Does tumor status influence cancer patients' satisfaction with the doctor-patient interaction?

The interaction of patients with their doctors impacts the experience of disease at many levels. It is thus important to measure patient satisfaction with such interaction as an outcome of care. Our goal was to investigate whether tumor status influences patient satisfaction with interaction with their doctors. Specifically, we investigated whether patients with no evidence of disease (NED), localized, or metastatic cancers seen in routine follow-up differ in their satisfaction with the oncologist. Outpatients attending clinics at a major cancer center completed a battery of questionnaires, including the Patient Satisfaction with Doctor (PSQ-MD) questionnaire, a 24-item, self-report instrument. It taps two facets of the doctor-patient exchange: perceived support and physician disengagement. Data concerning tumor status and satisfaction were obtained for 569 patients, sampled to include equivalent numbers of women and men with breast, head and neck, gastrointestinal, genitourinary, or lung cancer, or lymphoma. Controlling for age, marital status, annual family income, stressful life events, and employment status, patients with metastatic disease felt somewhat less supported by their physicians (mean=3.26+/-0.06) than those with localized disease (mean=3.42+/-0.04) or NED (mean=3.42+/-0.03), (analysis of covariance, p< 0.05). Physician disengagement did not differ across the groups (means=1.54+/-0.06, 1.43+/-0.04, and 1.47+/-0.03 respectively). These findings were consistent across cancer diagnoses. Patients with metastatic disease may feel less physician support than those with less advanced cancers. Increasing attention to satisfaction of different patient groups can pave the way to improved quality of care.