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Specialties Differ in Which Aspects of Doctor Communication Predict Overall Physician Ratings

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ABSTRACT

BACKGROUND

Effective doctor communication is critical to positive doctor–patient relationships and predicts better health outcomes. Doctor communication is the strongest predictor of patient ratings of doctors, but the most important aspects of communication may vary by specialty.

OBJECTIVE

To determine the importance of five aspects of doctor communication to overall physician ratings by specialty.

DESIGN

For each of 28 specialties, we calculated partial correlations of five communication items with a 0–10 overall physician rating, controlling for patient demographics.

PATIENTS

Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS®) 12-month Survey data collected 2005–2009 from 58,251 adults at a 534-physician medical group.

MAIN MEAsURES

CG-CAHPS includes a 0 (“Worst physician possible”) to 10 (“Best physician possible”) overall physician rating. Five doctor communication items assess how often the physician: explains things; listens carefully; gives easy-to-understand instructions; shows respect; and spends enough time.

KEY RESULTS

Physician showing respect was the most important aspect of communication for 23/28 specialties, with a mean partial correlation (0.27, ranging from 0.07 to 0.44 across specialties) that accounted for more than four times as much variance in the overall physician rating as any other communication item. Three of five communication items varied significantly across specialties in their associations with the overall rating (p < 0.05).

CONCLUSIONS

All patients valued respectful treatment; the importance of other aspects of communication varied significantly by specialty. Quality improvement efforts by all specialties should emphasize physicians showing respect to patients, and each specialty should also target other aspects of communication that matter most to their patients. The results have implications for improving provider quality improvement and incentive programs and the reporting of CAHPS data to patients. Specialists make important contributions to coordinated patient care, and thus customized approaches to measurement, reporting, and quality improvement efforts are important.

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Acknowledgements

This study was supported by a cooperative agreement from the Agency for Healthcare Research and Quality (U18 HS016980). Ron D. Hays was also supported in part by grants from the NIA (P30-AG021684) and the NIMHD (P20MD000182). The authors would like to thank Aneetha Ramadas, AB, Daisy Montfort, AB, and Fergal McCarthy, MPhil, for assistance with the preparation of the manuscript.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Authors and Affiliations

  1. RAND Corporation, 1776 Main St., Santa Monica, CA, 90401, USA

    Denise D. Quigley PhD, Marc N. Elliott PhD, Donna O. Farley PhD, Q Burkhart MS & Ron D. Hays PhD

  2. UCLA Division of General Internal Medicine & Health Services Research, Los Angeles, CA, USA

    Samuel A. Skootsky MD & Ron D. Hays PhD

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  1. Denise D. Quigley PhD
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  2. Marc N. Elliott PhD
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  3. Donna O. Farley PhD
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Correspondence to Marc N. Elliott PhD.

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Quigley, D.D., Elliott, M.N., Farley, D.O. et al. Specialties Differ in Which Aspects of Doctor Communication Predict Overall Physician Ratings. J GEN INTERN MED 29, 447–454 (2014). https://doi.org/10.1007/s11606-013-2663-2

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  • DOI: https://doi.org/10.1007/s11606-013-2663-2

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