Physician empathy affects HIV patient satisfaction
Physician empathy affects HIV patient satisfaction
Research looks at what patients really want
HIV-infected patients will be more satisfied with their physicians if they perceive that their doctors are showing empathy and are knowledgeable about HIV, according to a recent study.1
"It’s the quality of patient-doctor communication that drives patient satisfaction," says Jeffrey Samet, MD, MPH, associate professor of medicine and public health at Boston University Schools of Medicine and Public Health. Samet was the study’s principal investigator.
Patient satisfaction has become a more important issue in medicine in recent years, and HIV patients are no exception. Patients who are pleased with their medical care are more likely to be adherent to their treatment regimens and often have improved clinical outcomes, according to earlier research.
"There are a lot of reasons why one would like to enhance satisfaction," Samet says. Physicians would want to enhance customer satisfaction to demonstrate better clinical outcomes and to improve their quality report cards with managed care companies.
The study involved 203 HIV-infected patients who were assessed at baseline and divided into four categories: sociodemographic, HIV risk, alcohol and drug use, and health status and quality of life.
At six months, 146 of the original 203 patients were interviewed. Investigators measured their satisfaction by asking them two questions: "Does your primary care physician meet your expectations?" and "How satisfied are you with your primary care physician?"1
Patients were asked to respond on a four-point scale that included these responses: completely, somewhat, a little, and not at all. Patients’ responses were summed and scaled from 0 to 100.
The study found that 56% of patients were nearly completely satisfied with their physician, meaning that their answers to the two satisfaction questions were either "completely" and "completely," or "completely" and "somewhat."
There was an association between patients’ satisfaction levels and some of their answers to a long list of other questions related to their medical care. But there was no association between satisfaction and any of the sociodemographic characteristics of patients or to their risk factors, health status, or alcohol and drug use, Samet says.
"The important qualities of primary care physicians had to do with how they communicated with their patients," he says.
This finding was different from previous studies, which did find a significant association between a patient’s characteristics, the characteristics of the site of care, and overall satisfaction.
Here are some of the other issues that investigators asked patients to address at the six-month follow-up interview:
• Rate the convenience of their clinic’s hours.
• Was there one doctor’s office/clinic where the patient received most of his or her care?
• Did the patient see one doctor, nurse, or physician’s assistant at this office/clinic?
• How comfortable was the patient in discussing personal issues with the primary care physician?
• Were there relationship problems with the primary doctor?
• How well do patients understand what doctors tell them about the HIV illness and medications?
• How sympathetic is the primary care physician to what patients are going through?
• How well does the physician listen to patients?
• How often does the doctor ask for patients’ input when making medical care decisions?
• How often does the doctor ask about patients’ personal relationships?
These issues were strongly associated with patient satisfaction with the physician’s care:
• The patient found the clinic hours to be more convenient.
• The patient was comfortable discussing personal issues with the doctor.
• The patient understood the physician’s instructions.
• The physician demonstrated empathy.
• The patient participated in the medical encounter.
• The physician showed an interest in the patient’s personal relationships.
• The patient perceived the physician to be very knowledgeable about HIV.
If clinicians can draw any conclusions from this study, it might be that they should work on improving their patient-doctor communication, Samet says. "It’s not a gift that we were born with, although some may be naturally more talented in that realm," he says. "But it can be improved by training."
Physicians who choose to enhance their own skills in the realm of patient-doctor communication may improve their encounters with HIV patients and these patients’ satisfaction with those interactions, Samet adds.
Reference
1. Sullivan LM, Stein MD, Savetsky JB, Samet JH. The doctor-patient relationship and HIV-infected patients’ satisfaction with primary care physicians. J Gen Intern Med 2000; 15:462-469.
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