K. E. Engelhardt1,2, R. S. Matulewicz1, J. O. DeLancey1, C. Quinn1, L. Kreutzer1, K. Y. Bilimoria1 1Northwestern University,Chicago, IL, USA 2Medical University Of South Carolina,Charleston, Sc, USA
Introduction: Optimizing the patient experience has become a focus for hospitals, physicians, and other healthcare providers in recent years. The Centers for Medicare and Medicaid Services publicly reports patient-reported “likelihood to recommend” (LTR) for group practices and may report LTR for individual surgeons in the future. However, it is hypothesized that surgeon-level factors (e.g. age, sex, training, and specialty) may influence LTR scores. The objective of this study was to assess the relationship between surgeon factors and surgeon-specific LTR scores.
Methods: Patient experience survey data were analyzed from a common, third party, nationally-available survey for all surgeons at a single adult academic medical center for fiscal years 2013-2016. All surgical subspecialties were included. This survey includes questions about the patient’s experience with the surgeon in the clinic setting. Hierarchical logistic regression modeling was used to identify factors associated with a top box response (i.e., best score) on the surgeon-specific LTR question.
Results: A total of 18,100 surveys were returned for 118 surgical faculty members representing an overall response rate of 19.2%; mean individual question response rate among those who returned surveys was 94.4% (range 80.0-97.2%). Surgeons in our cohort were predominately male (78.0%) and fellowship-trained (72.9%). Surgeon-specific top box LTR percentages ranged from 54.5% to 97.5%. In adjusted analyses (Table), certain specialties had a significantly lower likelihood of top box LTR score when compared to general surgery (ophthalmology OR 0.60, 95%CI 0.42-0.85; ENT OR 0.64, 95%CI 0.41-1.00). Surgeon age, gender, and medical training characteristics (e.g., fellowship trained, top-25 medical school graduate, etc.) were not significantly associated with top box LTR response. In our data, no surgeon was rated significantly better or worse overall than the mean of all other surgeons studied (i.e. there was poor residual intraclass correlation: 0.059).
Conclusion: Surgeon demographics and medical training history were not significantly associated with LTR scores for individual surgeons. However, certain surgical specialties were associated with LTR responses. Adjustment for surgical specialty may be necessary to reduce bias and accurately portray patient experience when comparing LTR scores across departments of surgery.
