Characteristics of physicians with participatory decision making styles

Article Abstract:

Physicians are more likely to involve patients in treatment decisions if they have a lower volume of patients, have received interviewing training, are satisfied with their independence, and are white. Researchers analyzed questionnaires from 7,730 patients and 300 corresponding physicians in primary care medicine, cardiology, and endocrinology. Greater patient satisfaction was associated with a practice style that involved patients in decisions. Physicians in low volume practices who saw fewer patients per week were more likely to involve patients than those in high volume practices. Family practice physicians had significantly higher practice volumes than general internists, cardiologists, and endocrinologists. Cardiologists were the least likely to involve patients in decisions. Physicians who received training in patient interviewing or primary care were also more likely than those who did not to have a participatory decision-making style.

Social aspects, Decision-making, Decision making, Management, Practice, Physician and patient, Physician-patient relations, Physicians, Medical professions

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Patients' ratings of outpatient visits in different practice settings: results from the Medical Outcomes Study

Article Abstract:

Patients of solo or single specialty (SOLO) practices who pay a fee for service (FFS) may be more satisfied with their care than those with other types of health care arrangements. Patients of health maintenance organizations (HMO) may be least satisfied with their care. Researchers examined satisfaction with an outpatient visit among 17,671 adults. These individuals were patients of SOLO practices, multispecialty groups (MSG) or HMOs with FFS or prepaid physician payment arrangements. Sixty-four percent of SOLO patients rated their visit as excellent, compared with 48% of the MSG patients and 49% of the HMO patients. SOLO and MSG patients who paid FFS were likely to be more satisfied with certain aspects of their visit than patients with prepaid physician payment arrangements.

Evaluation, Medical care, Beliefs, opinions and attitudes, Patients, Ambulatory medical care, Ambulatory care

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Differences in 4-year health outcomes for elderly and poor, chronically ill patients treated in HMO and fee-for-service systems: results from the Medical Outcomes Study

Article Abstract:

Elderly and poor people with chronic illnesses may do worse under a managed care plan than a fee-for-service plan. This was demonstrated in the Medical Outcomes Study, which has followed 2,235 people with chronic diseases for 4 years. Overall, most patients did just as well under an HMO as under a fee-for-service plan. However, the elderly and the poor fared worse under an HMO than a fee-for-service plan. Sixty-eight percent of those covered by an HMO experienced a decline in health compared to 27% of those in a fee-for-service plan.

Health aspects, Analysis, Health maintenance organizations, Chronically ill, Outcome and process assessment (Health Care), Outcome and process assessment (Medical care)

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