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Tuesday, March 11, 2008

Patients value "thoroughness" in their docs

An article in WebMD discusses a survey from the UK which was published in the Annals of Family Medicine which indicated that the trait that patients value most in their physicians is thoroughness.

This characteristic was more important that friendliness or the doc being on time. It requires time on the physicians part to be considered thorough and to actually be thorough. As medicine continues to be transformed into something increasingly not under the physician's control , less time is spent with the patient.

In my non-scientific analysis of a patient satisfaction questionnaire that was used for a time in my practice I found that the most frequent comment made was in regard to how thorough my examination was. This was not recent and was still in an era in which I could spend time with patients. Interestingly, when I saw my new internist this year ( actually a former partner ) I came away with a much less satisfied feeling that I had the previous year when my former internist (also a former partner) did his exam which I perceived to be much more "thorough".

I remember an article a number of years ago (I cannot find the reference now even with Google) which deconstructed the physical exam "proving" that most aspects of it were a waste of time because each item per se has such a low yield of positive results. Maybe so,but we patients seem to really like the attention or some aspect of it when the doc seems to be thorough. That aspect may be that the physcian seems to care about enough about our problem to take the time to be thorough. The IOM and folks at the ACP like to talk about electronic medical records and team approach to medical care . I may have missed it but I cannot recall either group stressing the importance of taking time with the patient and how the current third party payer hegemony under which most doctors practice make this extremely difficult if not impossible. The retainer practice model in which time may be available looks like a good option for me ( as a patient) and if I still practiced, as a physician.


Anonymous said...

Do you think that too often what some patients consider thoroughness to be is really ordering tests (whether they are indicated or not)and with the ever increasingly truncated office visit it is easier to get the test ordered than explain why it is not appropriate.

james gaulte said...

I agree.The doctor who orders a lot of tests is more likely perceived to be thorough that one who is more of a minimalist in that regard.