Hannah Wiseman1, Paul Chappell2, Merran Toerien2, Rebecca Shaw3, Rod Duncan4, Markus Reuber5. 1. Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, United Kingdom. 2. Department of Sociology, University of York, Heslington, York YO10 5DD, United Kingdom. 3. Social Sciences Division, University of Oxford, Hayes House, 75 George Street, Oxford OX1 2BQ, United Kingdom. 4. Department of Neurology, Christchurch Hospital, Private Bag 4710, Christchurch 8140, New Zealand. 5. Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, United Kingdom. Electronic address: m.reuber@sheffield.ac.uk.
Abstract
OBJECTIVES: To determine how often patients are given choice in neurology outpatient consultations and whether choice is associated with greater patient satisfaction. METHODS: Prospective study in outpatient clinics in two United Kingdom centres. Interactions between 14 neurologists and 223 patients were studied. Participating doctors and patients completed post-appointment questionnaires asking whether choice had been offered/perceived. Patients completed the Medical Interview Satisfaction Scale 21 (MISS-21). RESULTS: Choice was reported after most encounters (patients 71.8%, neurologists 67.9%). Patients and Neurologists failed to agree about whether choice was offered after 32% of consultations. Choice was not associated with increased patient satisfaction. In fact, satisfaction was greater when no choice had been offered (p=0.05). Satisfaction scores were also greater when doctors were more certain about the diagnosis and when symptoms were considered explained by a medical condition (p≤0.001). CONCLUSIONS: Choice featured in the majority of clinical interactions but clinicians and patients often disagreed whether this was the case. Choice was not associated with greater patient satisfaction. PRACTICE IMPLICATIONS: Clinicians need to be very explicit if they want patients to know that they are being given choices. Choice is not necessarily valued by patients in all clinical interactions.
OBJECTIVES: To determine how often patients are given choice in neurology outpatient consultations and whether choice is associated with greater patient satisfaction. METHODS: Prospective study in outpatient clinics in two United Kingdom centres. Interactions between 14 neurologists and 223 patients were studied. Participating doctors and patients completed post-appointment questionnaires asking whether choice had been offered/perceived. Patients completed the Medical Interview Satisfaction Scale 21 (MISS-21). RESULTS: Choice was reported after most encounters (patients 71.8%, neurologists 67.9%). Patients and Neurologists failed to agree about whether choice was offered after 32% of consultations. Choice was not associated with increased patient satisfaction. In fact, satisfaction was greater when no choice had been offered (p=0.05). Satisfaction scores were also greater when doctors were more certain about the diagnosis and when symptoms were considered explained by a medical condition (p≤0.001). CONCLUSIONS: Choice featured in the majority of clinical interactions but clinicians and patients often disagreed whether this was the case. Choice was not associated with greater patient satisfaction. PRACTICE IMPLICATIONS: Clinicians need to be very explicit if they want patients to know that they are being given choices. Choice is not necessarily valued by patients in all clinical interactions.
Authors: Donald R Sullivan; Sara E Golden; Linda Ganzini; Renda Soylemez Wiener; Karen B Eden; Christopher G Slatore Journal: Ann Am Thorac Soc Date: 2017-11