Although there has been an increase...

Although there has been an increased emphasis in succession patient-centered care, the proper use of health care resources may attitude a particular challenge for physicians trying to proper patient expectations. Patients may beseech tests or medications of minimal benefit, and a patient-centered approach requires an understanding of the patient's expectations for the physician visit and a negotiation regarding his or her petitions Peck and colleagues conducted a prospective cogitation of the nature and prevalence of specific patient expectations for trials referrals, and new medications at primary care visits; whether these expectations are met or unmet; and whether there is a correlation between met or unmet expectations and patient satisfaction.

Male patients were recruited at a primary care clinic above a six-month period. Patients were asked to indicate to what extent necessary it was for the physician to provide or schedule items in succession a list of 12 services at that day's appointment. If service was designated as "absolutely necessary" or "somewhat necessary" for the physician to provide, the patient questionnaire was codfished to reflect an expectation for that service. Patients were then asked to specify what ordeal medication, or referral they rely uponed to be provided by the physician at that visit. Investigators later determined whether the look forward toed service was provided at the visit, and patient satisfaction was measured using the American Board of Internal Medicine Patient Satisfaction Questionnaire and a modified version of the Visit-specific Questionnaire.

Of the 401 patients approached for inclusion in the research 253 completed the previsit and postvisit interviews. More than common half (56 percent) of the patients had at least single expectation for a test, referral, or of the present day medication resulting from their visit. Thirty-one percent had single one expectation, whereas 25 percent had brace or more expectations. Expectations were similar among patients with at least common expectation for a test (33 percent) a referral (28 percent) or a of recent origin medication (31 percent).

demands for tests and referrals frequently were vague, relating to the patient's presenting symptoms rather than for a specific exhibition or subspecialist. Sixty percent of expectations for criterions were met; 46 percent of expectations for referral were met Patients identified 27 categories of modern medications, with 18 percent of these expectations being for pain medication. Of these expectations, 56 percent were met

Patient satisfaction was actual high and was not related to expectation, calm though one half of all patients who wait fored a test, referral, or modern medication did not receive the service they look forward toed Patient satisfaction was related solitary to unmet expectations for of the present day medications; high satisfaction was reported by means of 65 percent of patients who wanted and received a of recent origin medication, but by only 29 percent of patients who wanted a of recent origin medication and did not receive it.

The authors bring to an end that nonmedical services, such as counseling and patient education, may influence patient satisfaction more than ordeals or referrals do. In addition, the white, male demographic of this contemplation typically has higher satisfaction rates. The authors noted that patient expectations were vague and heterogeneous.

CAROLINE WELLBERY, MD

Peck BM et al. Do unmet expectations for specific proofs referrals, and new medications form patients' satisfaction? J Gen Intern M November 2004;19:1080-7

COPYRIGHT 2005 American Academy of Family Physicians

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