Meeting walk-in patients' expectations for testing. Effects on satisfaction.

OBJECTIVE: To examine the relation between meeting expectations for tests and visit satisfaction in walk-in patients.
DESIGN: Survey of patients before and after the visit.
SETTING: Walk-in medical clinic at a Veterans Affairs Medical Center. PATIENTS: 143 male veterans were eligible for this study: 128 agreed to participate; 109 completed both questionnaires. MEASUREMENTS: Before the visit, we measured health status, baseline satisfaction with care, and expectations for common tests. After the visit, we measured visit-specific satisfaction, patient perception of provider interpersonal behavior (provider humanism), and patient report of whether specific tests were received. Logistic regression was used to determine the effect of meeting expectations for tests while controlling for other factors.
RESULTS: Of all patients, 62% expected one or more tests, nearly as many as expected a medication or a diagnosis. In multivariate analysis restricted to those expecting tests, provider humanism was the sole significant predictor of visit-specific satisfaction (odds ration [OR] 6.4; 95% confidence interval [CI] 1.6, 26.1). The proportion of expectations for testing that were met was not significantly associated with satisfaction (OR 1.05; 95% CI 0.92, 1.21).
CONCLUSIONS: Meeting patient expectations for tests does not have an important effect on satisfaction. Even in the walk-in setting, patient perception of the providers' interpersonal behavior was a more important factor in satisfaction with the visit. Physicians who order tests solely to improve patient satisfaction may be able to reduce unnecessary testing without decreasing patient satisfaction.