title: Specialties differ in which aspects of doctor communication predict overall physician ratings.
abstract: BACKGROUND
  Effective doctor communication is critical to positive doctor-patient relationships and predicts better health outcomes. Doctor communication is the strongest predictor of patient ratings of doctors, but the most important aspects of communication may vary by specialty.
  
  
  OBJECTIVE
  To determine the importance of five aspects of doctor communication to overall physician ratings by specialty.
  
  
  METHODS
  For each of 28 specialties, we calculated partial correlations of five communication items with a 0-10 overall physician rating, controlling for patient demographics.
  
  
  METHODS
  Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS®) 12-month Survey data collected 2005-2009 from 58,251 adults at a 534-physician medical group.
  
  
  METHODS
  CG-CAHPS includes a 0 ("Worst physician possible") to 10 ("Best physician possible") overall physician rating. Five doctor communication items assess how often the physician: explains things; listens carefully; gives easy-to-understand instructions; shows respect; and spends enough time.
  
  
  RESULTS
  Physician showing respect was the most important aspect of communication for 23/28 specialties, with a mean partial correlation (0.27, ranging from 0.07 to 0.44 across specialties) that accounted for more than four times as much variance in the overall physician rating as any other communication item. Three of five communication items varied significantly across specialties in their associations with the overall rating (p < 0.05).
  
  
  CONCLUSIONS
  All patients valued respectful treatment; the importance of other aspects of communication varied significantly by specialty. Quality improvement efforts by all specialties should emphasize physicians showing respect to patients, and each specialty should also target other aspects of communication that matter most to their patients. The results have implications for improving provider quality improvement and incentive programs and the reporting of CAHPS data to patients. Specialists make important contributions to coordinated patient care, and thus customized approaches to measurement, reporting, and quality improvement efforts are important.
authors.affiliation: RAND Corporation, 1776 Main St., Santa Monica, CA, 90401, USA.
authors.forename: Denise D
authors.initials: DD
authors.lastname: Quigley
authors.forename: Marc N
authors.initials: MN
authors.lastname: Elliott
authors.forename: Donna O
authors.initials: DO
authors.lastname: Farley
authors.forename: Q
authors.initials: Q
authors.lastname: Burkhart
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Skootsky
authors.forename: Ron D
authors.initials: RD
authors.lastname: Hays
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods*; D005544:Forecasting; D006801:Humans; D008297:Male; D008511:Medicine / Q000592:standards*; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010820:Physicians / Q000592:standards*; D055815:Young Adult