# Association Between Resident Physicians’ Self-Rated Patient Care Ownership and Medical Professionalism Assessed by Patients: A Single-Center Study

## TL;DR

This study found no link between resident physicians' self-rated patient care ownership and how patients assessed their professionalism.

## Contribution

It is the first to examine the relationship between self-rated PCO and patient evaluations of professionalism in a Japanese clinical setting.

## Key findings

- J-PCOS scores were not associated with J-IPAMP scores after adjusting for confounders.
- Patients may evaluate professionalism based on visible behaviors rather than systemic responsibilities.
- Residents and patients may prioritize different aspects of care, leading to a disconnect in evaluations.

## Abstract

Introduction

Patient care ownership (PCO) has received substantial attention as a core aspect of medical professionalism. In recent years, a quantitative PCO Scale (PCOS) has been developed and widely utilized. Despite its growing importance, PCOS is measured through resident physician self-assessment, and the association between PCOS scores and resident evaluation by patients, the primary stakeholders in clinical care, remains underexamined.

Methods

This study was conducted at a rural postgraduate clinical training hospital in Japan from July 2022 to March 2023. PCO was assessed using the Japanese version of the PCOS (J-PCOS) as the explanatory variable. Patient-reported medical professionalism was measured using the Japanese version of the Instrument for Patient Assessment of Medical Professionalism (J-IPAMP) as the outcome variable. A linear mixed-effects model was employed to adjust for clustering within residents and individual covariates.

Results

Twelve residents and 99 of their patients were included in the analysis. After adjusting for potential confounders and clustering within physicians, J-PCOS scores were not associated with J-IPAMP scores.

Conclusions

Residents’ self-rated PCO was not associated with patient-reported professionalism. This may be because patients cannot observe key aspects of PCO, such as interprofessional communication and decision-making, and instead evaluate professionalism based on visible behaviors, such as bedside manner. Differences in priorities, with patients focusing on relational aspects of care while physicians emphasize systemic responsibilities and outcomes, may also contribute to this disconnect. Future studies should employ a multicenter design in Japan and conduct analogous surveys internationally.