.6 to 7.8) and the PSI-Physician (OR, 10.1; 95% CI, 3.7 to 27.4) summary scores. Differences were not seen on the summary scores at the VA site. Two individual items displayed significant differences between residents and attendings at both sites: “personal manner (courtesy, respect, sensitivity, friendliness) of the doctor” (P≤.03 at both sites) and “my doctor always treats me with the highest respect” (P<.001 at both sites).
CONCLUSIONS: After controlling for patient characteristics, patients of resident physicians were less satisfied than those of attending physicians, especially in regard to the doctor’s personal manner and respect toward the patient. Medical education should continue to emphasize the importance of these aspects of the physician-patient encounter.
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References
McLeod PJ, Tamblyn R, Benaroya S, Snell L. Faculty ratings of resident humanism predict patient satisfaction ratings in ambulatory medical clinics. J Gen Intern Med. 1994;9:321–6.
O’Malley PG, Omori DM, Landry FJ, Jackson J, Kroenke K. A prospective study to assess the effect of ambulatory teaching on patient satisfaction. Acad Med. 1997;72:1015–7.
Probst JC, Greenhouse DL, Selassie AW. Patient and physician satisfaction with an outpatient care visit. J Fam Pract. 1997;45:418–25.
Smith RC, Lyles JS, Mettler JA, et al. A strategy for improving patient satisfaction by the intensive training of residents in psychosocial medicine: a controlled, randomized study. Acad Med. 1995;70:729–32.
Tamblyn R, Benaroya S, Snell L, McLeod P, Schnarch B, Abrahamowicz M. The feasibility and value of using patient satisfaction ratings to evaluate internal medicine residents. J Gen Intern Med. 1994;9:146–52.
Frances V, Korsch BM, Morris MJ. Gaps in doctor-patient communications. N Engl J Med. 1969;280:535–40.
Reichheld FF. Learning from customer defections. HBR. 1996;74:56–69.
Eraker SA, Kirsch JP, Becker MH. Understanding and improving patient compliance. Ann Intern Med. 1984;100:258–68.
Davies AR, Ware JE. GHAA’s Consumer Satisfaction Survey and User’s Manual. Second Ed. Washington, DC: Group Health Association of America, Inc.; 1991.
Hall JA, Irish JT, Roter DL, Ehrlich CM, Miller LH. Satisfaction, gender, and communication in medical visits. Med Care. 1994;32:1216–31.
Ware JE, Hays RD. Methods for measuring patient satisfaction with specific medical encounters. Med Care. 1988;26:393–402.
Rubin HR, Gandek B, Rogers WH, Kosinski M, McHorney CA, Ware JE. Patients’ ratings of outpatient visits in different practice settings: results from the Medical Outcomes Study. JAMA. 1993;270:835–40.
Ware JE, Kosinski M, Keller SD. A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220–33.
Meng Y-Y, Jatulis DE, McDonald JP, Legorreta AP. Satisfaction with access to and quality of health care among medicare enrollees in a health maintenance organization. West J Med. 1997;166:242–7.
Jatulis DE, Bundek NI, Legorreta AP. Identifying predictors of satisfaction with access to medical care and quality of care. Am J Med Qual. 1997;12:11–7.
Huber PJ. The behavior of maximum likelihood estimators under non-standard conditions. In: Fifth Berkeley Symposium on Mathematical Statistics and Probability. Berkley, Calif: University of California Press; 1967:221–33.
White H. A hetroskedasticity-consistent covariance matrix estimator and a direct test for hetroskedasticity. Econometrica. 1980;48:817–30.
White H. Maximum likelihood estimation of misspecified models. Econometrica. 1982;50:501–25.
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Yancy, W.S., Macpherson, D.S., Hanusa, B.H. et al. Patient satisfaction in resident and attending ambulatory care clinics. J GEN INTERN MED 16, 755–762 (2001). https://doi.org/10.1111/j.1525-1497.2001.91005.x
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DOI: https://doi.org/10.1111/j.1525-1497.2001.91005.x