Correlates of satisfaction and dissatisfaction with medical care: a community perspective

The attitude of the public toward physicians and medical services is an issue of current concern and debate. To address this problem, an instrument was developed using Thurstone scaling methods in conjunction with a Likert format and a modified scoring technique. Following pretesting of the instrument among both patient and population samples, a survey was conducted among the residents of a probability sample of households in a city of 200,000 people. The attitude questionnaire was completed by 1,713 adults in 1,112 households. Overall, attitudes were favorable toward the professional competency and the personal qualities of physicians. Accessibility, including costs and convenience, were less highly regarded. Men were less satisfied than women and blacks less satisfied than whites. Particularly negative attitudes were expressed toward the personal qualities of physicians by young blacks, whereas among blacks over 60 the negative effect was toward cost and convenience. Having a regular physician and long attendance with that physician were correlated with positive attitudes. The most negative sentiment was expressed by women without regular source of care. Medical services are being sought and obtained by a large segment of society, but problems of costs and acceptability for the elderly, low social class persons, members of large families, and for blacks still remain.