Patient satisfaction in resident and attending ambulatory care clinics

OBJECTIVE: To measure and compare patient satisfaction with care in residen t and attending physician internal medicine ambulatory care clinics. DESIGN: A cross-sectional survey using a questionnaire derived from the Vis it-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 assoc iated Veterans' Affairs (VA) hospital. PARTICIPANTS: Two hundred eighty-eight patients of 76 resident and 25 atten ding physicians. RESULTS: Patients of resident physicians at the university site were more l ikely to be African American, male, have lower socioeconomic status and hav e lower physical and mental health scores on the Short Form-12 than patient s of university attendings. Patients of resident and attending physicians a t the VA site were similar. In multivariate analyses, patients of universit y attending physicians were more likely to be highly satisfied than patient s of university residents on the VSQ-Physician (odds ratio [OR], 3.5; 95% c onfidence interval [CI], 1.6 to 7.8) and the PSI-Physician (OR, 10.1; 95% C I, 3.7 to 27.4) summary scores. Differences were not seen on the summary sc ores 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 less than or equal to .03 at both sites) and "my doctor always treats me with the highest resp ect" (P < .001 at both sites). CONCLUSIONS: After controlling for patient characteristics, patients of res ident physicians were less satisfied than those of attending physicians, es pecially in regard to the doctor's personal manner and respect toward the p atient. Medical education should continue to emphasize the importance of th ese aspects of the physician-patient encounter.