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Changing family physicians' visit structuring behavior: a pilot study
Leonard J Haas1, John Houchins, Jennifer Paul Leiser
1Department of Family and Preventive Medicine, University of Utah, Salt Lake City 84132, USA. Leonard.Haas@hsc.utah.edu
Objective:
This study assessed the degree to which family physicians elicit patients' agendas and negotiate the agenda of the medical visit, related this behavior to late-arising patient concerns and satisfaction with the visit, and assessed the degree to which visit-structuring behavior can be modified by a brief workshop.
Methods:
We reviewed 65 audiotaped clinic visits conducted by three experienced family physicians before (36 visits) and after (29 visits) a workshop on structuring outpatient visits. We also collected patient and physician satisfaction ratings through post-visit questionnaires.
Results:
Patient concerns were explicitly elicited in 64% of pre-workshop visits and 90% of post-workshop visits. Significant increases occurred in agenda setting (14% of pre-workshop visits, 52% of post-workshop visits), agenda negotiating (0% of pre-workshop visits, 38% of post-workshop visits), and physician satisfaction with visits.
Conclusions:
A brief continuing medical education intervention improved family physicians' visit structuring.