Concerns and expectations in patients presenting with physical complaints: Frequency, physician perceptions and actions, and 2-week outcome

Richard L. Marple, Kurt Kroenke, Catherine R. Lucey, Jay Wilder, Christine A. Lucas

Research output: Contribution to journalArticle

135 Citations (Scopus)

Abstract

Background: Specific concerns and expectations may be a key reason that people with common physical complaints seek health care for their symptoms. Objectives: To determine the frequency of symptom-related patient concerns and expectations, physician perceptions and actions, and the relationship of these factors to patient satisfaction and symptom outcome. Methods: This was a prospective cohort study of 328 adult outpatients presenting for evaluation of a physical complaint. The setting was a general medicine clinic in a teaching hospital. Measures included previsit patient questionnaire to identify symptom-related concerns and expectations; a postvisit physician questionnaire to determine physician perceptions and actions; and a 2-week follow-up patient questionnaire to assess symptom outcome and satisfaction with care. Results: Pain of some type accounted for 55% of common symptoms, upper respiratory tract illnesses for 22%, and other physical complaints for 23%. Two thirds of patients were worried their symptom might represent a serious illness, 62% reported impairment in their usual activities, and 78%, 46%, and 41% hoped the physician would prescribe a medication, order a test, or provide a referral. Physicians often perceived symptoms as less serious or disabling and frequently did not order anticipated tests or referrals. While symptoms improved 78% of the time at 2-week follow-up, only 56% of patients were fully satisfied. Residual concerns and expectations were the strongest correlates of patient satisfaction. Conclusions: Improved recognition of symptom-related concerns and expectations might improve satisfaction with care in patients presenting with common physical complaints.

Original languageEnglish (US)
Pages (from-to)1482-1488
Number of pages7
JournalArchives of Internal Medicine
Volume157
Issue number13
StatePublished - Jul 14 1997
Externally publishedYes

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Physicians
Patient Satisfaction
Referral and Consultation
Teaching Hospitals
Respiratory System
Patient Care
Cohort Studies
Outpatients
Medicine
Prospective Studies
Delivery of Health Care
Pain
Surveys and Questionnaires

ASJC Scopus subject areas

  • Internal Medicine

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Concerns and expectations in patients presenting with physical complaints : Frequency, physician perceptions and actions, and 2-week outcome. / Marple, Richard L.; Kroenke, Kurt; Lucey, Catherine R.; Wilder, Jay; Lucas, Christine A.

In: Archives of Internal Medicine, Vol. 157, No. 13, 14.07.1997, p. 1482-1488.

Research output: Contribution to journalArticle

Marple, Richard L. ; Kroenke, Kurt ; Lucey, Catherine R. ; Wilder, Jay ; Lucas, Christine A. / Concerns and expectations in patients presenting with physical complaints : Frequency, physician perceptions and actions, and 2-week outcome. In: Archives of Internal Medicine. 1997 ; Vol. 157, No. 13. pp. 1482-1488.
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