Medical groups in Southern California rated lower than those in Northern California, Oregon and Washington in a first-ever patient satisfaction survey of large medical groups.
The survey, to be released to the public this week, was conducted by the Medical Quality Commission and the Pacific Business Group on Health.
Much as J.D. Power and Associates' consumer surveys promoted quality in the auto industry in the 1980s, the Physician Value Check Survey is designed to improve the quality of healthcare. Its goals are to help consumers and purchasers make more informed choices and give medical groups useful comparative data.
The survey could be emulated elsewhere as large medical groups form and assume more control over the delivery of healthcare in other parts of the country.
"Earlier patient satisfaction studies have focused on health plans, but patients judge their care by what happens when they visit their doctor's office," says Alan Zwerner, M.D., president and chief executive officer of the Seal Beach, Calif.-based Medical Quality Commission, which accredits capitated medical groups.
Unlike in the J.D. Power survey, the medical groups agreed to participate in advance, knowing the data would be made public. Zwerner says the response among group members who saw the data this summer was overwhelmingly positive, even for groups with the lowest scores.
"It gave them ammunition to go back to their groups and say, `We need to be better in this area,' " Zwerner says.
Nine groups were surveyed in Oregon and Washington, which were grouped together as the Northwest region, 22 were surveyed in Northern California and 27 in Southern California.
In Southern California, where providers have been squeezed by intense price competition, medical groups were rated lower in access to specialty care, wait times and getting prescriptions filled. Their patients were the least likely of the three regions to recommend their physician to others. Medical groups in Northern California and the Northwest rated higher in outcomes of care and overall quality.
Notably, independent practice associations, which offer large networks of physicians who maintain their own separate offices, often scored somewhat higher than medical groups (See chart).
The survey, meant to be the first phase of the study, was conducted in the summer of 1996. A second phase, which will measure patients' reported change in health status, will be conducted in 1998.
The survey sought the views of 58,000 HMO enrollees and 1,000 each from 58 medical groups and IPAs. An additional 4,000 patients in PPOs were included.