Abstract
Physicians are a largely untapped resource for evaluating medical care delivery in an ambulatory care facility. This study includes the attitudes of physicians in assessing care at the Northwestern University Medical School Clinics (NUMSC). A self-administered questionnaire was mailed to all clinic chiefs, attending physicians, and resident physicians who had worked in the clinics during the summer of 1973. Using a similar questionnaire, personal interviews were conducted with a sample of patients in the clinics. Physicians were consistently more critical than patients in their responses to the battery of questions on satisfaction and on indices constructed from these responses. The findings indicate a negative relationship between the physician's position of authority in the organization and his report of satisfaction: clinic chiefs were consistently more critical than either attending physicians or resident physicians, while the comparisons between attendings and residents were more mixed. Further, salaried physicians were more critical than those who received no salary and non-AMA members were more critical than AMA members. Adding the assessment of physicians to those of patients introduces a useful complement and strengthens the utility of such evaluation instruments.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alpert JJ, Kosa J, Haggerty RJ, et al: Attitudes and satisfactions of low-income families receiving comprehensive health care.Am J Public Health 60:499–506, 1970.
Andersen R, Kravitz J, Anderson O: The public's view of the crisis in medical care.Economic and Business Bulletin 24:44–52, 1971.
Hulka BS, Zyzanski SJ, Cassel JC, et al: Scale for the measurement of attitudes toward physicians and primary medical care.Med Care 8:420–436, 1970.
Hulka BS, Zyzanski SJ, Cassel JC, et al: Satisfaction with medical care in a low income population.J Chronic Dis 24:661–673, 1971.
Hulka BS, Cassel JC: The AAFP-UNC study of the organization, utilization and assessment of primary medical care.Am J Public Health 63:494–501, 1973.
Aday LA, Andersen R:Development of Indices of Access to Medical Care. Ann Arbor, Mich, Health Administration Press, 1975.
Tessler R, Mechanic D: Consumer satisfaction with prepaid group practice: A comparative study.J Health Soc Behav 16:95–113, 1975.
Ware JE: Effects of acquiescent response set on patient satisfaction ratings. Presented at the annual meeting of the American Public Health Association, Miami Beach, Florida, 1976.
Howell JR, Osterweis M, Huntley RR: Curing and caring—a proposed method for self-assessment in primary care organization.J Community Health 1:256–275, 1976.
Pozen MW, Bonnet PD: Effectiveness of educational and administrative interventions in medical outpatient clinics.Am J Public Health 66:151–155, 1976.
Becker MH, Drachman RH, Kirscht JP: A field experiment to evaluate various outcomes of continuity of physician care.Am J Public Health 64:1062–1070, 1974.
Freeborn DK, Pope CR: Consumer satisfaction: Views of consumers versus providers. Presented at the annual meeting of the American Public Health Association, Miami Beach, Florida, 1976.
Orden SR, Collette P, Idris-Soven E: Care for chronic conditions in specialty clinics: Fit or misfit? Presented at the third annual meeting of the Evaluation Network, St. Louis, Mo, 1977.
Shortell SM: Continuity of medical care: Conceptualization and measurement.Med Care 14:377–391, 1976.
Stratman WC: A study of consumer attitudes about health care: The delivery of ambulatory services.Med Care 13:537–548, 1975.
Swartz B:Queuing and Waiting. Chicago, University of Chicago Press, 1975.
Goodman LA, Kruskal WH: Measurements of association for cross classifications.J AM Stat Assoc 49:732–764, 1954, p 749.
Nie NH, Hull CH, Jenkins JG, et al:Statistical Package for the Social Sciences, Ed 2. New York, McGraw Hill, 1975, Pp 427–428.
Conver WJ:Practical Nonparametric Statistics. New York, John Wiley & Sons, 1971.
Becker SW, Neuhauser D:The Efficient Organization. New York, Elsevier Scientific Publishing Co, 1975.
Sudman S, Bradburn NM:Response Effects in Surveys. Chicago, Aldine Publishing Co, 1974.
Stamler R, Stamler J, Civinelli J, et al: Adherence and blood pressure response to hypertension treatment.Lancet 2:1227–1229, 1975.
Lebow JL: Consumer assessments of the quality of medical care.Med Care 12:328–337, 1974.
Giordana PC: The client's perspective in agency evaluation.Social Work 34–39, 1977.
Brooks CH: Associations among distance, patient satisfaction and utilization of two types of inner-city clinics.Med Care 11:373–383, 1973.
Hetherington RW, Hopkins CE, Roemer MI:Health Insurance Plans: Promise and Performance. New York, John Wiley & Sons, 1975.
Additional information
The authors are in the Department of Community Health and Preventitive Medicine at Northwestern University Medical School, where Ms. Orden is an Assistant Professor, Ms. Collette Assistant Professor, Dr. Souchek post-doctoral fellow, Ms. Masover research coordinator, and Dr. Stamler Professor and Chairman of the department. Requests for reprints should be addressed to Susan Orden, Northwestern University Medical School, 303 E. Chicago Avenue, Chicago, Illinois 60611. The authors wish to thank their colleagues in the department. Alan Dyer, Ph.D., Elizabeth Idris-Soven, M.A., Martha Ice, M.A., Michael Reagan, Julia Wannamaker, M.P.H., Rose Stamler, M.A., Leatrice Hauptman, M.A., the medical students and Odin W. Anderson Ph.D., Director of the Center for Health Administration Studies, University of Chicago. This research was supported by grant 21 HS 01585 from the National Center for Health Services Research.
Rights and permissions
About this article
Cite this article
Orden, S.R., Collette, P., Souchek, J. et al. Physician and patient assessment of ambulatory care in a university facility. J Community Health 4, 23–32 (1978). https://doi.org/10.1007/BF01349582
Issue Date:
DOI: https://doi.org/10.1007/BF01349582