Journal of General Internal Medicine

, Volume 29, Issue 3, pp 447–454 | Cite as

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

  • Denise D. Quigley
  • Marc N. ElliottEmail author
  • Donna O. Farley
  • Q Burkhart
  • Samuel A. Skootsky
  • Ron D. Hays
Original Research



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.


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


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


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.


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.


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).


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.


doctor–patient relationship specialty care quality improvement patient satisfaction 



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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Copyright information

© Society of General Internal Medicine 2013

Authors and Affiliations

  • Denise D. Quigley
    • 1
  • Marc N. Elliott
    • 1
    Email author
  • Donna O. Farley
    • 1
  • Q Burkhart
    • 1
  • Samuel A. Skootsky
    • 2
  • Ron D. Hays
    • 1
    • 2
  1. 1.RAND CorporationSanta MonicaUSA
  2. 2.UCLA Division of General Internal Medicine & Health Services ResearchLos AngelesUSA

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