Patient ratings of physicians: how meaningful are they?

Abstract

Background: Research has documented the importance of physician use of communication skills (empathy, listening, open-ended questions, and positive non-verbal behaviors) in their interactions with patients. As part of a curriculum of patient-centered care, our medical school, comprised of three campuses, provides training in doctor/patient communication skills to medical students. Methods: In clinical interviews with patients from different cultural and ethnic backgrounds, 224 second year medical students practiced their doctor/patient communication in a clinical case and were rated on their skills by patients and by physician preceptors. Both used the same rating sheet, and patients at each campus received rating instructions. Findings: Across all three campuses, analyses (T-Tests) revealed that patients rated students as performing better compared to the physician ratings (f=14.190, df=2, p.<.001). Patient ratings did not differ from each other across campuses. Discussion: Findings suggest that patients see medical students as more skilled communicators and rate them more highly than do physician preceptors. These findings were unexpected, since patients had been instructed on using the rating scale. The overarching issue emerging from theses findings relates to the meaning of patient ratings of their doctors. In an age of using the internet and social media for finding a physician, patients often use doctor ratings from other patients. Not only are such ratings global, their validity is questionable. Patients may misunderstand specific ratings or may simply view the physician as “good†or “bad†based on liking.