Patient-physician agreement on reasons for ambulatory general medical examinations

Abstract

Objective: To evaluate the physician's ability to identify patients' reasons for visits (RFVs) for a general medical examination (GME), to assess predictors of agreement between patient and physician on the RFV, and to determine whether agreement about the RFVs was associated with patient satisfaction with the visit.

Design: We conducted a prospective study involving patients scheduled for a GME and internists in a multispecialty group practice.

Material and methods: Patient-physician agreement on the RFV was independently assessed by two internists. Logistic regression was used to identify predictors of low agreement.

Results: The 458 patients reported a total of 848 RFVs for their GME. Patient-physician agreement on the patient's RFV was low in 20% of the visits. Female gender (odds ratio, 2.02; 95% confidence interval [CI], 1.11 to 3.66), multiple RFVs (odds ratio, 2.03; 95% CI, 1.06 to 3.91), and previous GME (odds ratio, 2.18; 95% CI, 1.07 to 4.44) were independent predictors of low agreement. Patient-physician agreement for RFVs was not associated with patient satisfaction with the medical visit.

Conclusion: In this study, physicians correctly identified the patient's main RFV in a majority of the visits. Failures to identify the patient's main RFV occurred more frequently in female patients, in patients with multiple RFVs, and in patients with a previous comprehensive GME. Surprisingly, patient-physician agreement was not associated with patient satisfaction.