From 1998 to 2001, researchers at the University of California, Davis, School of Medicine examined how patients' requests for medications, tests and other health care services influence physician behavior in a managed care practice.
The project was part of the Robert Wood Johnson Foundation (RWJF) Strengthening the Patient-Provider Relationship in a Changing Health Care Environment national program.
Key findings from the project, published in various peer-reviewed journals, include the following:
- When physicians are able to respond positively to patient requests, it improves both patient and physician satisfaction, and their perceptions of health outcomes.
- Patients desire services but do not explicitly request them in about 10 percent of encounters. Unvoiced desires are more common among younger and less educated patients, and decrease both patient and physician satisfaction.
- Patients leave the office with unmet expectations about one time in 10.
- Patients who trusted their treating physicians were more likely to request and receive prescription medications but not referrals or diagnostic studies.
- Patients who reported less trust in their physicians prior to the office visit:
- Were perceived as more demanding by the physician.
- Reported lower satisfaction with care.
- Were not as intent on following the physician's advice.
- Were less likely to report symptom improvement at the two-week follow-up.
- Patients who valued sharing of information and joint decision-making were actually less trusting of their physicians and less likely to see the doctor again or recommend the doctor to a friend.