title: Are Low Patient Satisfaction Scores Always Due to the Provider?: Determinants of Patient Satisfaction Scores During Spine Clinic Visits.
abstract: METHODS
  A prospective study.
  
  
  OBJECTIVE
  The aim of this study was to investigate the impact of various components on patient satisfaction scores SUMMARY OF BACKGROUND DATA.: Patient satisfaction has become an important component of quality assessments. However, with many of these sources collecting satisfaction data reluctant to disclose detailed information, little remains known about the potential determinants of patient satisfaction.
  
  
  METHODS
  Two hundred patients were contacted via phone within 3 weeks of new patient encounter with 11 spine providers. Standardized patient satisfaction phone survey consisting of 25 questions (1-10 rating scale) was administered. Questions inquired about scheduling, parking, office staff, teamwork, wait-time, radiology, provider interactions/behavior, treatment, and follow-up communication. Potential associations between these factors and three main outcome measures were investigated: (1) provider satisfaction, (2) overall clinic visit satisfaction, and (3) quality of care.
  
  
  RESULTS
  Significant associations (P < 0.0001) with provider satisfaction, overall clinic visit satisfaction, and perceived overall quality of care were found with appointment scheduling, parking, office staff, teamwork, wait time, radiology, provider interactions/behavior, treatment, and follow-up communication. Nurse-practitioner/resident involvement was positively associated with scores (P ≤ 0.03). A "candy-man" effect was not noted, as pain medication prescribing did not play a significant role in satisfaction (P > 0.05).In multivariate regression analysis, explanation of medical condition/treatment (P = 0.002) and provider empathy (P = 0.04) were significantly associated with provider satisfaction scores, while the amount of time spent with the provider was not. Conversely, teamwork of staff/provider and follow-up communication were significantly associated with both overall clinic visit satisfaction and quality of care (P ≤ 0.03), while provider behaviors or satisfaction were not.
  
  
  CONCLUSIONS
  Satisfaction with the provider was associated with better explanations of the spine condition/treatment plan and provider empathy, but was not a significant factor in either overall clinic visit satisfaction or perceived quality of care. Patients' perception of teamwork between staff and providers along with reliable follow-up communication were found to be significant determinants of overall patient satisfaction and perceived quality of care.
  
  
  METHODS
  3.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Penn State Milton S. Hershey Medical Center, Hershey, PA.
authors.forename: Jesse E
authors.initials: JE
authors.lastname: Bible
authors.affiliation: Vanderbilt Orthopaedic Institute, Vanderbilt University Medical CenterNashville, TN.
authors.forename: David N
authors.initials: DN
authors.lastname: Shau
authors.affiliation: Vanderbilt Orthopaedic Institute, Vanderbilt University Medical CenterNashville, TN.
authors.forename: Harrison F
authors.initials: HF
authors.lastname: Kay
authors.affiliation: Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Cheng
authors.affiliation: Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Oran S
authors.initials: OS
authors.lastname: Aaronson
authors.affiliation: Vanderbilt Orthopaedic Institute, Vanderbilt University Medical CenterNashville, TN.
authors.forename: Clinton J
authors.initials: CJ
authors.lastname: Devin
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010465:Perception; D011446:Prospective Studies; D011787:Quality of Health Care; D013122:Spinal Diseases; D013131:Spine; D011795:Surveys and Questionnaires; D013997:Time Factors