What did the doctor do? When physicians and patients disagree
M. Rohrbaugh and J. C. Rogers
School of Family and Consumer Resources, University of Arizona, Tucson.
OBJECTIVE: A serendipitous finding in a study of routine clinical
encounters was that physicians and patients frequently gave discrepant
reports of what had happened during a clinic visit. This report examines
the conditions under which these discrepant perceptions occurred. DESIGN:
Five experienced physicians and 189 patients completed postencounter
questionnaires immediately following visits to an academic family practice
clinic. After each encounter, the physician and patient estimated the
duration of the visit and reported whether each of seven clinical events
had occurred. RESULTS: The most common disagreements concerned whether the
physician had provided counseling or performed a treatment procedure.
Multiple regression analyses suggest that patient characteristics
contributed to specific forms of physician-patient disagreement but that
overall discrepancy was greatest in cases in which the physician minimized
the importance of psychosocial issues and/or felt relatively confident
about understanding the patient's problem. CONCLUSIONS: Although
correlation need not imply causality, the results raise the possibility
that physicians can promote shared physician-patient understanding by
paying more attention to psychosocial factors and being more circumspect in
drawing conclusions about patients' problems.
