The previously validated and reliable 30-item QUEST scale8 was used to measure patients' perceptions of quality of care and satisfaction with their physicians and nurses. The QUEST scales were based on items derived from the previous work of Matthews et al9 and Matthews and Feinstein,10 who had developed instruments to elicit patients' appraisals of physician performance. The QUEST scale transformed these items into 4 subscales, including quality of care from physicians, quality of care from nurses, satisfaction with physicians, and satisfaction with nurses. The quality-of-care subscales consist of 9 items, rated on a 5-point Likert scale ranging from never to always, with possible mean scale scores from 1.0 to 5.0. Patients rated the physicians as a whole and the nurses as a whole rather than individual physicians or nurses. Patients were asked how frequently their physicians and nurses performed a variety of behaviors including "spent enough time with you," "arrived late," "been hard to reach," "seemed distracted," "willing to listen," "treated you as a disease," "showed personal concern," "ignored your feelings," and "responded quickly." The satisfaction subscales consist of 6 items, rated on a 5-point Likert scale ranging from very dissatisfied to very satisfied, with possible mean scale scores from 1.0 to 5.0. Patients were asked how satisfied they were with the behavior of their physicians and nurses, including "bedside manner," "common courtesy," "way of talking," "clinical and technical skills," "concern," and "overall" level of satisfaction. The QUEST scales demonstrated good internal reliability, with Cronbach α values ranging from 0.83 to 0.95 for the 4 subscales.