Nurse practitioners outscore physicians in patient satisfaction survey

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Patient satisfaction, a major indicator of quality healthcare, was higher among low-income primary care patients treated by nurse practitioners than among those treated by physicians, according to researchers at the American Academy of Nurse Practitioners 26th Annual NP meeting.

 “The majority of survey questions showed statistically significant differences in satisfaction between patients in the NP and physician groups,” said study researcher, Angela White, RN, MSN, of the University of Michigan in Flint.

“This adds to the evidence that NPs are able to work independently,” fellow researcher Susan Lyons, RN, MSN, another nurse at the university, added. “Patient satisfaction comes from respect and listening, fewer hospitalizations and fewer prescriptions. This is just more proof NPs can operate effectively independently without supervision by physicians.”

They administered the U.S. Agency for Healthcare Research and Quality's Consumer Assessment of Healthcare Providers and Systems (CAHPS) questionnaire to a random sample of 97 low-income NP patients and 99 low-income physician patients in Flint. All patients were aged 16 to 62 years and were enrolled in a county-funded public health care plan for low-income patients.

The CAHPS questionnaire included questions about patient perceptions of how carefully clinicians listen, and how much respect clinicians showed for what they had to say.

“For 15 of 18 core questions, the difference was statistically significant, all in favor of NPs,” said Susan Lyons, RN, MSN, also of the University of Michigan. “It was unanimous!”

Globally, physicians did well too, Lyons and White noted — scoring an average 7.2 out of 10, but NPs received a near-perfect average score of 9.8.

In terms of careful listening, only 50% of physician patients reported that they felt that doctors “always” listened carefully, compared to more than 80% of NP patients.

Data from the study, which is ongoing and continues to recruit participants, will be added to the CAHPS database as it becomes available, White said.

“This is the first time the CAHPS patient satisfaction survey included NPs,” Lyons noted. But as data accrues from around the country, it will reveal whether or not NPs consistently outscore physicians for patient satisfaction in different populations.

Thus far, survey findings reflect previously published research that has indicated NP care in primary care settings as equal to that of physicians.

The researchers reported that they have no conflicts of interest.

Creech C, Filter M, Bowman S et al. “Comparing patient satisfaction with nurse practitioner and physician delivered care.” Poster presented at: 26th Annual American Academy of Nurse Practitioners Conference, 2011: Las Vegas, Nevada.

Bryant Furlow is a medical writer and award-winning investigative healthcare journalist based in Albuquerque, New Mexico.

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