Patient Satisfaction: Comparing Physician Assistants, Nurse Practitioners, and Physicians

Objective To evaluate patient satisfaction with care as managed by different types of providers: physician assistants (PAs), nurse practitioners (NPs), certified nurse midwives (CNMs), and physicians. Methods Questionnaires were mailed to members of a large health maintenance organization who visited medical offices in any of five medical specialties during 1995 or the first half of 1996. Patient-generated scores for eight provider attributes were combined to generate a mean score for each attribute by provider type. Scores were then compared. Results Satisfaction was reported by 89% to 96% of patients of PAs, NPs, CNMs, and physicians with regard to courtesy, understanding of problem, ability to explain, use of understandable words, listening, time spent, and confidence in provider. Clinicians in orthopedics and in obstetrics and gynecology scored slightly higher than did primary care clinicians. No statistically significant differences in scores were seen between providers by type, by age, by gender, or by length of employment. Conclusion Patient satisfaction with interpersonal care appears to depend on communication and style and not on type of provider. These findings suggest that policy decisions to incorporate PAs, NPs, and CNMs into medical practice have gained patient acceptance.