Do unmet expectations for specific tests, referrals, and new medications reduce patients' satisfaction?

B. Mitchell Peck, Peter A. Ubel, Debra L. Roter, Susan Dorr Goold, David A. Asch, Amy S. Jeffreys, Steven C. Grambow, James A. Tulsky

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Patient-centered care requires clinicians to recognize and act on patients' expectations. However, relatively little is known about the specific expectations patients bring to the primary care visit. OBJECTIVE: To describe the nature and prevalence of patients' specific expectations for tests, referrals, and new medications, and to examine the relationship between fulfillment of these expectations and patient satisfaction. DESIGN: Prospective cohort study. SETTING: VA general medicine clinic. PATIENTS/PARTICIPANTS: Two hundred fifty-three adult male outpatients seeing their primary care provider for a scheduled visit. MEASUREMENTS AND MAIN RESULTS: Fifty-six percent of patients reported at least 1 expectation for a test, referral, or new medication. Thirty-one percent had 1 expectation, while 25% had 2 or more expectations. Expectations were evenly distributed among tests, referrals, and new medications (37%, 30%, and 33%, respectively). Half of the patients who expressed an expectation did not receive one or more of the desired tests, referrals, or new medications. Nevertheless, satisfaction was very high (median of 1.5 for visit-specific satisfaction on a 1 to 5 scale, with 1 representing "excellent"). Satisfaction was not related to whether expectations were met or unmet, except that patients who did not receive desired medications reported lower satisfaction. CONCLUSIONS: Patients' expectations are varied and often vague. Clinicians trying to implement the values of patient-centered care must be prepared to elicit, identify, and address many expectations.

Original languageEnglish (US)
Pages (from-to)1080-1087
Number of pages8
JournalJournal of general internal medicine
Volume19
Issue number11
DOIs
StatePublished - Nov 2004

Keywords

  • Patient expectations
  • Patient satisfaction
  • Veterans

ASJC Scopus subject areas

  • Internal Medicine

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