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January 7, 1998

Patient Satisfaction and Ambulatory Encounters Involving Medical Students—Reply

Author Affiliations

Copyright 1998 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1998

JAMA. 1998;279(1):18-19. doi:10.1001/jama.279.1.17

In Reply.—Dr Barclay's concern about the possibility that patients from a "lower social class" may have more positive attitudes toward student involvement (thus, calling our conclusion into question) is based on a study involving students and patients on the maternity ward of a British hospital.1 Patients in this inpatient setting had an individual student assigned to them through their hospital stay, perhaps offering more time and focus to patients who sometimes are lacking full attention. On the other hand, in the ambulatory community setting, students may be viewed as an obstruction to the patient in reaching his or her primary physician, the "real doctor." As noted in our article and in other studies, there appear to be substantial differences in patient acceptance of students in the hospital2 and ambulatory settings.3 Since, to our knowledge, no studies have examined patient attitudes toward students by social class in ambulatory practice, Barclay's concerns, at this point, are theoretical. In fact, when controlling for the effect of race and insurance type on patient satisfaction for those with and without medical students in our sample, no significant statistical differences were noted in the total satisfaction scale or in component items, including meeting expectations, time waiting, time spent, or the explanation of what was done during the visit.