Does changing family practice reflect patient dissatisfaction?

Changing practice as a quality indicator for primary care: analysis of data on voluntary disenrollment from the English GP Patient Survey.
Nagraj S etal
BMC Fam Pract. 2013 Jun 25;14:89. doi: 10.1186/1471-2296-14-89.

• An analysis of patient satisfaction survey results, voluntary disenrollment (ie changing family practice without changing address) and practice / doctor characteristics found that family practices with low levels of patient satisfaction, especially for doctor patient communication, are more likely to experience high rates of disenrollment. 
• However substantial variation in disenrollment rates remains among practices with similar levels of patient satisfaction limit the use of voluntary disenrollment as a quality indicator for primary care.