Feedback from patients as a means of teaching nontechnological aspects of medical care

Despite an increased awareness of the importance of behavioral, psychological, and social aspects of medical care, physicians frequently fail to recognize problems in these areas. Therefore, a project was undertaken to improve house officers' recognition of these problems in an ambulatory population. An interviewer used a structured questionnaire to assess the patients' adherence to the therapeutic regimen, satisfaction with physician, psychiatric problems, recent stressful life events, and attitude toward illness. Recognition of medication noncompliance, psychiatric problems, and recent stressful life events was determined from a physician questionnaire and chart review for every patient interviewed. At the first clinic seesion after the interview, the author reviewed both the patient and physician questionnaires with the appropriate physician. The interviews identified a large number of potentially important problems which the patients' physicians had not recognized. While no change in problem recognition could be documented between the questionnaires administered at the beginning and end of the project, the vast majority of participating house officers felt that the project was worthwhile and should be continued.