title: Time Seeing a Hand Surgeon Is Not Associated With Patient Satisfaction.
abstract: BACKGROUND
  Previous studies, predominantly in the primary care setting, identified time spent with the physician as an important predictor of satisfaction. It is unknown if the same holds true in hand surgery.
  
  
  OBJECTIVE
  Is patient satisfaction measured immediately after an office visit associated with the duration of time spent with the hand surgeon? What other factors are associated with satisfaction directly after the visits and 2 weeks after the appointment?
  
  
  METHODS
  We prospectively enrolled 81 patients visiting our hand and upper extremity surgery outpatient clinic. We recorded their demographics and measured physical function, pain behavior, symptoms of depression, time spent in the waiting room, time spent with the physician, and patient satisfaction. Office times were measured using our patient ambulatory tracking system and by a research assistant outside the clinic room. To assess satisfaction we used items from the Consumer Assessment of Healthcare Providers and Systems survey (a federally developed standardized survey instrument) relevant to our study. Two weeks later, 51 (64%) patients were available for telephone followup and the same measures were completed. Mean time spent with the hand surgeon was 8 ± 5 minutes and mean in-office wait time to see the hand surgeon was 32 ± 18 minutes. A priori power analyses indicated that 77 patients would provide 80% power to detect an effect size f(2) = 0.18 for a regression with five predictors. This means that we would detect time spent with the physician as a significant factor if it accounted for 7% or more of the variability in satisfaction.
  
  
  RESULTS
  Time spent with the hand surgeon was not associated with patient satisfaction measured directly after the visit (r = -0.023; p = 0.84). Longer time waiting to see the physician correlated with decreased patient satisfaction (r = -0.30; p = 0.0057). The final multivariable model for increased satisfaction directly after the office visit included shorter waiting time (regression coefficient [β] -0.0014; partial R(2) 0.094; 95% confidence interval [CI], -0.0024 to -0.00042; p = 0.006) and being married/living with a partner (β 0.057; partial R(2) 0.11; 95% CI, 0.021-0.093; p = 0.002 [adjusted R(2) 0.18; p < 0.001]). Similarly, multivariable analysis found higher patient satisfaction 2 weeks after the visit to be independently associated with shorter waiting time (β -0.0037; partial R(2) 0.10; 95% CI, -0.0070 to -0.00054; p = 0.023) and being married/living with a partner (β 0.15; partial R(2) 0.12; 95% CI, 0.033-0.26; p = 0.012 [adjusted R(2) 0.16; p = 0.0052]).
  
  
  CONCLUSIONS
  Patient satisfaction among patients undergoing hand surgery may relate more to shorter time in the waiting room and to the quality more than the quantity of time spent with the patient.
  
  
  METHODS
  Level II, prognostic study.
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
authors.forename: Teun
authors.initials: T
authors.lastname: Teunis
authors.forename: Emily R
authors.initials: ER
authors.lastname: Thornton
authors.forename: Prakash
authors.initials: P
authors.lastname: Jayakumar
authors.forename: David
authors.initials: D
authors.lastname: Ring
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006225:Hand / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D009985:Orthopedics; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult