Factors Influencing Patient Selection of an Orthopaedic Sports Medicine Physician

Manning, Blaine; Bohl, Daniel D.; Saltzman, Bryan M.; Cotter, Eric J.; Wang, Kevin C.; Epley, Chad; Verma, Nikhil N.; Cole, Brian J.; Bach, Bernard R.

doi:10.1177/2325967117724415

Cited by 23 publications

(32 citation statements)

References 25 publications

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“…Our results are useful for orthopaedic sports medicine physicians seeking to balance efficiency and patient satisfaction as health care becomes increasingly value driven and consumer focused. Although previous studies have noted the physician's training background and credentials to be among the most important selection criteria considered by patients, [9][10][11] none have examined the midlevel provider's training background as a selection criterion. Our patients considered the midlevel provider's credentials when initially choosing a new sports medicine physician ( Figure 2), and most patients perceived no difference in the training levels of PAs and NPs (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

Patient Perspectives of Midlevel Providers in Orthopaedic Sports Medicine

Manning

Bohl

Hannon

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:Midlevel providers (eg, nurse practitioners and physician assistants) have been integrated into orthopaedic systems of care in response to the increasing demand for musculoskeletal care. Few studies have examined patient perspectives toward midlevel providers in orthopaedic sports medicine.Purpose:To identify perspectives of orthopaedic sports medicine patients regarding midlevel providers, including optimal scope of practice, reimbursement equity with physicians, and importance of the physician’s midlevel provider to patients when initially selecting a physician.Study Design:Cross-sectional study; Level of evidence, 3.Methods:A total of 690 consecutive new patients of 3 orthopaedic sports medicine physicians were prospectively administered an anonymous questionnaire prior to their first visit. Content included patient perspectives regarding midlevel provider importance in physician selection, optimal scope of practice, and reimbursement equity with physicians.Results:Of the 690 consecutive patients who were administered the survey, 605 (87.7%) responded. Of these, 51.9% were men and 48.1% were women, with a mean age of 40.5 ± 15.7 years. More than half (51.2%) perceived no differences in training levels between physician assistants and nurse practitioners. A majority of patients (62.9%) reported that the physician’s midlevel provider is an important consideration when choosing a new orthopaedic sports medicine physician. Patients had specific preferences regarding which services should be physician provided. Patients also reported specific preferences regarding those services that could be midlevel provided. There lacked a consensus on reimbursement equity for midlevel practitioners and physicians, despite 71.7% of patients responding that the physician provides a higher-quality consultation.Conclusion:As health care becomes value driven and consumer-centric, understanding patient perspectives on midlevel providers will allow orthopaedic sports medicine physicians to optimize efficiency and patient satisfaction. Physicians may consider these data in clinical workforce planning, as patients preferred specific services to be physician or midlevel provided. It may be worthwhile to consider midlevel providers in marketing efforts, given that patients considered the credentials of the physician’s midlevel provider when initially selecting a new physician. Patients lacked consensus regarding reimbursement equity between physicians and midlevel providers, despite responding that the physician provides a higher-quality consultation. Our findings are important for understanding the midlevel workforce as it continues to grow in response to the increasing demand for orthopaedic sports care.

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Section: Discussionmentioning

confidence: 99%

Patient Perspectives of Midlevel Providers in Orthopaedic Sports Medicine

Manning

Bohl

Hannon

et al. 2018

Orthopaedic Journal of Sports Medicine

Self Cite

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“…23,26,28-31 One study measured distance as travel time. 36 In six articles there was no calculation of actual distances at all, 24,25,33,34,37,38 but the role of distance was assessed and hence a general willingness to bypass the nearest provider could be assumed.…”

Section: Resultsmentioning

confidence: 99%

“…Especially patients without a medical background might not be able to rate quality themselves but rather refer to other sources. The most common alternatives are to rely on friends’ or families’ experiences or recommendations 36-38 or using the internet. In the latter, it was shown that the way information is presented determines how it is understood and used.…”

Section: Discussionmentioning

confidence: 99%

Identifying Determinants for Traveled Distance and Bypassing in Outpatient Care: A Scoping Review

Zander

Dukart

Berg

et al. 2019

INQUIRY

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The outpatient sector represents a growing share of health care. This review examines how patients choose their physician for continuous outpatient care and why they are willing to bypass the nearest physician. It was conducted according to the PRISMA extension for scoping reviews (PRISMA-ScR). Three databases (PubMed/Medline, ScienceDirect, and Ovid Medline) were searched, focusing on articles in which distance influenced the choice of physician. In all, 1,308 articles were accessed, and 17 selected for final review. First, we extracted methods for assessing distance traveled and bypassing. Second, we identified determinants that directly influence the traveled distance and transferred all into a conceptual framework. The center of this framework is the individual “willingness-to-go”, which reflects the willingness of patients to accept additional distances. Our findings can support studies on patient mobility and physician choice, which are essential for examining both the distribution and use of medical services, as well as for adequate need related planning.

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“…Although previous studies have found the surgeon’s credentials to be among patients’ top selection criteria, none investigated the physician extender’s credentials as a selection factor. 7-9 Our data suggest inclusion of midlevel providers in marketing initiatives such as practice websites may be worthwhile as most patients consider the physician extender’s credentials and training when choosing a new hand surgeon (Figure 2). Nearly one-third of our cohort perceived PAs as more highly trained than NPs (Figure 1).…”

Section: Discussionmentioning

confidence: 97%