Unformatted text preview: a truthful answer anyway. One major problem is that the provider does
not receive feedback on how the interaction
went and if info was communicated
effectively, if patient followed instructions,
and if patient was cured, in particular if patient
does not return.
does What was good, what could be improved. Question: Do you receive a questionnaire or evaluation
form from your physician after a visit (by
phone, mail, etc.)?
phone, Provider may not know when a satisfactory
personal relationship has been formed with
patient. Many patients cautious – will just switch
providers rather than give negative feedback.
providers Patients whose treatments have failed are more
likely to return than those with successes.
likely Learning is fostered more by positive feedback
than Positive feedback tells you what you are doing
right (and should continue).
right Negative feedback only tells you what not to
do, not what to do instead.
do, So physicians need both, but often get none or
mostly negative feedback.
mostly There are many negative results of poor
patient-provider Patients less likely to use medical services in
the future if not satisfied.
the Patients more likely to turn to non-traditional
services that satisfy emotional needs rather
than medical needs.
than Patients less likely to obtain medical checkups. Patients more likely to change doctors. Patients more likely to file complaint Patients
causing time consuming activities for
physician as well as patient.
physician Nonadherence to Treatment Regimens Estimates for nonadherence are between 15% Estimates
93% with an average of 26%.
93% Short term antibiotic treatment – 30%
nonadherence. About 80% drop out of lifestyle change
programs. About 70% do not take prescriptions exactly as
prescribed (either partial or total
nonadherence). Children with ear infection – 5% total adhered
to Adherence very high with HIV, arthritis,
gastrointestinal disorders and cancer.
gastrointestinal Adherence very low with pulmonary disease,
diabetes, and sleep disorders.
diabetes, More than 80% of patients who receive
behavioral change recommendations from their
doctors such as stop smoking or restrict diet,
fail to follow through.
fail Even cardiac rehab patients – only 66% - 77%
adherence! How do we measure adherence? Self-report: We ask patients, family members,
physician, Not reliable.
Lie to look more socially desirable.
Faulty or biased memory. Biological measures Blood tests.
Carbon monoxide tests (for smoking cessation)
Good but expensive and cumbersome to do
frequently. High Tech Devices Pill bottles with microchip that records when
opened. Expensive. Not complete – does not tell if...
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- Fall '11
- Health care provider, treatment regimens