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Client Satisfaction and the Organization of Medical Practice: Why Time Counts
Catherine E. Ross, Blair Wheaton and Raymond S. Duff
Journal of Health and Social Behavior
Vol. 22, No. 3 (Sep., 1981), pp. 243-255
Published by: American Sociological Association
Stable URL: http://www.jstor.org/stable/2136519
Page Count: 13
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We examine client satisfaction with medical practices that range in organizational complexity from fee-for-service solo practice to large prepaid bueaucratically organized multispecialty groups. Although theories and data in the literature led us to expect differences in client satisfaction between the two extremes on the organizational continuum, we initially found none. In trying to account for this nondifference, we specified a model in which expectations about medical care and experiences with care counteract each other. Specifically, clients enter HMOs and other large prepaid groups with negative expectations, whereas they enter solo practice with positive expectations. However, their experiences with the medical care in solo practice tend to be negative compared with the experiences of clients in large groups. (Experiences include factors such as the number of minutes in the visit, the quality of the physician's technical care, and the quality of the "caring" psychosocial aspects of the interaction.) Experiences accumulate, and over time they begin to offset expectations. Thus, when time is not taken into account, there appears to be no difference in client satisfaction between the two types of practices. We develop a model that specifies the changing satisfaction patterns over time in different types of practices, and we explain these changes in terms of accumulating experiences.
Journal of Health and Social Behavior © 1981 American Sociological Association