What do patients want in a physician and how do people select their doctors? These are questions that prompt different answers from different people. Answers likely vary depending on the type of health insurance those responding have. The following is from a Health Services Research study that is now 20 years old. It found that consumers were somewhat passive in their choice of physicians:
Although a minority of respondents actively searches for a physician, there appears to be substantial variation in the degree of consumer activism across patient subgroups. Poor health status, higher levels of service use in the past year, and stronger ties to individual physicians are associated with less consumer activism. At the same time, greater levels of consumer activism were found among racial and ethnic minorities, among those who report using information to choose their physicians, and among those who switched physicians as a result of dissatisfaction some time in the past five years. Source of quality information (medical experts versus patient advocates) did not influence stated willingness to switch physicians.
A more recent survey published in 2023 asked patients what they most wanted in a doctor. Physicians probably believe clinical experience matters the most. Say a physician educated at Harvard finishes a residency at Yale-New Haven Hospital, then goes on to practice for 20 years. That would put him or her among the elite in terms of training and experience. Although patients undoubtedly like the idea of having the “best doctor” it ranks relatively low on their stated preferences. Clinical experience was the top priority for only about 28% of patients. Among black patients, clinical experience was a top priority only among 22%. About half of patients preferred so-called “soft skills”.
Compassion, empathy, and active listening are important in any relationship — and the doctor-patient relationship is no exception.
What patients want in a physician varies by race.
- One-third of white patients thought listening was their top priority, compared to only one-in-five black patients.
- More than twice the proportion of black patients (19% to 8%) thought sensitivity and respect towards race, gender, ethnicity, and sexual orientation was the most important trait.
- Technology like online scheduling and telemedicine was also more important to black patients than white patients (17% to 10%).
Black patients were more than twice as likely as white patients (41% compared to 22%) to say they preferred a physician who shared their race, ethnicity, or sexual orientation. Black patients were also twice as likely compared to white patients (41% compared to 17%) to say they thought their health outcomes would be better if their doctors shared their ethnicity or other characteristics. Black patients also thought having a doctor who shared their characteristics would motivate them to take their doctors’ advice more seriously. Yet, black patients have a harder time finding physicians who look like them and share their ethnicity.
Finding a doctor compatible with their preferences was important to 82% of those surveyed. People reported being more willing to expend effort to find a doctor they like than other professional services. In the survey, more than one-third said they are currently looking for a new doctor. Yet, consumers report finding a new physician is difficult. Only about one-third said it was easy to find a primary care physician, while a smaller proportion (28%) said it was easy to find a primary care physician they could trust. Only about 20% said it was easy to find a specialist.
An obstacle to finding a primary care physician is one who both accepts new patients and accepts your insurance plan. For many new patients I suspect that is the only criteria they use. Although not part of the survey, patients willing to pay cash for a direct primary care physician likely have an easier time finding a doctor who meets their needs.
Physicians have their own likes, dislikes, and preferences for patients that you will likely never read about in a survey. I know a family physician who years ago was recruited to a new practice requiring a move to a new city. Once settled into the practice, his schedule was quickly inundated with elderly Medicare patients. His Medicare patients were sicker than average, requiring longer office visits (approaching 30 minutes). A pediatrician colleague, performing well-baby visits, could see five or six patients an hour compared to his two. Medicare also reimburses at a fraction of similar privately insured patients. The physician’s income fell on an annualized basis to less than half of the average for primary care physicians. He soon resigned and left the practice. He was a good doctor and I suspect his patients were saddened that after finding a doctor they liked he was gone before their next visit.
Read more at: New Survey Asks: What Do Patients Want Most in a Doctor?