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Unhappy patients will leave their physicians

A study in the Journal of Family Practice reports that doctors say managed care pressures keep them from relating better with patients.

By Leigh Page, amednews staff. March 19, 2001.

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A new study shows that the relationship between primary care doctors and patients in Massachusetts is in decline, causing patients to leave their physicians at significant rates.

Published in the February Journal of Family Practice in two articles, the study is one of the few to closely examine that relationship and the first to show how it affects patients' decisions to switch doctors, the authors said.

They conjectured that they will find the same results in a nationwide survey of Medicare beneficiaries, which they are still tabulating and will release later in the year.

Surveying Massachusetts state employees, the study authors found declines from 1996 to 1999 of 10% to 15% in patient satisfaction with personal interactions, communication of information and trust for their primary care physicians.

The survey identified this dissatisfaction as the major reason for patients' switching plans, which they did at a rate of 20% over the three years studied.

Physicians told of the findings agreed that the doctor-patient relationship seems to be deteriorating nationwide, and blamed managed care for it.

"Managed care has put a tremendous barrier between the physician and the patient," said Neil Brooks, MD, a former president of the American Academy of Family Physicians, who practices in Rockville, Conn.

He pointed out that if physicians who are very satisfied with practicing are put into an atmosphere where autonomy is hampered, the result will be unhappy physicians.

Health plans have challenged physicians' authority, distracted them with paperwork and imposed efficiency quotas on them, he and other physicians said. [...]