Patient Satisfaction with Physicians and Nurse Practitioners in Multiple Slerosis Centers
With the predicted severe shortage of neurologists, care of patients with multiple sclerosis (MS), a chronic complex disease affecting over 400,000 people in the US will be compromised. Nurse Practitioners have successfully filled the provider gaps in a variety of care settings without any negative impact on care outcomes. Patient satisfaction, often synonymous with quality of care, was rated similar or improved with NPs or a team (physician-NP) approach in long term management of persons with chronic illnesses. However patient satisfaction with NPs and physicians working with Multiple Sclerosis patients have not been studied.
Objectives: The purpose of this study is to determine patient satisfaction with physicians and nurse practitioners in Multiple Sclerosis Centers.
Methods: This is a cross-ectional pilot study where a convenience sample (n=60) was recruited from two Multiple Sclerosis Centers in the Long Island region of New York. After obtaining an informed consent, the demographic data was collected pre-visit and the satisfaction surveys were completed post-visit. Sample characteristics were described using descriptive statistics. The two groups of patients; patients who saw a physician and the patients who saw a nurse practitioner were compared for different attributes of satisfaction using non-parametric tests. A Chi square analysis was used to further analyze the differences. The visit time and the allotted time and its relationship to satisfaction scores was also analyzed.
Patient satisfaction with both types of providers were high (VSQ9 mode-81). All attributes of satisfaction were equal for nurse practitioners and the physicians despite the differences in their educational preparation. Providers spent comparable amount of time with their patients (MD mean=26minutes, NP mean= 27minutes), yet which often exceeded the time allotted for the physicians in the clinic. Encounter duration (more or less than 20 minutes) was a strong determinant of patient satisfaction (p=0.01). Patients who carried the diagnosis for 10 or more years (p=0.01) or had the progressive type (p=0.03) were more satisfied with care.
Conclusions: Patients in MS centers are equally satisfied with the care they receive from nurse practitioners and physicians. A collaborative team approach between NPs and MDs can improve access to care and patient outcomes.