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Study: More Docs Doesn't Add Up to Happier Patients

By John Reichard, CQ HealthBeat Editor

February 3, 2011 -- Medicare beneficiaries living in an area with a larger supply of doctors aren't any more satisfied with physician care and aren't able to spend more time with their doctors than beneficiaries living in areas with fewer physicians, according to a new study.

Based on a survey of 2,515 Medicare patients living in different parts of the country, the study also found no significant differences in access to specialists or availability of tests. The study was done by researchers from the Dartmouth Institute for Health Policy and Clinical Practice and the Centers for Medicare and Medicaid Services.

"Our results suggest that simply training more physicians is unlikely to lead to improved access to care," the researchers concluded. "Instead, focusing health policy on improving the quality and organization of care may be more beneficial."

The survey included 12 questions relating to perceptions of care and access. It found that in areas with the highest concentration of doctors, 95 percent of respondents said they have a personal physician, while in the lowest-concentration areas, 94.5 percent of respondents said they had one. A total of 88.7 percent in high-concentration areas said they had a primary care doctor as a personal physician compared to 89.3 percent in lowest-concentration areas.

When asked if their doctors always or usually spent enough time with them, 88.4 percent of respondents living in high-concentration areas said yes while 85 percent of those in low-concentration areas said their doctors did.

On a scale of one to 10, the proportion of beneficiaries giving their doctors an overall rating of 9 or 10 in terms of satisfaction of care was 56.5 percent in high-concentration areas compared to 58.8 percent in low-concentration areas.

"Policy discussions . . . often focus narrowly on potential workforce shortages based on physician supply per se," the researchers wrote in the study, posted by the policy research publication Health Affairs. "This happens despite the complexity of estimating workforce requirements and the fact that having a large workforce does not guarantee high-quality care."

Rather than simply invest in increasing the number of doctors in a given area, it might be possible to improve access to and satisfaction with care through less costly means, such as practicing in better-organized networks or at a more local level, the study suggested.

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