RT Journal Article
SR Electronic
T1 Are Patients’ Ratings of Their Physicians Related to Health Outcomes?
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 229
OP 234
DO 10.1370/afm.267
VO 3
IS 3
A1 Peter Franks
A1 Kevin Fiscella
A1 Cleveland G. Shields
A1 Sean C. Meldrum
A1 Paul Duberstein
A1 Anthony F. Jerant
A1 Daniel J. Tancredi
A1 Ronald M. Epstein
YR 2005
UL http://www.annfammed.org/content/3/3/229.abstract
AB PURPOSE Observational studies using patient reports suggest associations between physician interpersonal styles and patient outcomes. Possible confounding of these associations has not been carefully examined. METHODS Approximately 4,700 patients of 96 physicians completed a survey instrument that included reported health status changes during the previous year, perceptions of their physician (satisfaction, trust, knowledge of patient, and autonomy support), and sociodemographic and clinical covariates. We examined the adjusted relationship between patient perceptions of their physicians and reported health status changes. Using multilevel analyses, we then explored differences among physicians in patient perceptions of their physicians and whether these differences were explained by the relationship between patient perceptions and reported health status changes. RESULTS There were significant adjusted relationships between patient perceptions of their physician and reported health status changes: better perceptions were associated with a smaller risk of health status decline (adjusted odds ratio = 1.14; 95% confidence interval [CI], 1.05–1.24; P <.01). Multilevel analysis showed significant differences between physicians in patient perceptions of their physicians (ρ = 0.10; 95% CI, 0.07–0.13; P <.01), but these physician differences were unrelated to reported health status decline (ρ = 0; P >.99). CONCLUSIONS Using methods similar to those of previous studies, we found a relationship between patient perceptions of their physicians and reported health status declines. Multilevel analysis, however, suggested that this relationship is not a physician effect; it may reflect unmeasured patient confounding. Multilevel analyses may help to examine the relationships between physician styles and outcomes.