Advertisement

Journal of General Internal Medicine

, Volume 19, Issue 11, pp 1088–1095 | Cite as

Satisfaction with the outpatient encounter

A comparison of patients’ and physicians’ views
  • Linda C. ZandbeltEmail author
  • Ellen M. A. Smets
  • Frans J. Oort
  • Mieke H. Godfried
  • Hanneke C. J. M. de Haes
Original Articles

Abstract

OBJECTIVE: To compare patients’ and physicians’ visit-specific satisfaction in an internal medicine outpatient setting, and to explain their respective views.

DESIGN: Patients’ and physicians’ background characteristics were assessed prior to outpatient encounters. Immediately after the encounter, both patients and physicians completed a questionnaire assessing satisfaction with the visit.

SETTING: The outpatient division of an academic teaching hospital.

PARTICIPANTS: Thirty residents and specialists in general internal medicine, rheumatology, and gastroenterology, and 330 patients having a follow-up appointment with one of these physicians.

MEASUREMENTS AND MAIN RESULTS: Patients’ and physicians’ visit-specific satisfaction was assessed using 5 Visual Analogue Scales (0 to 100). Patients’ overall satisfaction was higher than physicians’ satisfaction (mean 81 vs. 66), and correlation of patients’ and physicians’ overall satisfaction with the specific visit was medium sized (r=.28, P<.001). Patients’ satisfaction ratings were associated with their previsit self-efficacy in communicating with their physician (P<.001) and with visiting a female physician (P<.01). Physicians’ satisfaction was associated with patients’ higher educational level (P<.05), primary language being Dutch (P<.001), better mental health (P<.05), and preference for receiving less than full information (P<.05).

CONCLUSIONS: In an outpatient setting, patients’ visit-specific satisfaction ratings were substantially higher than, and only moderately associated with, physicians’ ratings of the same visit. The dissimilar predictors explaining patients’ and physicians’ satisfaction suggest that patients and physicians form their opinion about a consultation in different ways. Hence, when evaluating outpatient encounters, physicians’ satisfaction has additional value to patients’ satisfaction in establishing quality of care.

Key words

physician-patient relations patient satisfaction physician satisfaction outpatients 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Suchman AL, Roter D, Green M, Lipkin MJ. Physician satisfaction with primary care office visits. Collaborative Study Group of the American Academy on Physician and Patient. Med Care. 1993;31:1083–92.PubMedCrossRefGoogle Scholar
  2. 2.
    Fairhurst K, May C. Consumerism and the consultation: the doctor’s view. Fam Pract. 1995;12:389–91.PubMedCrossRefGoogle Scholar
  3. 3.
    Orden SR, Collette P, Souchek J, Masover L, Stamler J. Physician and patient assessment of ambulatory care in a university facility. J Community Health. 1978;4:23–32.PubMedCrossRefGoogle Scholar
  4. 4.
    Lewis CC, Pantell RH, Sharp L. Increasing patient knowledge, satisfaction, and involvement: randomized trial of a communication intervention. Pediatrics. 1991;88:351–8.PubMedGoogle Scholar
  5. 5.
    Shore BE, Franks P. Physician satisfaction with patient encounters. Reliability and validity of an encounter-specific questionnaire. Med Care. 1986;24:580–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Roter DL, Stewart M, Putnam SM, Lipkin MJ, Stiles W, Inui TS. Communication patterns of primary care physicians. JAMA. 1997;277:350–6.PubMedCrossRefGoogle Scholar
  7. 7.
    Hornberger J, Thom D, McCurdy T. Effects of a self-administered previsit questionnaire to enhance awareness of patients’ concerns in primary care. J Gen Intern Med. 1997;12:597–606.PubMedCrossRefGoogle Scholar
  8. 8.
    Mann S, Sripathy K, Siegler EL, Davidow A, Lipkin M, Roter DL. The medical interview: differences between adult and geriatric outpatients. J Am Geriatr Soc. 2001;49:65–71.PubMedCrossRefGoogle Scholar
  9. 9.
    Detmar SB, Muller MJ, Schornagel JH, Wever LD, Aaronson NK. Health-related quality-of-life assessments and patient-physician communication: a randomized controlled trial. JAMA. 2002;288:3027–34.PubMedCrossRefGoogle Scholar
  10. 10.
    Kurata JH, Nogawa AN, Phillips DM, Hoffman S, Werblun MN. Patient and provider satisfaction with medical care. J Fam Pract. 1992;35:176–9.PubMedGoogle Scholar
  11. 11.
    Jung HP, Wensing M, Olesen F, Grol R. Comparison of patients’ and general practitioners’ evaluations of general practice care. Qual Saf Health Care. 2002;11:315–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Rashid A, Forman W, Jagger C, Mann R. Consultations in general practice: a comparison of patients’ and doctors’ satisfaction. BMJ. 1989;299:1015–6.PubMedGoogle Scholar
  13. 13.
    Winefield HR, Murrell TG, Clifford J. Process and outcomes in general practice consultations: problems in defining high quality care. Soc Sci Med. 1995;41:969–75.PubMedCrossRefGoogle Scholar
  14. 14.
    Probst JC, Greenhouse DL, Selassie AW. Patient and physician satisfaction with an outpatient care visit. J Fam Pract. 1997;45:418–25.PubMedGoogle Scholar
  15. 15.
    Weinberger M, Greene JY, Mamlin JJ. The impact of clinical encounter events on patient and physician satisfaction. Soc Sci Med. 1981;15:239–44.Google Scholar
  16. 16.
    Hall JA, Dornan MC. Patient sociodemographic characteristics as predictors of satisfaction with medical care: a meta-analysis. Soc Sci Med. 1990;30:811–8.CrossRefGoogle Scholar
  17. 17.
    Jackson JL, Chamberlin J, Kroenke K. Predictors of patient satisfaction. Soc Sci Med. 2001;52:609–20.PubMedCrossRefGoogle Scholar
  18. 18.
    Sitzia J, Wood N. Patient satisfaction: a review of issues and concepts. Soc Sci Med. 1997;45:1829–43.PubMedCrossRefGoogle Scholar
  19. 19.
    Kreft I, de-Leeuw J. Introducing Multilevel Modeling. Thousand Oaks, Calif: Sage Publications, 1998:x, 149.Google Scholar
  20. 20.
    Blanchard CG, Ruckdeschel JC, Fletcher BA, Blanchard EB. The impact of oncologists’ behaviors on patient satisfaction with morning rounds. Cancer. 1986;58:387–93.PubMedCrossRefGoogle Scholar
  21. 21.
    Ong LML, Visser MRM, Lammes FB, de Haes JCJM. Doctor-patient communication and cancer patients’ quality of life and satisfaction. Patient Educ Couns. 2000;41:145–56.PubMedCrossRefGoogle Scholar
  22. 22.
    Cassileth BR, Zupkis RV, Sutton-Smith K, March V. Information and participation preferences among cancer patients. Ann Intern Med. 1980;92:832–6.PubMedGoogle Scholar
  23. 23.
    Sutherland HJ, Llewellyn-Thomas HA, Lockwood GA, Tritchler DL, Till JE. Cancer patients: their desire for information and participation in treatment decisions. J R Soc Med. 1989;82:260–3.PubMedGoogle Scholar
  24. 24.
    Maly RC, Frank JC, Marshall GN, DiMatteo MR, Reuben DB. Perceived efficacy in patient-physician interactions (PEPPI): validation of an instrument in older persons. J Am Geriatr Soc. 1998;46:889–94.PubMedGoogle Scholar
  25. 25.
    Ware JJ, 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.PubMedCrossRefGoogle Scholar
  26. 26.
    de Monchy C, Richardson R, Brown RA, Harden RM. Measuring attitudes of doctors: the doctor-patient (DP) rating. Med Educ. 1988;22:231–9.PubMedGoogle Scholar
  27. 27.
    Batenburg, V. Medical students’ attitudes: attitude development in a medical school. PhD Thesis, Utrecht: Elinkwijk BV; 1997.Google Scholar
  28. 28.
    Miller KI, Stiff JB, Ellis BH. Communication and empathy as precursors to burn-out among human service workers. Commun Monogr. 1988;55:250–65.CrossRefGoogle Scholar
  29. 29.
    Hox JJ. Multilevel Analysis. Techniques and Applications. London, UK: Lawrence Erlbaum Associates, Inc.; 2002.Google Scholar
  30. 30.
    SPSS Inc. SPSS 11.5 Syntax Reference Guide: Base System, Advanced Models, Regression Models. Chicago, Ill: SPSS Inc.; 2003.Google Scholar
  31. 31.
    Rashbash J, Browne W, Goldstein H, et al. A User’s Guide to MLwiN. London, UK: University of London, Centre of Multilevel Modelling, Institute of Education; 2002.Google Scholar
  32. 32.
    Cohen J. Statistical Power Analysis for the Behavioral Sciences. Rev. ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1987:xv, 474.Google Scholar
  33. 33.
    Laine C, Davidoff F, Lewis CE, et al. Important elements of outpatient care: a comparison of patients’ and physicians’ opinions. Ann Intern Med. 1996;125:640–5.PubMedGoogle Scholar
  34. 34.
    Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Upper Saddle River, NJ: Prentice-Hall; 1986:xiii, 617.Google Scholar
  35. 35.
    Linn LS, Cope DW, Leake B. The effect of gender and training of residents on satisfaction ratings by patients. J Med Educ. 1984;59:964–6.PubMedGoogle Scholar
  36. 36.
    Delgado A, Lopez-Fernandez LA, Luna JD. Influence of the doctor’s gender in the satisfaction of the users. Med Care. 1993;31:795–800.PubMedGoogle Scholar
  37. 37.
    Bertakis KD, Helms LJ, Callahan EJ, Azari R, Robbins JA. The influence of gender on physician practice style. Med Care. 1995;33:407–16.PubMedCrossRefGoogle Scholar
  38. 38.
    Roter DL, Geller G, Bernhardt BA, Larson SM, Doksum T. Effects of obstetrician gender on communication and patient satisfaction. Obstet Gynecol. 1999;93:635–41.PubMedCrossRefGoogle Scholar
  39. 39.
    Murphy-Cullen CL, Larsen LC. Interaction between the sociodemographic variables of physicians and their patients: its impact upon patient satisfaction. Soc Sci Med. 1984;19:163–6.PubMedCrossRefGoogle Scholar
  40. 40.
    Anderson LA, Zimmerman MA. Patient and physician perceptions of their relationship and patient satisfaction: a study of chronic disease management. Patient Educ Couns. 1993;20:27–36.PubMedCrossRefGoogle Scholar
  41. 41.
    Haas JS, Cook EF, Puopolo AL, Burstin HR, Cleary PD, Brennan TA. Is the professional satisfaction of general internists associated with patient satisfaction? J Gen Intern Med. 2000;15:122–8.PubMedCrossRefGoogle Scholar
  42. 42.
    Roter DL, Hall JA, Aoki Y. Physician gender effects in medical communication: a meta-analytic review. JAMA. 2002;288:756–64.PubMedCrossRefGoogle Scholar
  43. 43.
    Gattellari M, Butow PN, Tattersall MH. Sharing decisions in cancer care. Soc Sci Med. 2001;52:1865–78.PubMedCrossRefGoogle Scholar
  44. 44.
    Golin C, DiMatteo MR, Duan N, Leake B, Gelberg L. Impoverished diabetic patients whose doctors facilitate their participation in medical decision making are more satisfied with their care. J Gen Intern Med. 2002;17:857–66.PubMedGoogle Scholar
  45. 45.
    Williams B, Coyle J, Healy D. The meaning of patient satisfaction: an explanation of high reported levels. Soc Sci Med. 1998;47:1351–9.PubMedCrossRefGoogle Scholar
  46. 46.
    Williams S, Weinman J, Dale J. Doctor-patient communication and patient satisfaction: a review. Fam Pract. 1998;15:480–92.PubMedCrossRefGoogle Scholar
  47. 47.
    Mead N, Bower P. Patient-centred consultations and outcomes in primary care: a review of the literature. Patient Educ Couns. 2002;48:51.PubMedCrossRefGoogle Scholar
  48. 48.
    Lewin SA, Skea ZC, Entwistle V, Zwarenstein M, Dick J. Interventions for providers to promote a patient-centered approach in clinical consultations. Cochrane Database Syst Rev. 2001;CD003267.Google Scholar

Copyright information

© Society of General Internal Medicine 2004

Authors and Affiliations

  • Linda C. Zandbelt
    • 1
    Email author
  • Ellen M. A. Smets
    • 1
  • Frans J. Oort
    • 1
  • Mieke H. Godfried
    • 2
  • Hanneke C. J. M. de Haes
    • 1
  1. 1.the Departments of Medical PsychologyAcademic Medical Center/University of AmsterdamAmsterdamThe Netherlands
  2. 2.Internal MedicineAcademic Medical Center/University of AmsterdamAmsterdamThe Netherlands

Personalised recommendations