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Patient life satisfaction and conscientiousness are associated with patient-reported physician satisfaction

Bruce Friedman, Peter J Veazie, Kevin A Fiscella, Benjamin P Chapman, Paul R Duberstein


Rationale, aims and objectives: The main purpose of our study was to determine whether patient personality and life satisfaction are associated with patient-reported physician satisfaction (PRPS). PRPS ratings are becoming increasingly important in public reporting and in healthcare policy relating to choice, quality and cost. Although some PRPS ratings adjust for patient sociodemographic characteristics and health status, most have not yet accounted for patient psychosocial factors. If psychosocial characteristics are associated with physician ratings, then websites, reports and payers that evaluate, rank, or pay physicians on the basis of PRPS can be misleading.

Method: The Medicare Primary and Consumer-Directed Care Demonstration (1998-2000) included 19 counties in three U.S. states from which community-dwelling Medicare patients with disabilities and recent significant healthcare use were recruited. Cross-sectional analyses were conducted on data provided by 376 patients of 24 primary care physicians with at least 10 patients enrolled in the Medicare Demonstration. The mean patient age was 79.4 years and 71% were female. The key psychosocial analytic variables were 5 patient personality traits (Neuroticism, Extraversion, Openness to Experience, Agreeableness and Conscientiousness) and patient-reported life satisfaction. The mean T-scores for 4 of the Big Five personality traits were similar to national norms. The outcome variable was a 5-item PRPS scale. A zero-inflated negative binomial regression model was employed.

Results: Higher Conscientiousness (p=0.026) and greater (excellent-very good) life satisfaction (p=0.026) were associated with higher PRPS.

Conclusions: Two patient factors not typically considered reflective of physician quality - life satisfaction and Conscientiousness - were associated with patients’ satisfaction with their physicians. Further research is needed to replicate and extend these findings and to explore how and why Conscientiousness and life satisfaction are related to PRPS ratings. Policymakers and payers should consider whether patient psychosocial characteristics should be used to adjust PRPS.


Evaluation, healthcare, health policy, health services research, patient-centered care, patient life satisfaction, patient-reported physician satisfaction, person-centered healthcare

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