Garcia LC, Chung S, Liao L, Altamirano J, Fassiotto M, Maldonado B, Heidenreich P, Palaniappan L., JAMA Netw Open. 2(2):e190027. doi: 10.1001/jamanetworkopen.2019.0027., 2019 Feb 01
Importance: Patient satisfactionscores are used to inform decisions about physician compensation, and thereremains a lack of consensus regarding the need to adjust scores for patientrace/ethnicity. Previous research suggests that patients prefer physicians of the same race/ethnicity as themselves and that Asian patients provide lowersatisfaction scores than non-Hispanic white patients.
Objective: To examine whetherAsian physicians receive less favorable patient satisfaction scores relative tonon-Hispanic white physicians.
Design, Setting, andParticipants: This population-based survey study used data from Press GaneyOutpatient Medical Practice Surveys collected from December 1, 2010, toNovember 30, 2014, which included 149?775 patient survey responses for 962physicians. Every month, 5 patients per physician were randomly selected tocomplete a satisfaction survey after an outpatient visit. Hierarchicalmultivariable logistic regression was used to examine the association betweenAsian race/ethnicity of the physician and racial/ethnic concordance of thepatient with the probability of receiving the highest score on the survey itemrating the likelihood to recommend the physician. Statistical analysis wasperformed from April 2 to August 27, 2018.
Exposures: Physiciancharacteristics included race/ethnicity, sex, years in practice, and proportionof Asian patient responders. Patient characteristics included race/ethnicity,sex, age, and language spoken.
Main Outcomes and Measures: Thehighest score (a score of 5 on a 1-5 Likert scale, where 1 indicates very poorand 5 indicates very good) on the survey item rating the likelihood torecommend the physician on the Press Ganey Outpatient Medical Practice Survey.
Results: Of the 962 physiciansin this study, 515 (53.5%) were women; physicians had a mean (SD) of 19.9 (9.1)years of experience since graduating medical school; 573 (59.6%) were white,and 350 (36.4%) were Asian. In unadjusted analyses, the odds of receiving thehighest score on the survey item rating the likelihood to recommend thephysician were lower for Asian physicians compared with non-Hispanic whitephysicians (odds ratio, 0.78; 95% CI, 0.72-0.84; P < .001). This associationwas not significant after adjusting for patient characteristics, includingpatient race/ethnicity. However, Asian patients were less likely to give thehighest scores relative to non-Hispanic white patients (odds ratio, 0.56; 95%CI, 0.54-0.58; P < .001), regardless of physician race/ethnicity.
Conclusions and Relevance: Thisstudy suggests that Asian physicians may be more likely to receive lowerpatient satisfaction scores because they serve a greater proportion of Asianpatients. Patient satisfaction scores should be adjusted for patientrace/ethnicity.