Physicians earn nearly perfect ratings from most patients

Even as physicians face increasing pressure to perform well on measures of patient satisfaction, they may take some comfort in knowing that most patients rate their own doctors very highly.

The average physician rating is 9.3 out of 10, according to a study based on nearly 15,000 patient online ratings between 2004 to 2010. The analysis is based on data from DrScore.com, an online rating site started by a physician. Sites such as Yelp.com may highlight venomous comments from some unhappy patients and paint a misleading portrait of overall patient satisfaction, said Rajesh Balkrishnan, PhD, lead author of the study.

"This instrument that we set up is an anonymous survey that patients can go online and fill out and reflect on every aspect of their visit," said Balkrishnan, associate director for research and education at the University of Michigan Center for Global Health. "When you look at the responses from something like this, it gives you a signal that there doesn't seem to be cause for so much concern. This takes into account responses from thousands and thousands of physician encounters, as opposed to a few isolated cases that attract a lot of attention."

The survey asked patients to rate elements such as their physician's attitude, the thoroughness of the visit, how well the doctor communicated and how long they sat in the waiting room. Seventy percent of the physicians earned a perfect 10.

The less time that patients spend in the waiting room and the more time they spend in the exam room with a physician, the higher the doctor's rating, the study said. Only the ratings of physicians with 10 or more assessments were included in the study.

A quarter of the doctors rated were family physicians, 11% were internists, 6% were pediatricians and the remainder were specialists outside primary care, said the study, published in the November issue of Health Outcomes Research in Medicine.

Other indicators of satisfaction

The need for physicians to meet patients' quality expectations is growing. More than 60% of health care organizations are using patient satisfaction scores to determine physician incentive payments, according to a report released in October by the Hay Group, a Philadelphia management consultancy. Medicare also plans to link 1% of pay to hospitals' performance on quality metrics, with 30% of that total based on patient satisfaction ratings.

The study is not unique in its finding that most patients are happy with their care. A November Gallup poll found that 82% of adults say the quality of the health care they receive is "good" or "excellent." Meanwhile, 94% of nearly 42,000 patients in 2010 rated their physicians a seven or higher on a 10-point scale, according to the results of the Clinician and Group Consumer Assessment of Healthcare Providers and Systems survey developed by the Agency for Healthcare Research and Quality.

When patients are asked specifically about elements of care such as physician communication in the exam room, doctors usually rate well, said Bruce Bagley, MD, medical director for quality improvement at the American Academy of Family Physicians.

"Doctors should stop worrying about those things, and focus on the customer service pieces where they probably are not making such great ratings," Dr. Bagley said. "Things like always answering the phone, having open appointment scheduling and zero waiting times. We all have a ways to go on those customer service features."