The mood of the care recipient to see if the impression (expectations) of service are met by the patient may be defined as patient satisfaction. The current perspective on service efficiency tends to be that patient treatment meets public standards and requirements in terms of interpersonal support as well as professional assistance. (Hardy et al. 1996). For various reasons, customer satisfactions in the healthcare industry have been investigated. First it was important to decide on the extent and the degree to which patient care seekers, the meeting of drugs criteria and the continuous use of these services have effect, satisfaction as a quality of service metric, as well as allowing doctors and health services to better appreciate and use the input of the patient. (Ong et al. 2000). Consumer satisfaction with healthcare services is a multi-panel term that refers to the core facets of treatment and suppliers, while PS medical services with the quality enhancement systems from the patient context, full control of quality and the intended outcomes of services are considered to be of primary importance (Janicijevic et al. 2013). The Pakistani health system is being changed somewhat and there are wonderful scope for applying standard of services to health care. Patients in Pakistan now have access to increased quality health care. Obviously, the staff and staff are the most important winners of a successful health care environment of every community sector framework (Bakari et al. 2019). The medical clinic of today's study is the product of a long and complicated war of civilization to quantify produce and study and to give thought to the thoughtful (Fullman et al. 2017).

1. PATIENTS' SATISFACTION TOWARDS
DOCTORS TREATMENT
(A STUDY OF STATE HOSPITALS
MULTAN, PAKISTAN)
By
Nosheen Afzal
Supervised By
Dr. Tehmina Sattar

2. Introduction
■ The mood of the care recipient to see if the impression (expectations) of service
are met by the patient may be defined as patient satisfaction. The current
perspective on service efficiency tends to be that patient treatment meets public
standards and requirements in terms of interpersonal support as well as
professional assistance. (Hardy et al. 1996).
■ For various reasons, customer satisfactions in the healthcare industry have
been investigated. First it was important to decide on the extent and the degree
to which patient care seekers, the meeting of drugs criteria and the continuous
use of these services have effect, satisfaction as a quality of service metric, as
well as allowing doctors and health services to better appreciate and use the
input of the patient. (Ong et al. 2000).

3. ■ Consumer satisfaction with healthcare services is a multi-panel term that refers
to the core facets of treatment and suppliers, while PS medical services with the
quality enhancement systems from the patient context, full control of quality and
the intended outcomes of services are considered to be of primary importance
(Janicijevic et al. 2013).
■ The Pakistani health system is being changed somewhat and there are
wonderful scope for applying standard of services to health care. Patients in
Pakistan now have access to increased quality health care. Obviously, the staff
and staff are the most important winners of a successful health care
environment of every community sector framework (Bakari et al. 2019).
■ The medical clinic of today's study is the product of a long and complicated war
of civilization to quantify produce and study and to give thought to the thoughtful
(Fullman et al. 2017).

4. ■ When the roles and components of an emergency clinic have been thoroughly
understood, a fundamental aspect of the general public whose ability is required
to provide adequate health care and mitigation insurance for the dependent
community and whose institutional outpatient can bind the household in its
home condition. In general, the clinic can thoroughly judge the quantity of beds,
the techniques, structural innovations and equipment forms, the scale of the
financial cap, etc on a structured nonmental basis, but the true means for
auditing the patient never respond to those factual numbers. (Wells et al. 2002).
■ Patient satisfaction represents the patient's perceived need, health system
preferences and hospital experience. This multidimensional definition covers
both medical and non-medical healthcare elements. Different theories have
been written on patient satisfaction in healthcare. The following hypotheses
contain perceptions, beliefs and previous expectations surrounding treatment in
order to affect the happiness of a patient and the second is the philosophy of
quality health care, which stresses that the interpersonal healthcare process
plays an integral role in the guarantee of satisfaction of the patient. (Williams et
al. 1994).

5. ■ The literary analysis highlights many aspects which could influence the
satisfaction of patients. These determinants may be linked either to the provider
or to the patient. Such considerations pertaining to providers include the
proficiency and expertise of medical practitioners and interpersonal contact,
hospital personnel attitudes, access to critical resources and facilities. The
socio-demographic aspects of the case, the stage and patients' level of faith and
a sense of participation in the option on their own treatment are patient-related
influences. (Mumtaz, S. 2000).
■ The patient in contemporary life is more informed of, trained, accessed and
expected by the health system. Therefore, resolving concerns relating to service
provision in this sense is today more relevant than ever before. A patient with a
positive perception is more likely to produce positive effects. Where unpleasant
behavior in the patient and the unhappiness of health care leads to low
compliance and in serious situations, patients use a weak word of mouth to
deter others from accessing healthcare. Studies have shown that people have
not visited their local primary health centres in Africa except for serious disease
due to perceived inadequate standard of treatment. (Nieder et al. 2006).

6. ■ While several surveys were performed in Pakistan with respect to patient
satisfaction, this survey was conducted with the intention of researching another
primary field in medical facilities, i.e. outpatient hospital department. (OPD). This
research focused on particular fields, including emergency department, daycare
or family medicine. Therefore a Lahore tertiary level hospital with references to
the doctor-patient-interaction registration desk, waiting area and general health
facilities were chosen for this analysis with the goal of assessing the level of
patient satisfaction against OPD services. The study findings would be helpful in
instituting effective action for hospital administration and health care system
management at various levels (Memon et al. 2013).
■ Quality in healthcare is a worldwide epidemic. The primary goal of health
services is to provide patient care and enhance population health status. The
variety of health services varies considerably from country to nation. The
additional health systems are impacted by national and local health issues in
general and continually changing, their attitude of need and available funding.
History indicates that healthcare in recent years has experienced numerous
shifts in terms of societal requirements and access to services and technology.
(Smith et al. 2007).

7. Research Questions
■ Is patients are satisfied with the health care process?
■ Is patients are satisfied with the treatment of doctors?
■ Is patients are satisfied with the behavior of doctors?
■ Is patients can be satisfied with the information & communication regarding
healthcare services?

8. Objectives
■ To examine the behavior of the doctor is good and friendly.
■ To examine the basic satisfaction of the patients towards doctors treatment.
■ To examine those doctors should thoroughly explain the reasons for any medical
test.
■ To draw conclusions from this study with ultimate objective of improving the
doctors treatment towards their patients.

9. Hypothesis of the study
■ There would be a significant effect of doctor treatment on patient’s satisfaction.
■ There would be a significant effect of doctor behavior on patient satisfaction.
■ There would be a significant effect of care and cost on patient satisfaction.

10. Literature Review
■ Memon et al., (2017) In order to ensure better outcomes of the medical consultation,
respecting the patient's views on doctor's advice implementation is important. Therapy
conformity is a crucial determinant of effective therapy. The authors considered this to be
a grave lack of analysis. The research aimed to establish the degree and determinants of
failure to comply with the advice of the doctor amongst study participants. A descriptive
cross-section study of 230 subjects suffering from different diseases was carried out in the
present population. Patients were recorded by way of a comfort study. On pre-structured
Performa the data have been stored. The details contain concerns about the conformity of
patients with doctoral consultations, which may be preventive, prime and therapeutic. The
average interviewees were 36.6 ± 7.4 years. In 31,2% of the subjects, the average
adherence of doctors was shown. The care advice enforcement was 35.8 percent; 29.5
percent for primitive wellness advice and 28.4 percent for preventive illness advice. In
contrast to consultants, there were 70% of total compliance, which is 26.4 percent. There
was a significant association between compliance and older age (p= 0.02), non-infective
illness (p=0.04), disease severity (p=0.01), oral route of administration (p=0.00) and a
shorter duration of illness (p=0.00). However the effects of gender compliance were
statistically marginal. This research found that the inability to cooperate with doctor
therapy is a significant health concern and should be viewed as a latent disease risk
factor. In non-communicable diseases, compliance with physician guidance was more
popular compared with communicable diseases. Moreover, fear of adverse outcomes and
high care costs were two primary factors for non-compliance with medication.

11. ■ Lim et al., (2016) This analysis is based on prior studies focused on the relationship
among doctors and patients with elderly cancer; the research is also focused on the
derogatory attitudes and oppressive actions of doctors to the elderly, so that we can
recommend ways to decrease ageism. Sequent use was made of a qualitative
approach and a quantitative method. In this report, we interviewed 8 doctors in detail
and subsequently performed 274 surveys. The questions from the in-depth interview
were clustered according to meaningful facts and in the explanation statistical
analyses and t-testing combined using PASW statistics 18 the survey results were
analysed. The following is found by in-depth interviews: Doctors hardly alert elderly
patients with cancer directly; patients' relatives do not do so; doctors even display
differing attitudes or derogatory behaviour towards the elderly. Based on the
comprehensive findings of the interviews, questions were created and conducted in
the form of a survey about diagnostics notification and how to describe the procedure.
Just 8.4% of doctors reported notifying the Elderly cancer patient specifically through
the study, and reported giving less detail to elderly people about care, side effects,
prediction and medical expenses than mid-aged patients. This study has not only
established prejudice against patients with elderly cancer, but has also demonstrated
the reasons behind it. To overcome the phenomenon, doctors should understand the
variations and heterogeneity in physiological processes independently and should be
mindful of the psychological transition to interact with them after the cancer diagnosis
better. The mentality of the social family that over-protects the aged still needs to be
improved.

12. ■ Samra et al., (2015) While studies in government and charitable organisations claim that
negative staff attitudes towards the elderly which lead to unequal treatment for the elderly
relative to younger patients (those under 65 years old), these attitudes have not been
identified in depth in the research paper. Twenty-five semi-structured medical and hospital
doctor interviews took place in the United Kingdom's acute education hospital. In line with
the psychological literature on the meanings of attitudes (affective, cognitive and
behavioural information) participants were asked about their values, feelings, and
behavioural tendencies towards older people. There was a thematic review of the details.
Attitudes about and the treatment of older patients may be conceptualised in: I the belief
on the elderly; (ii) the special needs of elderly patients and the expertise available to care
for them. In comparison to older people generally, our results established prevalent
attitudes and assumptions unique to older patients. Elderly patients had special treatment
needs. Usually, the participants identified negative feelings about the care of older
patients, but the causes of frustration contribute primarily to the operational environment
and framework from which these patients undergo medication. This project was one of the
first in-depth efforts to investigate perceptions in the healthcare community of older
patients in the UK.

13. ■ Butow et al., (2015) for both conventional cancer therapies and new cancer treatments
in a clinical sample, informed consent is required. It is difficult to achieve efficient and
responsive contact between the practitioner and the patient about the informed consent.
Our mission was to educate doctors in a clearly aware, collaborative and ethical
communication and to assess the effect of education on the attitude, tension and
happiness of doctors. 21 oncologists from 10 centres in Australia/ New Zealand were
present, and 41 oncologists from 10 centres in Switzerland/ Germany/Austria (SGA).
Oncologists have been randomized to attend a workshop for 1-day or not. Before and
during school, patients were hired. Doctors have been required to consult 1–2
audiotapes before and during school. Physicians have completed outcomes tests before
and after completing the cohort recruiting post-training. The audiotape was composed of
ninety-five consultation interactions. The teaching was assisted actively by physicians.
The ANZ intervention doctors found that collaborative cooperation was greatly improved
(P = 0.03). Training has little effect on other habits of the doctor. Trained physicians did
not exhibit decreased burnout and stress. There is presentation of medical results
elsewhere. Any facets of the informed consent protocol can be enhanced by
preparation. Training approaches are needed to improve the effect which can require
longer training and more intensive follow-up.

14. ■ Pattison et al., (2013) Examine end-of-life support for families, family members,
oncologists, palliative care professionals, critical care advisors and nurses who are
seriously ill with cancer. End-of-life treatment is quite elusive for chronically ill patients,
almost 20% of which will die in intensive care (Truog et al. 2008). End-of-life treatment
is an existing cancer domain; however, research on the dying and seriously ill cancer
patients' experiences has not historically been carried out. There were high-quality
detailed phenomenological interviews. Experience of 27 individuals was analyzed by
phenomenology: high risk patients that survived, relatives who were afflicted,
oncologists, palliative and critical care specialists and nurses. Critical care unit
objective sampling was done by the UK. Deep interviews were taped using the
phenomenological research method of Van Manen. A phenomenological view is
provided of mortality of serious cancer diagnosis and its effects on end-of-life treatment
opportunities. Three primary subjects included: dual forecasting; the importance of
decision-making; and end-of- life treatment procedures. End-of-life care for all
participants was an intimate experience; key values of successful end-of-life care
included convenience, technology less apparent, anonymity and integrity. These
effects are discussed in terms of end-of-life diagnosis, cancer and major diseases. The
pace at which critical disease dies is sometimes uncertain and thus has an effect on
end-of-life treatment potential. Caring was not limited to nurses, and the cost of end-of-
life treatment was high.

15. Theoretical Framework
■ The mechanism will help or maintain a research analysis theory is a theoretical
construct. The analytical context outlines the hypothesis and discusses why the
research problem is studied.

16. Conceptual frame work
Background variables Independent variable Dependent variable
 Student
 Age
 Gender
 Literacy
 Marital Status
 Place of
Residence
 Social Media
User
 Monthly Family
Income
1. Towards Doctor Treatment
 Sociological Perspectives on
Satisfaction
 Professional standards and their
assessment
 Type of treatment
 Lack of attention
 Outcomes of health care
 Social relations
 Social capital
 Human capital
 Legal duty
 Effectiveness in achieving and
satisfaction
 The doctor–patient relationship
 Health and illness behavior levels
 Patient participation in the planning
 Rehabilitation of the patient’s health
 Good communication time
 Patient’s complaints awareness
 Need to study
 Strategies for managed care plans
 Specter of health services
 Direct relationship
Patient’s
satisfacti0n
 Good doctor
 Therapeutic
treatment
 Persist of
proper care
 Measure of
care
efficiency
 Lack of
valid and
reliable
 Level of
Education
 Patient’s
disease and
better
health care
 The quality
of hospital
care services
 Informed by
the provided
services
Fig. 2.6 Propose Conceptual Model

17. Patient satisfaction and social
identity theory
■ Linder-pelz (1982) assumed a paradigm of value-expectancy in the formulation of
satisfaction and described patient satisfaction as an optimistic attitude. A
constructive appraisal of a different component of healthcare, such as a particular
hospital visit, the entire treatment process, particularly in the sense of preventive
care or a strategy or general conduct of the health system by Fishbein and Azjen
(1975) as the "common judgment or sense of favorability against the object
concerned." Based on this theory of social identity, attitudes are moderated by
environmental, human, physical, psychological or sociological variables” in her later
study, Jessie L. Trucker (2002) Patient satisfaction theory was taken as an attitude
and its findings indicate that patient perceptions of patient access, connectivity,
results and efficiency were important predictors of satisfaction. The theory of patient
satisfaction was empirically validated. The theory of social identity suggests that
demographic, situational, and psychological influences altered and effected
behaviors, and its empirical outcomes showed that patients' individual
characteristics clarify their happiness considerably.

18. Satisfaction Theory
■ Despite several decades of studies on patient or consumer satisfaction and the
creation of several standardized instruments and various ad hoc steps, the
validity and reliability have been varying but typically poor (Sitzia, 1999), The
majority of applications for analysis and software assessment have been
practical and problem-oriented and thus (Linder-Pelz, 1982; Locker & Dunt,
1978; Sitzia & Wood, 1997; Williams et al., 1998). A limited but increasingly the
number of disciplines and methods have sought, however to explain both
satisfaction and expectations constructions and steps and describe the personal
and service variables deciding expectations and satisfaction. Much analytical
work has been undertaken in the field of healthcare and the subsequent
analysis will draw on this literature.

19. Satisfaction and Elements of
Care
■ Patient satisfaction, in most research, is defined as the measurement or appraisal of
medical intervention on a particular issue or problem of health (Sitzia & Wood, 1997;
Williams, 1994). A broader variety of patient satisfaction surveys have resulted in
arrangement for patients to measure theoretically appropriate satisfaction
dimensions, more appropriately named health components or healthcare features
(Sitzia & Wood, 1997). Table 1 sums up three of the most comprehensively
analyzed patient satisfaction metrics from varying time spans and reveals the
myriad features. As the table shows, the basic health-care elements that can be
taken into account in patient satisfaction analysis differ considerably. Although
variability is criticise for the various components of the care produced and used in
various studies, this could vary depending on the specific context in which
satisfaction is measured, as well as by the individual and subpopulations measuring
it (Avis, Bond, & Arthur, 1995; Like & Zyzanski, 1987; Sitzia & Wood, 1997).
Although, as can be seen from the table, the elements of treatment often overlap
considerably when they are clustered in large categories.

20. Points
■ Good doctor
■ Patient's disease and better health care
■ Legal duty
■ Lack of attention
■ Professional standards and their assessment
■ Effectiveness in achieving and satisfaction
■ The doctor–patient relationship
■ Rehabilitation of the patient’s health
■ Doctor’s Attention

21. ■ Measure of care efficiency
■ Informed by the provided services
■ The quality of hospital care services
■ Persist of proper care
■ Patient participation in the planning
■ Goal of health care
■ Therapeutic treatment
■ Direct relationship
■ Health and illness behavior levels
■ Environmental factor
■ Patient’s complaints awareness
■ Outcomes of health care

22. ■ Sociological Perspectives on Satisfaction
■ Lack of valid and reliable
■ Specter of health services
■ Need to study
■ Strategies for managed care plans
■ Good communication time

23. Methodology
■ This thesis has been planned to review "Patient Satisfaction with Doctor's
Therapy" (Multan State Based Hospital)." The principal goal of this chapter is to
describe different instruments and techniques used to capture, examine and
interpret data. This chapter explains in brief the method and the methodology of
study, along with mathematical tests and operational descriptions of the
principles used. Study uses a form of quantitation. Many tools to assess patient
satisfaction are possible. The analysis technique is the means by which data is
obtained, interpreted and evaluated correctly to determine the relation between
the variables. These are the quantitative methods. A guide to research
methodology involves principles, schedules and procedures that define the
nature of the analysis, methods for gathering studio-related data, capturing data
in the proper manner, and the description of their data analyses in order to
determine the relationship between study variables. A methodology is an
essential part of any research study and provides guidance for future research
to evaluate any studies to verify its outcome (Martin, 1989).The quantitative data
collection was concurrent; Data was collected from the state base hospitals
Multan Pakistan.

24. Research Setting
■ The investigator prefers the city of Multan because in this city are the largest
number of public hospitals. As a universe, the researcher preferred Multan State
Basic Hospital.
Age
■ In these clinics, the investigator chose stakeholders, the age of the patient
above 15 and over 40 years, and the researcher selected them above.
Sex
■ In comparison to the female patients, both men and women were chosen in the
researchers. Male patients were more frequent. In addition, the investigator
interviewed both men and women, but males were more frequent than females.

25. Literacy Level
■ Education rate in six levels. Education standard. Literacy skills of persons of
level 1 or lower are regarded as very weak, while level 3 is regarded as the
lowest literacy level required to manage their daily lives. This was important to
know patients' experience to understand doctors' behavior dependent on care,
knowledge of best hospitals, medication, and so on.

26. Marital status
■ Marital status is the legally defined marital state. There are several types of
marital status: single, married, widowed, divorced. This term used in
questionnaire just for categorized the patients.

27. First stage
■ By using basic random sampling methods the researcher picked 1 division in
southern Punjab out of 3 divisions. In the initial stage of the sampling process,
the Multan Division was chosen by the investigators from three districts, namely
Bahawalpur, Multan Division and DG Khan of southern Punjab.

28. Second stage
■ Then 490 of 211 hospitals were chosen by the researcher. In the second stage
of the sampling process the researcher selected simple random sampling
techniques.

29. Tool for Data collection
■ The data are obtained through the interview secugel after illustration of the
sample and design of the applicable testing technique. In the interview software
the investigator concentrated on query and attempts to escape the partiality and
mistakes in the form of the questionnaire. The mistakes are referred to as
reaction results. The researcher just has questions that are closed.

30. Field Experience
■ Since Covid 19 and all the hospital were explicitly prohibited from accessing the
hospital for any solid excuse, the researcher had faced several problems in
gathering data. Patients are also fearful that they will exchange knowledge
because of COVID-19.

31. Pre –Testing
■ Pre-testing was carried out to ensure the authenticity and consistency of
questions. The pretest curriculum for 20 patients was finished. After the
researcher had completed the pre-test the questioner found that a lot of
questions were not acceptable and hurdled in the response from the
respondent. After pre-testing, the researcher had to adjust any issue. Given this,
several questions were updated by the researcher. Some questions have had
the same importance, and that's why the researcher excludes this from the
questionnaire. While the researchers placed a few additional questions about
the basic measures used for pretesting the researchers helped to bring good
amendments to the study goals.

32. Coding/Decoding
■ The coding process was performed for computational purposes. Mathematical
numbers have coded responses/categories to statistically verify the relation
between variables, indifferent d data can be understood easily.

33. Data Entry and Data Analysis
■ For feeding into the machine, the data was organized and organized. The
findings were analyzed and interpreted using the computer. After data coding,
data processing has been entered and then analyzed using programme "SPSS."
In order to allow a simple explanation of data that allowed statistical
interpretation for study the researcher had combined detailed information in a
set of categories. The data was entered into the PC and analyzed using Minitab
software after completion of data collection and analysis.

34. Results
■ H1: There would be a significant effect of doctor treatment on patient’s
satisfaction
■ a. Dependent Variable: patient situation
Model Unstandardized Coefficients Standardized Coefficients t Sig.
B Std. Error Beta
(Constant) 3.215 .108 29.895 .000
Dr. Treatment .176 .029 .266 6.151 .000

35. H2: There would be a significant
effect of doctor behavior on
patient satisfaction.
Model Unstandardized Coefficients Standardized Coefficients t Sig.
B Std. Error Beta
(Constant) 3.404 .121 28.037 .000
Dr. Behavior .127 .033 .172 3.880 .000
a. Dependent Variable: patient Satiation

36. H3: There would be a significant
effect of care and cost on patient
satisfaction.
■ a. Dependent Variable: Patient Satiation
Model Unstandardized Coefficients Standardized Coefficients t Sig.
B Std. Error Beta
(Constant) 2.676 .150 17.787 .000
Hospital Care Cost .318 .040 .337 7.981 .000

37. Key Findings
■ Majority indicates of the respondents (254) 51.0% which belonged to the age of 31-45.
■ Majority indicates of the respondents (278) 55.8% which belonged to female gender.
■ Majority indicates of the respondents (150) 30.1% which belonged to up to matric level.
■ Majority indicates of the respondents (283) 56.8% which belonged to married marital status.
■ Majority indicates of the respondents (287) 57.6% which belonged to the pre-urban place of
residence.
■ Majority indicates of the respondents (312) 62.7% which belonged to the social media user.
■ Much of respondents (307) show that they should be admitted without a problem 61.6 percent
who firmly accepted that they seek medical care.
■ Most of them (221) suggest that 44.4% of those who belonged to tp agreed with doctors have
to treat me more thoroughly.

38. ■ Most of them (221) suggest that 44.4% of those who belonged to tp agreed with
doctors have to treat me more thoroughly.
■ Most (283) state that I am very pleased with the medical attention I get from
respondents (56.8 percent) who were in connection.
■ Ten. Much of the respondents (193) show that 38.8 percent agreed that I'm
concerned about large-scale diagnostic studies.
■ Much of the respondents (215) state that 43.2% who were firmly in favour of it is
easy for me to get an emergency medical.
■ Fifteen. The majority showed that 40,2 percent of respondents (200) who
agreed with the doctors would clarify why the diagnostic experiments were
done.
■ Most of respondents (219) suggested that I was 44.0% who acknowledged that,
when I was on a doctor's office, I generally waited for a long time.
■ Much of the respondents (200) suggest that they (40.2%) believed that I believe
that my doctor's office has something to do with the whole healthcare system.
■ Majority shows that 40.4 percent of respondents (201) who have closely helped
me should display more regard for doctors who care me .

39. Conclusion
■ Indeed, customer satisfaction is a function of the patients' aspirations and
perceptions. Satisfaction is typically generally strong for existing visits to those
services. Nonetheless, details on the reasons for the unhappiness still proves to
be invaluable for discovery of inefficiencies and loopholes and final programs
action that is expected to be taken by the government. Restricted resources
against recipient's expectations the population, the manpower limitations and
the time to dealing with huge workloads eventually leads to high workloads
unhappiness at both ends of the distribution system. To build on our current
parameters. Unavoidably, it's a need in this era of recognition and rapid growth
in the field of medicine to implement changes for innovations that meet
consumers’ changing requirements and wants.