Patient expectations and the outcomes of doctor - patient encounters with respect to these expectations

Patient expectations and the outcomes of doctor-patient encounters with respect to these expectationsAim: Interviewing with the patient constitutes the basis of family practice. Patient expectations and priorities which are major components of patient-centered clinical method should be defined and met by the doctors; this plays an important role in structuring the consultation. In this study, we aimed to determine the expectations of the patients who applied to Family Medicine Policlinic at Adnan Menderes University Medical School in Aydın, the outcomes of patient-doctor interview with respect to their expectations and the awareness level of family physicians with regard to meeting their patients? expectations.Methods: Two hundred volunteering patients who applied to the Family Medicine Policlinic between November 2007 and June 2008, who could fill in the questionnaires on their own, and who were older than 18 tears, were included in the study. In the study, three different questionnaires incorporating patient expectations were used; two prepared for the patient to fill in before and after the consultation and one for the doctor to fill in after the consultation.Findings: Of all the patients participated in the study, 49 (24.5%) were male and 151 (75.5%) were female. The mean age of the participants was 44.8 (SD:13.8) and the age interval was 18-83 years. The factor analysis to determine the expectations of patients as declared before the interview revealed four different factors: expectations related to `Medical issues and getting informed? (Cronbach?s alfa: 0.85), expectations of `relation and participation? (Cronbach?s alfa: 0.81), expectations related to `communication? (Cronbach?s alfa: 0.79), expectations related to `partnership and mutual understanding? (Cronbach?s alfa: 0.73). These factors explained the 57.8% of the variance.Patients who had high expectations about medical issues and getting informed were mostly those who appreciated their health status at medium level in the last 12 months, those who had moderate complaints and those who regularly attended to our policlinic. Similarly, the patients who had expectations related to relation and participation were mostly those who appreciated their health status at medium level in the last 12 months, those who had moderate complaints and those who regularly attended to our clinic. Patients who had high expectations about better communication were those who appreciated their health status at medium level in the last 12 months, those who applied for an acute illness, those who had moderate complaints and those with an education level of secondary school or lower. Finally, personal characteristics such as gender, age, and marital status and perceptions like how they felt themselves showed no relation to any of the components of the patient centered approach.There was a good correlation between the patients? met expectations in terms of expectations related to communication and patient expectations and doctor?s perception of meeting these expectations. There was a medium correlation between the patients? met expectations regarding medical issues and getting informed and patient expectations and doctor?s perception of meeting patient expectations. There was a good correlation between the patient expectations and the patients? met expectations, with regarding to partnership and developing mutual understanding. A weak but statistically significant correlation was determined between the patient expectations regarding relationship and participation expectations and the patients? met expectations and doctors? perception of meeting these expectations.Conclusion:Patients attending to Family Medicine Policlinic want patient centered approach with the expectations of getting informed, relationship and participation, communication, and partnership and mutual understanding. That the trainees have used the patient centered approach demonstrates that the Family Medicine Department is successful in teaching patient centered clinical method to the trainees.Key words: Patient expectations, consultation, outcomes, doctors? perceptions