Isha Patel, Travis Chapman, Fabian Camacho, Shameen Shrestha, Jongwha Chang, Rajesh Balkrishnan, Steven R Feldman

There is a lack of research in the USA comparing patient satisfaction with pediatricians and other primary care physicians (PCPs). We examined and compared patient satisfaction toward their pediatricians and PCPs and characterized factors associated with higher patient satisfaction in these two groups. A random coefficient model with random slope and intercept was fit to the data, with patient satisfaction as a function of pediatrician/PCP, covariates, and physician random effects. Effect heterogeneity was assessed by allowing slope to vary as a function of covariates. Mediation analysis using the random coefficient model was conducted to calculate average total effect, average natural direct effect, and average indirect effect of pediatrician/PCP on satisfaction mediated by waiting/visit times. Pediatricians had higher predicted satisfaction ratings than PCPs (total effect = 4.8, 95% CI 3.7-5.9), with population-averaged mean of 82.2 (0.54) vs 77.4 (0.13). The direct effect was 3.9 (2.8-5.0) and the indirect effect was 0.9 (0.9-0.9), suggesting that part but not all of the total effect can be explained by pediatricians having decreased waiting/visit times leading to increased satisfaction. Predictions by subgroup suggested that pediatricians had lower ratings than PCPs for first visit, but higher ratings for all other covariate strata considered. Having longer waiting times and decreased visit times coincided with closer mean ratings between pediatricians and PCPs, other significant effect modifiers included patient sex, provider sex, and region of practice. Pediatricians scored higher patient satisfaction ratings than the combined group of other PCPs. Pediatricians had shorter wait times to see their patients compared to PCPs. Shorter wait times and longer visit times were associated with higher patient satisfaction ratings.