- What evidence is there that the information collected in the survey is important?
Physician-patient communication is important to patient outcomes and patient satisfaction. There is an increasing body of evidence for this.
For example, one bibliography of articles on the importance of physician-patient communication is at the website of the Institute for Healthcare Communication (www.healthcarecomm.org). It includes many articles on the impacts of effective physician-patient communication on health, functional, and emotional status; improvement in diagnostic accuracy; adherence to treatment plans; increased trust in the physician; improved patient and clinician satisfaction; informed consent; and reduction in malpractice risk.
A 2007 article in the Journal of the American Medical Association, "The Value of Assessing and Addressing Communication Skills," summarizes the evidence:
"In a diverse set of studies since [the late 1960s], effective communication has been linked with increases in patient and physician satisfaction, better adherence to treatment plans, more appropriate medical decisions, better health outcomes, and fewer malpractice claims...."
"Education and accreditation initiatives have evolved along with the research trajectory. Indeed, the focus on communication now extends throughout the continuum of medical education and practice...."
Evidence of the recognition medical standard-setters have given to the importance of physician-patient communication includes the following:
- Communication is one of six required competencies identified by the Accreditation Council on Graduate Medical Education (ACGME), and elements of competent communication are featured in four of the six ACGME competencies.
- The Association of American Medical Colleges (AAMC) published recommendations for communication in the Medical School Objective Project, Paper III.
- The National Board of Medical Examiners (NBME) is requiring objective standardized clinical examinations to assess interviewing and communication skills.
- The Institute of Medicine, in its 2004 report, "Improving Medical Education: Enhancing the Behavioral and Social Science Content of Medical School Curricula," names communication skills as one of six curricular domains.
- The new standards to elevate physician life-long learning assessment adopted by the American Board of Medical Specialties for Maintenance of Certification programs include assessment of communication skills as a standard for all physician diplomates with direct patient care--using a CAHPS patient survey (similar to the communication questions used in the CHECKBOOK/CSS pilot surveys) or other approved survey.
While key questions in the CHECKBOOK/CSS survey focus on physician-patient communication, the survey also includes questions about access to careappointment scheduling and responsiveness to medical questions by phoneand about office staff helpfulness and courtesy. These dimensions of office operations are also important to patient satisfaction and health. On access issues, for example, a 2007 article in The Joint Commission Journal on Quality and Patient Safety summarized the challenge: "delays for appointments are prevalent, resulting in patient dissatisfaction, higher costs, and possible adverse clinical consequences."