Patient satisfaction scores should adjust for race, ethnicity
A study published in JAMA Open Network found Asian physicians received lower likelihood to recommend (LTR) scores, compared to non-Hispanic white physicians. With this in mind, health organizations using patient satisfaction scores for physician compensation and promotion should adjust for patient race and ethnicity.
“Patient satisfaction scores are used to inform decisions about physician compensation, and there remains a lack of consensus regarding the need to adjust scores for patient race/ethnicity,” wrote lead author Luis C. Garcia, MS, of Stanford University, and colleagues. “Previous research suggests that patients prefer physicians of the same race/ethnicity as themselves and that Asian patients provide lower satisfaction scores than non-Hispanic white patients.”
Garcia and colleagues sought to determine if Asian doctors receive lower patient satisfaction scores, compared to non-Hispanic white doctors. They used data collected from 149,775 patient satisfaction surveys (Likert scale) for more than 960 doctors. They compared the race/ethnicity of the patient to the race/ethnicity of the doctor.
Evaluation of the cohort found 53 percent of physicians studied were women, they had an average 19.9 years of work experience post medical school graduation, about 60 percent were white and 36 percent were Asian.
Asian physicians were 22 percent less likely to receive the highest score on the survey item rating the likelihood to recommend the physician, in unadjusted analyses. This association was not significant after adjusting for patient characteristics, including patient race race/ethnicity. The researchers found Asian patients were 44 percent less likely to give the highest scores relative to non-Hispanic white patients, regardless of physician race/ethnicity.
“Asian physicians served a greater proportion of Asian patients, who were more likely to give lower satisfaction scores than non-Asian patients,” the researchers wrote.
The researchers noted lower LTR scores given by Asian patients could explain the lower scores of Asian doctors. Past research also shows Asian patients are more likely to select midpoints on Likert-type surveys, impacting the likelihood of Asian patients providing favorable ratings.
“The results of the present study therefore suggest that statistically adjusting patient satisfaction scores by patient race/ethnicity may help avoid unduly penalizing physicians who serve greater proportions of Asian patients,” the researchers concluded.
As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.