GOOD HEALTH MAGAZINE : MEDICINE : GOOD DOCTOR : THE TIMES POLL FINDS THAT ‘ABILITY’ AND ‘CONCERN’ RANK HIGH WHEN PEOPLE RATE THEIR PHYSICIANS. WHAT THEY HATE MOST IS WAITING

When asked to single out the most important quality of a good doctor, nearly half of all patients say it is the “ability” of their doctor that matters most. But a similarly large proportion of patients say that it is more important that a doctor show “concern” for patients.

And, according to a nationwide survey of the general public conducted by the Los Angeles Times Poll, most doctors aren’t doing a very good job either in treating their patients’ ailments or in showing genuine interest in their patients’ welfare.

The biggest complaint people have about their doctors is that they keep patients waiting, according to poll results.

Of the 2,046 people who were interviewed, nearly one in three says delays in seeing the doctor is what he or she most dislikes about physicians. One in 10 says doctors rush through visits. A handful complain that the doctors are either too impersonal or fail to listen to their complaints. And some people even believe that their doctors are unable to figure out what is wrong with them.

The Times Poll, directed by I.A. Lewis, conducted its survey by telephone this past winter. On a survey of this size and complexity, the margin of error is estimated to be 3 percentage points in either direction.

According to respondents, only about half of the time do doctors diagnose ailments correctly on the first visit to the office. By the second visit, four out of five doctors find out what is actually wrong, and by the third visit, nine out of 10 doctors have gotten it right.

Only one in five people thinks a doctor orders the right number of tests. About 20% think doctors order too few tests, and nearly half say they think their doctors order too many tests, in some cases perhaps because doctors are perceived as getting financial kickbacks from laboratory tests. In fact, the vast majority of people, seven of 10, think that their doctors get some kind of financial benefit from the tests they order.

But in other ways, many people seem to lack confidence in their doctor’s ability to treat ailments. More than half think doctors are too quick to prescribe drugs. One in 10 thinks a doctor too often withholds drugs. Only about 22% think doctors prescribe “the right amount.”

“There was a time when patients had unqualified respect for their doctors,” says Lewis, who has been conducting opinion polls for more than 20 years. “But that is clearly no longer the case.

“The fact that people look for concern and compassion in their doctors may be an indication that they do not always find it, and it’s important to them. They don’t like to be kept waiting and they are. They don’t like it that doctors don’t always listen to them.”

Although the majority of people, 62%, think doctors are interested in treating their patients’ health problems above all else, nearly one out of three people says that making sure the patient pays the bill is a physician’s primary concern.

Almost no one thinks doctors are underpaid for the services they render, but people are undecided as to whether doctors are overpaid. Nearly half say doctors are paid too much, while the other half say doctors are paid about the right amount.

Many people, however, grossly underestimate how much their doctors actually make.

According to the American Medical Assn., the average physician’s income after business expenses is $145,00 a year, and government analysts place the figure even higher, probably approaching an average of $300,000 yearly.

Yet only one in four people thinks the average physician’s salary exceeds $200,000 a year; 29% think doctors earn between $100,000 and $199,000; 35% think doctors earn less than $100,000 a year; and 12% say they simply don’t know.

Younger people and those without health insurance are less pleased with their doctors than are older people and those who have medical coverage.

Of all people, whites (84%) are most likely to think their doctors are good or fairly good, followed by Latinos (72%) and blacks (64%).

Only about two out of three patients say they think their doctors are “very good” with respect to the quality most valued in a physician. Nearly one in four patients thinks the doctor is “fairly good,” although only a handful think their doctors are “fairly bad” or don’t have an opinion.

“When you think there are about 600,000 doctors in the United States, you’d think that people would go get a better one” if they aren’t fully satisfied, Lewis says.

On the other hand, only two in 100 patients say their doctors are “bad,” and only six of the 2,046 respondents say doctors are “very bad.”

The vast majority of Americans, 81%, say they have a “personal doctor,” although there are variations depending on the kind of medical insurance they carry and the part of the country in which they live.

As one might expect, people who have private health insurance are more likely to have a regular doctor than those who have no insurance or who are members of health maintenance organizations. But there are also curious regional differences. In the Midwest, 87% of the people say they have personal doctors, as do 82% of the people in the East and South, whereas this is true of only 69% of those living in the West.

By choice or by necessity, nine in 10 people go to male doctors, but here, too, there are differences among various groups. Women are almost three times as likely as men to go to female doctors. People who are members of health maintenance organizations are twice as likely to go to female doctors as are those who have private physicians and regular health-insurance coverage. Similarly, younger people are more likely than older people to go to female doctors, and blacks are more likely than whites to be treated by female physicians.

One interpretation of this is that women in the medical profession tend to work in areas that serve the poor and minorities, with one exception. Of all ethnic groups including whites, Latinos are the least likely to have a woman doctor.

OBJECTIONABLE PROCEDURES OF A PHYSICIAN* Keeps you waiting: 27% Rushes through visit: 8% Fails to figure out what is wrong: 4% Impersonal: 3% Dismisses alternative medicine / treatment: 3% Hardly listen to concerns: 2% Other: 5% Don’t know: 41% Don’t have doctor: 16% MOST IMPORTANT QUALITY OF A GOOD PHYSICIAN* Ability:43% Concern: 43% Availability: 26% Dedication: 18% Experience: 18% Intelligence: 11% Character: 9% Other: 1% Don’t know: 3% DO MOST DOCTORS ORDER TOO MANY TESTS OR TOO FEW? Too many: 48% Right amounti 20% Too few: 17% Don’t know: 15% HOW MANY TIMES DO YOU GENERALLY HAVE TO GO TO THE DOCTOR BEFORE HE FINDS OUT WHAT’S WRONG WITH YOU? One visit: 52% Two visits: 30% More than two: 13% Don’t know: 5% * Totals add up to more than 100% due to multiple responses. Source: Los Angeles Times Poll