Effect of Physician Turnover on Patient Satisfaction in an Academic Primary Care Practice

• Objective: To examine the effects of physician turnover on patient satisfaction with their primary care. • Design: Prospective cohort study. • Setting and participants: Patients at least 75 years of age, or patients between 50 and 74 years with 1 of 7 chronic conditions who were receiving care from general internists (faculty, fellows, residents) in an inner-city academic primary care practice. • Measures: Patient satisfaction with physician-patient communication using a 10-item questionnaire and with the care delivered in a visit using a 7-item questionnaire. • Methods: Patient satisfaction surveys were administered after all scheduled visits for a period of 1 year. After controlling for resident versus faculty status of the physician and the number of prior encounters between patients and their physicians, satisfaction scores for patients whose physicians left in July 1994 were compared with patients whose physicians stayed. • Results: 572 study patients made 2377 visits to 90 physicians; 24 of these physicians left in July 1994. Before July, patients whose physicians subsequently left were significantly more satisfied with their physicians and their primary care visits than were patients whose physicians stayed. After July, satisfaction with the physicians and the primary care visits declined significantly among patients whose physicians left the practice. • Conclusion: Physicians who left had the most satisfied patients prior to their leaving the practice; satisfaction among their patients declined significantly after the physicians’ departure. Efforts should be made to minimize the effects of physician turnover on patient satisfaction, especially among academic practices where turnover is greatest.