Motivating physicians to increase productivity and maximize patient satisfaction may result in conflicted behavior, raising questions about whether one must be sacrificed for the other. To determine if high satisfaction (measured by Press Ganey patient satisfaction survey) can be achieved while maintaining high productivity (measured in McGladrey relative value units, MRVU), longitudinal data collected from January 2002 to July 2004 were modeled using repeated measures regression. A total of 136 000 patient-completed satisfaction questionnaires evaluating 417 physicians were collected for analysis. Patient confidence (positively correlated; P= .001) and physician/patient time (inversely correlated; P= .001) were associated with higher physician productivity. Increases in MRVU were associated with decreases in patient perceptions of time with the physician (P= .003). The relationships between patient satisfaction and physician productivity were relatively small, suggesting that they are not necessarily incompatible and that both can be improved simultaneously. (Am J Med Qual 2009;24:498-504)
vom Eigen KA , Delbanco TL, Phillips RSPerceptions of quality of care and the decision to leave a practice. Am J Med Qual. 1998;13:181-187.
2.
Drain M.Quality improvement in primary care and the importance of patient perceptions . J Ambul Care Manage. 2001;24:30-46.
3.
Institute of Medicine.Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press; 2001 .
4.
Clark PAMedical practices’ sensitivity to patients’ needs. Opportunities and practices for improvement. J Ambul Care Manage. 2003;26:110-123.
5.
Epstein RM, Franks P., Fiscella K., et al. Measuring patient-centered communication in patient-physician consultations: theoretical and practical issues. Soc Sci Med . 2005;61: 1516-1528.
6.
Epstein RMMaking communication research matter: what do patients notice, what do patients want, and what do patients need?Patient Educ Couns. 2006;60:272-278.
7.
Stewart M., Brown JB, Donner A., et al. The impact of patient-centered care on outcomes. J Fam Pract. 2000;49:796-804.
8.
Centers for Medicare and Medicaid Services and Agency for Healthcare Research and Quality.CAHPS Hospital Survey (HCAHPS) fact sheet. http://www.cms.hhs.gov/HospitalQualityInits/30_HospitalHCAHPS.asp . Accessed August 16, 2006.
9.
Dugdale DC, Epstein R., Pantilat SZTime and the patient-physician relationship. J Gen Intern Med. 1999;14(suppl 1): S34-S40.
10.
Morrell DC, Evans ME, Morris RW, Roland MOThe "five minute" consultation: effect of time constraint on clinical content and patient satisfaction. Br Med J (Clin Res Ed). 1986;292:870-873.
11.
Zyzanski SJ , Stange KC, Langa D., Flocke SATrade-offs in high-volume primary care practice . J Fam Pract. 1998; 46:397-402.
12.
Lin CT, Albertson GA, Schilling LM, et al. Is patients’ perception of time spent with the physician a determinant of ambulatory patient satisfaction? Arch Intern Med. 2001; 161:1437-1442.
13.
Johnson SE, Newton WPResource-based relative value units: a primer for academic family physicians . Fam Med. 2002;34:172-176.
14.
Hurdle S., Pope GCImproving physician productivity. J Ambul Care Manage. 1989;12:11-26.
15.
Duck E., DeLia D., Cantor JCPrimary care productivity and the health care safety net in New York City . J Ambul Care Manage. 2001;24:1-14.
16.
Radecki SE, Kane RL, Solomon DH, Mendenhall RC, Beck JCDo physicians spend less time with older patients? J Am Geriatr Soc. 1988;36:713-718.
17.
Smith DM, Martin DK, Langefeld CD, Miller ME, Freedman JAPrimary care physician productivity: the physician factor. J Gen Intern Med. 1995;10:495-503.
18.
Coleman DL, Moran E., Serfilippi D., et al. Measuring physicians’ productivity in a Veterans’ Affairs medical center. Acad Med. 2003;78:682-689.
19.
Duberstein P., Meldrum S., Fiscella K., Shields CG, Epstein RMInfluences on patients’ ratings of physicians: physicians demographics and personality. Patient Educ Couns . 2007;65:270-274.
20.
Anderson R. , Barbara A., Feldman S.What patients want: a content analysis of key qualities that influence patient satisfaction. J Med Pract Manage. 2007;22:255-261.
21.
Fan VS, Burman M., McDonell MB, Fihn SDContinuity of care and other determinants of patient satisfaction with primary care. J Gen Intern Med. 2005;20:226-233.
22.
Cooper LA, Roter DL, Johnson RL, Ford DE, Steinwachs DM, Powe NRPatient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med. 2003;139:907-915.
23.
Leddy KM, Kaldenberg DO, Becker BWTimeliness in ambulatory care treatment. An examination of patient satisfaction and wait times in medical practices and outpatient test and treatment facilities . J Ambul Care Manage. 2003;26: 138-149.
