Journal of general internal medicine
-
Comparative Study
Older patients perceptions of "unnecessary" tests and referrals: a national survey of Medicare beneficiaries.
Unnecessary exposure to medical interventions can harm patients. Many hope that generalist physicians can limit such unnecessary exposure. ⋯ When faced with new symptoms, many older patients report that they would want a diagnostic test or specialty referral that their generalist thought was unnecessary. Generalists striving to provide patient-centered care while at the same time limiting exposure to unnecessary medical interventions will need to address their patients' perceptions regarding the need for these services.
-
Randomized Controlled Trial Comparative Study
The impact of consumer-directed health plans and patient socioeconomic status on physician recommendations for colorectal cancer screening.
Consumer-directed health plans are increasingly common, yet little is known about their impact on physician decision-making and preventive service use. ⋯ Patient SES and deductible-level affect physician recommendations for preventive care. Coverage of preventive services and funds in medical savings accounts may help to mitigate the impact of high-deductibles and SES on inappropriate recommendations.
-
Randomized Controlled Trial Comparative Study
Quality of care for cardiovascular disease-related conditions in patients with and without mental disorders.
We compared the quality of care for cardiovascular disease (CVD)-related risk factors for patients diagnosed with and without mental disorders. ⋯ Quality of care for major chronic conditions associated with premature CVD-related mortality is suboptimal for VA patients with SMI, especially for procedures requiring care by a specialist.
-
Comparative Study
Patient assessments of the most important medical decision during a hospitalization.
How medical decisions are made in real-life situations is largely unexplored. We explored patients' perceptions of decision-making during a hospitalization and examined the conformity of the decision process with expert recommendations. ⋯ A majority of patients discharged from a general hospital were able to identify and rate a medical decision. Recommended features of the process of medical decision-making were associated with greater satisfaction with the decision.
-
Comparative Study
Contents of general practitioner-patient consultations in the treatment of depression.
Counseling of patients is an indispensable part of any drug treatment and even more so in the treatment of depression. ⋯ Counseling plays an important part in day-to-day encounters of general practitioners. Pharmacotherapy is embedded in comprehensive psychological care. Training programs for general practitioners should be specific in respect to different tasks and parts of the physician-patient encounter (e.g., building a therapeutic alliance, support for life problems or change of cognitions).