The Influence of Physician Patient-Centered Behaviors on Black and African-American Male Cardiology Patients' Satisfaction and Ratings of Quality

Clinical technical competency is a necessary but insufficient condition of desired outcomes because the delivery of healthcare requires interpersonal interaction with patients. Cardiology patients’ outcomes are influenced the by both the clinical competency and patient-centeredness of their physicians. Despite HHS’s and the IOM’s identification of patient-centeredness as a core component of quality healthcare, current operational definitions lack sufficient specificity to demonstrate patient-centeredness’ influence on Black and African-American male cardiology patients. PURPOSES: Accordingly, this study examined whether the patient-centered behaviors of physicians influenced Black and African-American male cardiology patients’ satisfaction, likelihood to return, and overall ratings of quality, correlates of improved health outcomes. METHODS: A two-factor multigroup structural equation modeling design was used with three randomly selected national test and cross-validation samples of Black and African-American male cardiology patients, where test (N₁=290) and cross-validation samples (N₂=279; N₃=271) were employed. Goodness of fit, measurement invariance, and post hoc competing model experiments were conducted to test the model’s plausibility. RESULTS: The model fit well supporting the hypothesis that patient-centeredness was an underlying ability of physicians that influenced Black and African-American male cardiology patients’ satisfaction, likelihood to return, and overall ratings of quality. Physician patient-centeredness explained 63% of patients’ satisfaction variability. A standardized increase in physician patient-centeredness concomitantly increased patients’ satisfaction, likelihood to return, and overall ratings of quality by .791, .717, and .745 units respectively. These effects were stable (invariant) across all samples (test and cross-validation). The model was sustained when compared to competing model. DISCUSSION: This study demonstrated that the patient-centeredness is a underlying ability of physicians that influences Black and African-American male cardiology patients’ satisfaction, likelihood to return, and overall ratings of quality. The Primary Provider Theory and this investigation offer evidence-based models for the measurement and improvement of Black and African-American male patients’ satisfaction and other outcomes in hospital cardiology units.