Patient life satisfaction and conscientiousness are associated with patient-reported physician satisfaction
Abstract
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.
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Reimann, S. & Strech, D. (2010). The representation of patient experience and satisfaction in physician rating sites: A criteria-based analysis of English- and German-language sites. BMC Health Services Research 10, 332.
Mpinga, E.K. & Chastonay, P. (2011). Satisfaction of patients: A right to health indicator? Health Policy 100 (2-3) 144-150.
Williams, B. (1994). Patient satisfaction: A valid concept? Social Science and Medicine 38 (4) 509-516.
Hirschman, A.O. (1970). Exit, Voice, and Loyalty: Responses to Decline in Firms, Organizations, and States. Cambridge, MA: Harvard University Press.
Le Grand, J. (2007). The Other Invisible Hand: Delivering Public Services through Choice and Competition. Princeton, NJ: Princeton University Press.
Safran, D., Montgomery, J., Chang, H., Murphy, J. & Rogers, W. (2001). Switching doctors: Predictors of voluntary disenrollment from a primary physician’s practice. Journal of Family Practice 50 (2) 130-135.
Wartman, S.A., Morlock, L.L., Malitz, F.E. & Palm, E.A. (1983). Patient understanding and satisfaction as predictors of compliance. Medical Care 21 (9) 886-891.
Crow, R., Gage, H., Hampson, S., Hart, J., Kimber, A., Storey, L. & Thomas, H. (2002). The measurement of satisfaction with healthcare: Implications for practice from a systematic review of the literature. Health Technology Assessment 6 (32) 1-277.
Shirley, E.D. & Sanders, J.O. (2013). Patient satisfaction: Implications and predictors of success. Journal of Bone and Joint Surgery 95 (10) e69(1)-e69(4).
Friedman, B., Veazie, P.J., Chapman, B.P., Manning, W.G. & Duberstein, P.R. (2013). Is personality associated with health care use by older adults? Milbank Quarterly 91 (3) 491-527.
Ware, J.E., Davis-Avery, A. & Stewart, A.L. (1977). The Measurement and Meaning of Patient Satisfaction: A Review of the Literature. The Rand Paper Series P-6036. Santa Monica, CA: The Rand Corporation.
Pascoe, G.C. (1983). Patient satisfaction in primary health care: A literature review and analysis. Evaluation and Program Planning 6 (3-4) 185-210.
Strasser, S., Aharony, L. & Greenberger, D. (1993). The patient satisfaction process: Moving toward a comprehensive model. Medical Care Review 50 (2) 219-248.
Guckes, A.D., Smith, D.E. & Swoope, C.C. (1978). Counseling and related factors influencing satisfaction with dentures. Journal of Prosthetic Dentistry 39 (3) 259-267.
Kiyak, H.A., McNeill, R.W., West, R.A., Hohl, T. & Heaton, P.J. (1986). Personality characteristics as predictors and sequelae of surgical and conventional orthodontics. American Journal of Orthodontics and Dentofacial Orthopedics 89 (5) 383-392.
Green, S.M., Hadjistavropoulos, T. & Sharpe, D. (2007). Client personality characteristics predict satisfaction with cognitive behavior therapy. Journal of Clinical Psychology 64 (1) 40-51.
Serber, E.R., Cronan, T.A. & Walen, H.R. (2003). Predictors of patient satisfaction and health care costs for patients with fibromyalgia. Psychology & Health 18 (6) 771-787.
Block, C.A., Erickson, B., Carney-Doebbling, C., Gordon, S., Fallon, B. & Konety, B.R. (2007). Personality, treatment choice and satisfaction in patients with localized prostate cancer. International Journal of Urology 14 (11) 1013-1018.
Costello, B.A., McLeod, T.G., Locke, G.R., Dierkhising, R.A., Offord, K.P. & Colligan, R.C. (2008). Pessimism and hostility scores as predictors of patient satisfaction ratings by medical out-patients. International Journal of Health Care Quality Assurance 21 (1) 39-49.
Weiss, G.L. (1988). Satisfaction with primary medical care: Evaluation of sociodemographic and predispositional factors. Medical Care 26 (4) 383-392.
Friedman, B., Wamsley, B.R., Liebel, D.V., Saad, Z.B. & Eggert, G.M. (2009). Patient satisfaction, empowerment, and health and disability status effects of a disease management–health promotion nurse intervention among Medicare beneficiaries with disabilities. Gerontologist 49 (6) 778-792.
Weiss, A., Costa, P.T. Jr., Karuza, J., Duberstein, P.R., Friedman, B. & McCrae, R.R. (2005). Cross-sectional age differences in personality among Medicare patients aged 65 to 100. Psychology and Aging 20 (1) 182-185.
Tanne, J.H. (2008). How patients rate doctors. British Medical Journal 337, a1408.
Sitzia, J. & Wood, N. (1997). Patient satisfaction: A review of issues and concepts. Social Science and Medicine 45 (12) 1829-1843.
Sixma, H.J., Spreeuwenberg, P.M. & van der Pasch, M.A. (1998). Patient satisfaction with the general practitioner: A two-level analysis. Medical Care 36 (2) 212–229.
Salisbury, C., Wallace, M. & Montgomery, A.A. (2010). Patients’ experience and satisfaction in primary care: Secondary analysis using multilevel modelling. British Medical Journal 341, c5004.
Roghmann, K.J., Hengst, A. & Zastowny, T.R. (1979). Satisfaction with medical care: Its measurement and relation to utilization. Medical Care 17 (5) 461-479.
Jerant, A., Fenton, J.J., Bertakis, K.D. & Franks, P. (2014). Satisfaction with health care providers and preventive care adherence: A national study. Medical Care 52 (1) 78-85.
Costa, P.T., Jr. & McCrae, R.R. (1992). Revised NEO Personality Inventory and NEO Five Factor Inventory: Professional Manual. Odessa, FL: Psychological Assessment Resources.
Greiner, P.A., Snowden, D.A. & Greiner, L.H. (1996). The relationship of self-rated function and self-rated health to concurrent functional ability, functional decline, and mortality: Findings from the Nun Study. Journal of Gerontology, Series B, Psychological Sciences and Social Sciences 51B (5) S234-S241.
Ware, J.E., Kosinski, M. & Keller, S.D. (1994). SF-36 Physical and Mental Health Summary Scales: A User’s Manual. Boston, MA: Health Institute.
Cronbach, L.J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika 16 (3) 297-334.
Nunnally, J. (1978). Psychometric Theory. 2nd edn. New York, NY: McGraw-Hill.
Martin, L.R., Friedman, H.S. & Schwartz, J.E. (2007). Personality and mortality risk across the lifespan: The importance of conscientiousness as a biopsychosocial attribute. Health Psychology 26 (4) 428-436.
Roberts, B.W., Lejuez, C., Krueger, R.F., Richards, J.M. & Hill, P.L. (2014). What is conscientiousness and how can it be assessed? Developmental Psychology 50 (5) 1315-1330.
Hargraves, J.L., Hays, R.D. & Cleary, P.D. (2003). Psychometric properties of the Consumer Assessment of Health Plans Study (CAHPS) 2.0 Adult Core Survey. Health Services Research 38 (6, Pt 1) 1509-1527.
Safran, D.G., Karp, M., Coltin, K., Chang, H., Li, A., Ogren, J. & Rogers, W.H. (2006). Measuring patients’ experiences with individual primary care physicians: Results of a statewide demonstration project. Journal of General Internal Medicine 21 (1) 13-21.
Gray, B.M., Vandergrift, J.L., Gao, G., McCullough, J.S. & Lipner, R.S. (2015). Website ratings of physicians and their quality of care. JAMA Internal Medicine 175 (2) 291-293.
Lucas, R.E. & Donnellan, M.B. (2012). Estimating the reliability of single-item life satisfaction measures: Results from four national panel studies. Social Indicators Research 105 (3) 323-331.
Diener, E., Inglehart, R. & Tay, L. (2013). Theory and validity of life satisfaction scales. Social Indicators Research 112 (3) 497-527.
Chapman, B., Duberstein, P.R., Sörensen, S. & Lyness, J.M. (2006). Personality and perceived health in older adults: The Five Factor Model in primary care. Journal of Gerontology, Series B, Psychological Sciences and Social Sciences 61 (6) P362-P365.
Tenney, E.R., Turkheimer, E. & Oltmanns, T.F. (2009). Being liked is more than having a good personality: The role of matching. Journal of Research in Personality 43 (4) 579-585.
Duberstein, P., Meldrum, S., Fiscella, K., Shields, C.J. & Epstein, R.M. (2007). Influences on patients’ ratings of physicians: Physicians’ demographics and personality. Patient Education and Counseling 65 (2) 270-274.
Roberts, B.W., Walton, K.E. & Viechtbauer, W. (2006). Patterns of mean-level change in personality traits across the life course: A meta-analysis of longitudinal studies. Psychological Bulletin 132 (1) 1-25.
DOI: http://dx.doi.org/10.5750/ejpch.v5i3.1342
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