At Doximity, we have long believed in the value of physician-peer relationships and the strength that comes from physician networks. Robust networks provide value to physicians, expanding access to knowledgeable specialists for tough cases and encouraging social-professional connections that help combat clinician burnout. A recent study published in JAMA Internal Medicine1 suggests that physician-peer relationships are associated with improvements in patient care, suggesting that these relationships are even more impactful for both doctors and patients.
The 2022 study analyzed EHR data from specialist visits between 2016 and 2019 at a large health system. The authors analyzed data to compare the experiences of two patient groups - one group whose primary care providers (PCPs) co-trained for at least one year with the specialist the patient was referred to, versus one group who did not. Within physician duos that overlapped for at least one year during medical school or postgraduate medical training, patients reported a 9.0 percentage point increase in composite patient rating of their specialist care. This increase was consistent across 9 out of 10 patient experience items, including friendliness/courtesy, explanations, concern shown, inclusion in decisions, medication information, understandable words used, time spent, patient confidence, and likelihood of recommending. Notably, these categories indicate that the response among physicians extended beyond a simple change in demeanor to include behavioral changes that promoted patient-centered care.
While the study defined co-training as at least one year of overlap during either medical school or postgraduate training at any level, the authors conducted further analysis into level of co-training overlap. There were positive associations at all levels of training with at least one year of overlap, but there were stronger associations when PCPs and specialists overlapped for the entirety of their training, especially at the postgraduate level. Given that co-training is only a predictor of peer relationships, this stronger association with additional overlap suggests that deeper peer relationships can have more significant impacts on patient experiences. Therefore, the magnitude of the impact of physician-peer relationships developed in other contexts (eg. social networking, undergraduate co-training, later career overlap, etc.) could be even more significant.
There are many explanations for the impact of physician co-training on patient experience. The authors suggest that when specialists are aware that PCPs they know can observe aspects of their care, it may encourage them to deliver even better care and remind them of the commonly valued code of professionalism among physicians. Regardless of why, the authors assert that “the estimated effects of co-training on patient ratings of specialist care are much larger than the effects of other policies, interventions, or efforts to improve patient experiences, including public reporting, accountable care organizations, health plan effects, and hospital characteristics.” Furthermore, the results show longevity in their impact – relationships built during education and training years ago continue to influence patient experience in the present. And, this study, unlike others on peer motivation, shows impact even when peer interactions are asynchronous and/or virtual, as there is no assumption that PCP-specialist dyads interact in person before, during, or after the patient care experience. Therefore, online platforms, conferences, and networking opportunities are a viable method for building physician relationships that can directly result in improved patient experiences.
These study results indicate tremendous power in physician-peer relationships. As the authors state, “There is room to foster and harness peer relationships more systematically…Peer relationships could be fostered and deployed to improve quality more broadly and even reduce disparities.”
As healthcare marketers, we encourage systemic change in the way physicians develop relationships with peers – for their benefit and for the benefit of their patients. Professional networks like Doximity provide the opportunity to connect with peers on a confidential, social-professional platform that encourages relationship building. Leveraging this relationship-building opportunity could make a tangible difference in the care that patients experience from physicians and hospitals.
1Pany MJ, McWilliams JM. Physician-Peer Relationships and Patient Experiences With Specialist Care. JAMA Intern Med. 2023;183(2):124–132. doi:10.1001/jamainternmed.2022.6007