According to a study funded by Pfizer it was found that older patients gave their doctors higher marks than they deserved based on a review of whether physicians followed accepted standards for technical quality. The study was conducted among 236 elderly patients. The findings were published in the Annals of Internal Medicine. The patients said that they received about 55% of the recommended care. But most patients rated all the health care they received in the past year as 10 out of 10.

Patients rate the doctors based on their communication and maintaining a good rapport with their them. But it doesn't always correlate with sound care. Dr. Neil Wenger, the senior author of the report and a general internist at the University of California-Los Angeles Medical Center said that there is a mismatch between patients' perceptions and the technical quality of care they received. The study was unusual in its depth because researchers obtained patients' total medical records and devised measurements to evaluate their care during 1998-99. The patients were then interviewed, with proxies standing in for those who were unwell or had dementia. It was found that patients don't really know what care they need. More patients are taking it upon themselves to become educated about the proper treatment of their chronic conditions.

The National Committee for Quality Assurance and some states also assess quality-performance measures, though many groups so far offer limited information. Medicare is experimenting with pay for performance where doctors and hospitals receive financial incentives for following widely accepted protocols for treating chronic conditions. The goal is to improve health outcomes. The study's analysis showed back lag in care in the fields such as high blood pressure and pneumonia care. Apart from this it faired poorly in conditions of aging such as gait and balance abnormalities and falling, urinary incontinence, cognitive impairment, end-of-life care, things that are less mainstream. In conclusion the author said that this study has served as an eye opener for improved attention to geriatric care.