Patient trust and satisfaction: Ways to make a difference

K Walsh 
 Department of BMJ Learning, BMJ, London, United Kingdom

Correspondence Address:
Dr. K Walsh
Department of BMJ Learning, BMJ, London
United Kingdom

Full Text

Sir,

Baidya et al. have presented a fascinating and unique account of patient-physician trust among adults of rural Tamil Nadu. [1] Trust clearly influences satisfaction even though it appears to be independent of other factors. Interestingly though, a number of factors were associated with satisfaction with the physician - these included the physician's gender and age, self-reported health status, and the time spent with the physician. This list is interesting - not least because it is a mix of unchangeable and changeable factors. While we cannot change the physician's gender or age or the self-reported health status of the patient, we could change the amount of time spent in consultation. Should we therefore concentrate our efforts in this regard? It seems logical to do so, and yet this factor might be difficult to change. In medicine as in life, time is money and it may require significant funding to lengthen consultation times. This funding may simply not be available. If this initial strategy of lengthening consultation times proves difficult, then it is also worth considering alternatives. There are two broad possibilities. Firstly, it is worth considering transfer of skills with some consultations being conducted by non-physicians (such as nurses). Non-physicians are typically paid less than physicians and can thus provide the same amount of care for less or as importantly could prolong the consultation times (thus improving satisfaction) and be cost-neutral. A second alternative is to change the nature of the consultation. Often it is not the actual length of the consultation in minutes that patients notice but rather the quality of the consultation and the feeling that their time is precious to the physician and they are not being rushed. All too often the opposite occurs with physicians interrupting patients within seconds of them starting to tell their story. Patients may thus have the perception that the consultation time is too short. In contrast by improving the consultation skills patients might perceive that the consultation time is longer and their satisfaction rates might go up as a result. The best research produces findings that can be acted upon and it may be that these findings are amongst the most important in the study by Baidya et al.

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