Physician knowledge about each other’s quality is essential to clinical practice, though often not utilized effectively in the healthcare system to identify potential quality improvements. However, in the selection of chief medical residents, discussion of interpersonal skills, teaching ability, and clinical expertise are a key part of the process.

A recent study published in JAMA Internal Medicine by Warren Alpert Foundation Professor of Health Care Policy, Michael McWilliams, MD, PhD, and Lucy Chen, PhD, an MD-PhD student in Health Policy, examined differences in quality of care among Primary Care Physicians (PCPs) who were former chief medical residents and non-chief PCPs by comparing the experiences of patients treated by the two groups of physicians.

The study used Medicare Fee-For-Service Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data spanning from 2010-2018, Medicare claims of 20% random samples of fee-for service beneficiaries, and medical board data from 4 large US states. They compared care for patients of former chief PCPs with that of non-chief PCPs in the same practice using linear regression.

Findings revealed that patients rated former chief PCPs significantly higher than non-chief PCPs, with noticeably higher ratings for physician-specific communication and interpersonal skills, both qualities typically emphasized in chief medical resident selection.

Notably, differences in ratings were large for patients of racial and ethnic minority groups, patients dually eligible for Medicare and Medicaid, and those with less education.

In contrast to care experiences, minimal differences in spending and utilization were observed, though results suggested lower acute care use for the same subgroups who reported large patient experience gains. However, only a limited set of outcomes were examined in the study, and interpretation of results was challenging.

The study’s results suggest that physicians do possess meaningful information about each other’s quality and that harnessing physicians’ acquired knowledge could be a strategy for improving quality of care with important implications for practice and policy.