What do measures of patient satisfaction with the doctor tell us?

OBJECTIVE To gain an understanding of how patient satisfaction (PS) with the doctor (PSD) is conceptualized through an empirical review of how it is currently being measured. The content of PS questionnaire items was examined to (a) determine the primary domains underlying PSD, and (b) summarize the specific doctor-related characteristics and behaviors, and patient-related perceptions, composing each domain. METHODS A scoping review of empirical articles that assessed PSD published from 2000 to November 2013. MEDLINE and PsycINFO databases were searched. RESULTS The literature search yielded 1726 articles, 316 of which fulfilled study inclusion criteria. PSD was realized in one of four health contexts, with questions being embedded in a larger questionnaire that assessed PS with either: (1) overall healthcare, (2) a specific medical encounter, or (3) the healthcare team. In the fourth context, PSD was the questionnaire's sole focus. Five broad domains underlying PSD were revealed: (1) Communication Attributes; (2) Relational Conduct; (3) Technical Skill/Knowledge; (4) Personal Qualities; and (5) Availability/Accessibility. CONCLUSIONS Careful consideration of measurement goals and purposes is necessary when selecting a PSD measure. PRACTICE IMPLICATIONS The five emergent domains underlying PSD point to potential key areas of physician training and foci for quality assessment.

[1]  Stephen Strasser,et al.  Patient Satisfaction: What we Know about and What we Still Need to Explore , 1993, Medical care review.

[2]  Alastair Baker,et al.  Crossing the Quality Chasm: A New Health System for the 21st Century , 2001, BMJ : British Medical Journal.

[3]  J E Ware,et al.  The Primary Care Assessment Survey: tests of data quality and measurement performance. , 1998, Medical care.

[4]  David B. Greenberger,et al.  The Patient Satisfaction Process: Moving Toward a Comprehensive Model , 1993, Medical care review.

[5]  W H Rogers,et al.  Patients' ratings of outpatient visits in different practice settings. Results from the Medical Outcomes Study. , 1993, JAMA.

[6]  Organizational performance impacting patient satisfaction in Ontario hospitals: a multilevel analysis , 2013, BMC Research Notes.

[7]  D. Cook,et al.  The development and validation of a novel questionnaire to measure patient and family satisfaction with end-of-life care: the Canadian Health Care Evaluation Project (CANHELP) Questionnaire , 2010, Palliative medicine.

[8]  S. Squires.  Patient satisfaction: how to get it and how to keep it. , 2012, Nursing management.

[9]  L. Frostholm,et al.  The Uncertain Consultation and Patient Satisfaction: The Impact of Patients' Illness Perceptions and a Randomized Controlled Trial on the Training of Physicians' Communication Skills , 2005, Psychosomatic medicine.

[10]  J. Haggerty.  Measurement of primary healthcare attributes from the patient perspective. , 2011, Healthcare policy = Politiques de sante.

[11]  James G. Wright,et al.  The characteristics of patient satisfaction measures. , 2000, Spine.

[12]  J E Ware,et al.  Defining and measuring patient satisfaction with medical care. , 1983, Evaluation and program planning.

[13]  E. Struening,et al.  The multidimensionality of patient satisfaction with a clinic visit , 2005, Journal of Community Health.

[14]  M. Robin DiMatteo,et al.  The significance of patients' perceptions of physician conduct , 1980, Journal of Community Health.

[15]  Richard M Shewchuk,et al.  Understanding Patient Satisfaction, Trust, and Loyalty to Primary Care Physicians , 2008, Medical care research and review : MCRR.

[16]  S. Linder-Pelz,et al.  Social psychological determinants of patient satisfaction: a test of five hypothesis. , 1982, Social science & medicine.

[17]  David Wilkin,et al.  Measures of Need and Outcome for Primary Health Care , 1992 .

[18]  P. Kofoed,et al.  Patient surveys--a key to organizational change? , 2010, Patient education and counseling.

[19]  T. Koepsell,et al.  Patient-physician racial concordance and the perceived quality and use of health care. , 1999, Archives of internal medicine.

[20]  Sabrina T. Wong,et al.  Shared Decision Making and the Experience of Partnership in Primary Care , 2006, The Annals of Family Medicine.

[21]  Bayram Şahin,et al.  Analysis of Factors Affecting Patient Satisfaction , 2006 .

[22]  Judith K Walker.  Patient Satisfaction: The Past Directs the Way to the Future , 2006, The Journal of perinatal & neonatal nursing.

[23]  S. Leinster,et al.  Identifying professional characteristics of the ideal medical doctor: The laddering technique , 2010, Medical teacher.

[24]  Sarah Boslaugh,et al.  How Patient Reactions to Hospital Care Attributes Affect the Evaluation of Overall Quality of Care, Willingness to Recommend, and Willingness to Return , 2010, Journal of healthcare management / American College of Healthcare Executives.

[25]  M. Robin DiMatteo,et al.  Patients' percentions of physicians' behavior , 1979, Journal of Community Health.

[26]  J. Sitzia,et al.  Patient satisfaction: a review of issues and concepts. , 1997, Social science & medicine.

[27]  D. Locker,et al.  Theoretical and methodological issues in sociological studies of consumer satisfaction with medical care. , 1978, Social science & medicine.

[28]  Michael R. Hyman,et al.  Antecedents and consequences of trust in a service provider: The case of primary care physicians , 2004 .

[29]  N. Taub,et al.  Patient feedback in revalidation: an exploratory study using the consultation satisfaction questionnaire. , 2011, The British journal of general practice : the journal of the Royal College of General Practitioners.

[30]  Tim Freeman,et al.  Using performance indicators to improve health care quality in the public sector: a review of the literature , 2002, Health services management research.

[31]  Jason R. Frank,et al.  The CanMEDS 2005 Physician Competency Framework , 2005 .

[32]  A. Porter,et al.  The need for another look at the patient in general practice satisfaction surveys. , 1993, Family practice.

[33]  Angela Coulter,et al.  The Picker Patient Experience Questionnaire: development and validation using data from in-patient surveys in five countries. , 2002, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[34]  K. Collins,et al.  The Meaning of ‘Satisfaction’ for People with Dermatological Problems: Reassessing Approaches to Qualitative Health Psychology Research , 2002, Journal of health psychology.

[35]  S. Schraub,et al.  A comprehensive assessment of satisfaction with care: preliminary psychometric analysis in French, Polish, Swedish and Italian oncology patients. , 2001, Patient education and counseling.

[36]  D. Razavi,et al.  A comprehensive assessment of satisfaction with care for cancer patients , 1998, Supportive Care in Cancer.

[37]  Melvin F Hall.  Looking to improve financial results? Start by listening to patients. , 2008, Healthcare financial management : journal of the Healthcare Financial Management Association.

[38]  M. Sajid,et al.  Quality of Health Care: An Absolute Necessity for Public Satisfaction , 2006 .

[39]  G. C. Pascoe,et al.  Patient satisfaction in primary health care: a literature review and analysis. , 1983, Evaluation and program planning.

[40]  P. Spreeuwenberg,et al.  Patient satisfaction with the general practitioner: a two-level analysis. , 1998, Medical care.

[41]  S. Chlabicz,et al.  Understanding patient satisfaction with family doctor care. , 2010, Journal of evaluation in clinical practice.

[42]  Ron D. Hays,et al.  The Patient Satisfaction Questionnaire Short Form (PSQ-18): , 1994 .

[43]  R. Baker,et al.  Development of a questionnaire to assess patients' satisfaction with consultations in general practice. , 1990, The British journal of general practice : the journal of the Royal College of General Practitioners.

[44]  M P Malone,et al.  Satisfied patients can spell financial well-being. , 1991, Healthcare financial management : journal of the Healthcare Financial Management Association.

[45]  J. Ware,et al.  How to Survey Patient Satisfaction , 1981, Drug intelligence & clinical pharmacy.

[46]  J. Hibbard,et al.  Hospital performance reports: impact on quality, market share, and reputation. , 2005, Health affairs.

[47]  Arnold M. Epstein,et al.  Older Patients' Health Status and Satisfaction With Medical Care in an HMO Population , 1990, Medical care.

[48]  S. Linder-Pelz.  Toward a theory of patient satisfaction. , 1982, Social science & medicine.

[49]  R. Challenor.  Southwest Regional Genitourinary Physicians' Audit Group: setting regional benchmarks for patient satisfaction , 2003, International Journal of STD and AIDS.

[50]  L. Berry,et al.  Patients' perspectives on ideal physician behaviors. , 2006, Mayo Clinic proceedings.

[51]  J. Lucas.  The satisfaction survey that matters. , 2012, American journal of obstetrics and gynecology.

[52]  F Davidoff,et al.  Important Elements of Outpatient Care: A Comparison of Patients' and Physicians' Opinions , 1996, Annals of Internal Medicine.

[53]  D. Moher,et al.  A guide to direct measures of patient satisfaction in clinical practice. , 1992, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[54]  J. de Haes,et al.  A comprehensive assessment of satisfaction with care: preliminary psychometric analysis in an oncology institute in Italy. , 1999, Annals of oncology : official journal of the European Society for Medical Oncology.

[55]  Marie-Dominique Beaulieu,et al.  Operational Definitions of Attributes of Primary Health Care: Consensus Among Canadian Experts , 2007, The Annals of Family Medicine.

[56]  P. Bower,et al.  The General Practice Assessment Questionnaire (GPAQ) – Development and psychometric characteristics , 2008, BMC family practice.

[57]  吴东,et al.  Good medical practice , 2014 .

[58]  S. Chlabicz,et al.  Patient satisfaction with healthcare provided by family doctors: primary dimensions and an attempt at typology , 2009, BMC health services research.

[59]  Kurt C Stange,et al.  Continuity of Primary Care: To Whom Does It Matter and When? , 2003, The Annals of Family Medicine.

[60]  C Tishelman,et al.  A conceptual framework for patient–professional communication: an application to the cancer context , 2005, Psycho-oncology.

[61]  D. Safran.  Defining the Future of Primary Care: What Can We Learn from Patients? , 2003, Annals of Internal Medicine.

[62]  Janette Bennett,et al.  A model and measure for quality service user involvement in health research , 2010 .

[63]  Fatma Yilmaz,et al.  Factors Affecting Inpatient Satisfaction: Structural Equation Modeling , 2007, Journal of Medical Systems.

[64]  B. McNeil,et al.  Patient satisfaction as an indicator of quality care. , 1988, Inquiry : a journal of medical care organization, provision and financing.

[65]  M. Hojat,et al.  A brief instrument to measure patients' overall satisfaction with primary care physicians. , 2011, Family medicine.

[66]  Veljko Marinković,et al.  Patient care, satisfaction and service quality in health care , 2013 .

[67]  H. Rubin.  Patient evaluations of hospital care. A review of the literature. , 1990, Medical care.

[68]  U. Sarkar,et al.  What Patients Say About Their Doctors Online: A Qualitative Content Analysis , 2012, Journal of General Internal Medicine.

[69]  Deborah F. Spake,et al.  The Impact of Perceived Closeness on the Differing Roles of Satisfaction, Trust, Commitment, and Comfort on Intention to Remain with a Physician , 2009, Health marketing quarterly.

[70]  W. Stiles,et al.  The medical interview satisfaction scale: Development of a scale to measure patient perceptions of physician behavior , 1978, Journal of Behavioral Medicine.

[71]  J. Sitzia.  How valid and reliable are patient satisfaction data? An analysis of 195 studies. , 1999, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[72]  H. Hearnshaw,et al.  Patients in Europe evaluate general practice care: an international comparison. , 2000, The British journal of general practice : the journal of the Royal College of General Practitioners.

[73]  R. Carr-Hill,et al.  The measurement of patient satisfaction. , 1992, Journal of public health medicine.

[74]  L L Kupper,et al.  Communication, compliance, and concordance between physicians and patients with prescribed medications. , 1976, American journal of public health.

[75]  A. Bezjak,et al.  Development and testing of a visit-specific patient satisfaction questionnaire: the Princess Margaret Hospital Satisfaction With Doctor Questionnaire. , 1999, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[76]  Deirdre Mylod,et al.  Does patient satisfaction affect patient loyalty? , 2011, International journal of health care quality assurance.

[77]  A. Mainous,et al.  Continuity of care and trust in one's physician: evidence from primary care in the United States and the United Kingdom. , 2001, Family medicine.

[78]  Edward U. Bond,et al.  Patient satisfaction and patient-centered care: necessary but not equal. , 2012, JAMA.

[79]  Ella E. Young,et al.  What Do People Think Is Important about Primary Healthcare? , 2008, Healthcare policy = Politiques de sante.

[80]  Judith A. Hall,et al.  Meta-analysis of satisfaction with medical care: description of research domain and analysis of overall satisfaction levels. , 1988, Social science & medicine.

[81]  Thorsten Gruber,et al.  Uncovering the desired qualities and behaviours of general practitioners (GPs) during medical (service recovery) encounters , 2011 .