Do patients want choice? An observational study of neurology consultations. Issue 7 (July 2016)

• Record Type: Journal Article
• Authors: Wiseman, Hannah; Chappell, Paul; Toerien, Merran; Shaw, Rebecca; Duncan, Rod; Reuber, Markus
• Is Part Of: Patient education and counseling. Volume 99:Issue 7(2016)
• Page Start: 1170
• Page End: 1178
• Publication Date: 2016-07
• Subjects: Patient choice -- Patient satisfaction -- Neurology consultations; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2016.02.015
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: Public bodies have increasingly encouraged doctors to give patients choices. Patients perceived 'choice' in 71.8% of United Kingdom neurology outpatient appointments. Neurologists stated that they had given patients 'choice' after 67.9% of outpatient appointments. Patients and neurologists disagreed whether choice had featured after 32% of appointments. 'Choice' did not increase patient satisfaction with their neurology outpatient encounter. Abstract: Objectives: To determine how often patients are given choice in neurology outpatient consultations and whether choice is associated with greater patient satisfaction. Methods: Prospective study in outpatient clinics in two United Kingdom centres. Interactions between 14 neurologists and 223 patients were studied. Participating doctors and patients completed post-appointment questionnaires asking whether choice had been offered/perceived. Patients completed the Medical Interview Satisfaction Scale 21 (MISS-21). Results: Choice was reported after most encounters (patients 71.8%, neurologists 67.9%). Patients and Neurologists failed to agree about whether choice was offered after 32% of consultations. Choice was not associated with increased patient satisfaction. In fact, satisfaction was greater when no choice had been offered (p = 0.05). Satisfaction scores were also greater when doctors were more certain about the diagnosis and when symptoms were considered explained by a medical condition (p ≤ 0.001). Conclusions: Choice featured in the majority of clinical interactions but clinicians and patients often disagreed whether this was the case. Choice was not associated with greater patient satisfaction. Practice implications: Clinicians need to be very explicit if they want patients to know that they are being given choices. Choice is not necessarily valued by patients in all clinical interactions.