Concordance between physicians and their older and younger patients in the primary care medical encounter.

To test the hypothesis that less concordance exists between older patients and their physicians than between younger patients and their physicians, we examined agreements between physicians and patients on the major goals and topics discussed during an outpatient medical encounter. Using coded audiotapes of the medical visit, patient postvisit interviews, and physician questionnaires, concordance was found to be significantly greater for younger patients and their physicians than for older patients and their physician on the major goals and major medical topics discussed during the primary care interview. This paper explores possible explanations for these findings.