Clinician denial of some patient requests decrease patient satisfaction


Background: Literature regarding patient satisfaction often focuses on nonspecific recommendations to improve patient-centered communication. There is lack of guidance on concrete advice for clinicians, particularly with regard to how a provider’s responses to different patient requests are received.

Study design: Cross-sectional study.

Setting: An outpatient family medicine clinic.

Synopsis: Patient requests from 1,141 patients visiting the University of California, Davis, Family Medicine Clinic were sampled. The study examined clinician’s approval or denial of patients’ requests for referrals, pain medications, other new medicines, laboratory testing, radiology testing, or other testing and the patients’ reported satisfaction of the clinician.

Clinician denial of particular requests was associated with decreased patient satisfaction. Specifically, a 19.75% drop for referral, 10.72% drop for pain medication, 20.36% drop for other new medications, and 9.19% drop for laboratory test. This study did not examine other potential reasons for decreased satisfaction.

Bottom line: Clinicians can better understand how to communicate in a patient-centered manner by understanding that not all patient requests are perceived as equal.

Citation: Jerant A et al. Association of clinical denial of patient requests with patient satisfaction. JAMA Intern Med. 2018 Jan 1;178(1):85-91.

Dr. Shaffie is a hospitalist at Denver Health Medical Center and an assistant professor of medicine at the University of Colorado at Denver, Aurora.

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