Patient satisfaction in resident and attending ambulatory care clinics

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 <or= .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.