PHYSICIANS ATTITUDES TOWARD USING PATIENT REPORTS TO ASSESS QUALITY OF CARE

Purpose. Patients' reports about their care, including reports about s pecific physician behaviors, are increasingly being used to assess qua lity of care. The authors surveyed physicians in an academic environme nt about their attitudes concerning possible uses of these reports. Me thod. A survey was conducted of the 540 hospital- and community-based internists and housestaff at Beth Israel Hospital in Boston, Massachus etts, in 1993-94. The survey instrument included seven items designed to assess the physicians' views about potential uses of patient report s about their care, The physicians were asked to rate the items on a f ive-point scale (ranging from ''strongly agree'' to ''strongly disagre e''). Results. A total of 343 (64%) of the physicians responded. Eight y-six percent agreed that patient judgments are important in assessing quality of care. There was widespread agreement with four potential u ses of patient judgments: for changing a specific physician behavior ( 94% agreed), for receiving feedback from patients (90%), for use in ph ysician education programs (81%), and for evaluating students and hous estaff (72%). However, far fewer of the physicians agreed with two use s over which physicians would have less control: publishing judgments to help patients select physicians (28% agreed) and the use of judgmen ts to influence physician compensation (16%). While the housestaff wer e less likely to agree with the use of patient reports in housestaff e valuations, the housestaff and faculty had similar opinions about all the other potential uses. Conclusion. The physicians believed that pat ients' reports about experiences with their physicians are valid indic ators of quality. They responded that they would accept using these re ports to improve care when the uses are nonthreatening and within the control of physicians. In contrast, there was far less support when th e uses are external to physician control and potentially threatening.