Causal Effect Analysis of Demographic Concordance of Physician Trust and Respect in an Emergency Care Setting

Amy F Ho,1,* Yuan Zhou,2,* Jessica J Kirby,1 Md Mamunur Rahman,2 Kathryn Tessitore,1 Yousef Abdel-Raziq,1 James P d’Etienne,1 Chet D Schrader,1 Hao Wang1 1Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, Fort Worth, TX, 76104, USA; 2Department of Industrial, Manufacturing, and Systems Engineering, The University of Texas at Arlington, Arlington, TX, 76019, USA*These authors contributed equally to this workCorrespondence: Yuan ZhouDepartment of Industrial, Manufacturing, and Systems Engineering, The University of Texas at Arlington, 701 S. Nedderman Dr., Arlington, TX, 76019, USAEmail yuan.zhou@uta.eduHao WangIntegrative Emergency Services, John Peter Smith Health Network, 1500 S. Main St., Fort Worth, TX, 76104, USATel +1 817-702-8696Fax +1 817-702-1143Email hwang@ies.healthcareObjective: Patient perceptions of physician trust and respect are important factors for patient satisfaction evaluations. However, perceptions are subjective by nature and can be affected by patient and physician demographic characteristics. We aim to determine the causal effect on patient–physician demographic concordance and patient perceptions of physician trust and respect in an emergency care setting.Methods: We performed a causal effect analysis in an observational study setting. A near-real-time patient satisfaction survey was sent via telephone to patients within 72 h of discharge from an emergency department (ED). Patient-trust-physician (PTP) and physician-show-respect (PSR) scores were measured. Patient and physician demographics (age, gender, race, and ethnicity) were matched. Causal effect was analyzed to determine the direct effect of patient–physician demographic concordance on PTP/PSR scores.Results: We enrolled 1815 patients. The treatment effect of patient–physician age concordance on PTP scores was − 0.119 (p = 0.036). Other treatment effect of patient–physician demographic concordance on patient perception of physician trust and respect ranged from − 0.02 to − 0.2 (p > 0.05).Conclusion: Patient–physician age concordance may cause a negative effect on patient perception of physician trust. Otherwise, patient–physician demographic concordance has no effect on patient perceptions of physician trust and respect.Keywords: patient, physician, demographics, trust, respect