Different patients come with different expectations. (P1, Male PCP, First group interview with PCPs), 2. Patients and doctors can often have different expectations of the outcomes of treatment. Speak their language Physicians need to describe things in a way patients can understand, and they need to keep doing so until they’re certain the patient comprehends the information. The profit-orientation of public facilities, as a result of inadequate government financial subsidies, was considered to be the primary driving force behind the commercial ideologies held by patients (Table 2, Quote 9). Doctors engaging in small talk was a need for only 38% of patients but 78% doctors seems to believe that our patient expect that. Insurance status and out-of-pocket medical expenses were also considered to have an impact on patients’ expectations (Table 2, Quote 6). In the past, clinicians promoted the use of IV in treating patients and instilled in patients the idea that IV infusion would make them recover faster. Doctors reported feeling undervalued and disrespected when patients requested consultation fee refunds. Doctors spend adequate time with each patient during their consultation. These may be realistic and achievable, or unrealistic and impossible. While over one third (36.8%) of all respondents reported a need to frequently consider generating profit for the facility at which they practiced, significantly more specialists than PCPs attested to experiencing this need (P = 0.004). Terminating the doctor-patient relationship should be a last resort. The patients’ desire to be cured was regarded as a driving force behind patients searching for relevant, but not necessarily accurate, information (Table 2, Quote 4). 2. What decisions do patients expect the general practitioner to take within the consultation and to what extent are these expectations fulfilled? "The world of medicine and medical education is rapidly changing with new technologies, evolving expectations and different ways of working regularly being introduced." The requirement for teaching and training communication skills in undergraduate and postgraduate training is well established in developed countries and it is gaining popularity in the rest of the world [5,6]. When the patient feels the treatment is ineffective, s/he would directly change to another doctor next time, 6. Interviews were facilitated by a trained research assistant and one of the authors from September 2014 to April 2015. Information gathered in this study would be valuable in training doctors and students on doctor patient communication. Previous research has found remarkably high prescription rates of IV antibiotics (ranging from 34 to 60.6%) for patients with minor health problems. . 1. When a significant proportion of patients (29%) feel that doctors do not entertain patient’s point of view only half of the doctors perceive this opinion of patients. Some provinces propose to regulate IV provision at public clinics [27], but it is recommended that this should occur alongside systematic health education campaigns so patients may understand the potential ill-effects of inappropriate IV infusion. Individual views and attitudes are influenced by many factors, ranging from the domain of personal experience, to exposure to certain organizational philosophies. Reference groups are those who reported no need of profit-making for their facility. One of the nine specialists did not reply to our invitation for an individual interview. A pretested and validated questionnaire was administered to 700 consecutive patients attending the out-patients clinics and all the doctors in a tertiary care hospital. Involving patients in deciding the management was supported only by 83% while “not exploring patient’s ideas” and “not involving patients in management” (items 4.1, 4.2. between primary care patients' expectations and what they receive from the general practitioner affects patient satisfaction. About one in four were African-Americans or Hispanics. The mean age of all participants was 34.3 years (SD = 5.8) and 61% of the participants were male. Papers; Patients’ Expectations of Doctors and Nurses on Healthcare Delivery within Ibadan Metropolis However, while some of these expectations are well-justified, others seem quite unrealistic. 5. Most interviews lasted around 60 min and took place in private rooms away from the participants’ workplace. Doctors also perceive this expectation of our patients. Topic guides were developed for interviews, with themes and prompts covering doctors’ views about patients’ expectations and relevant behaviours (Appendix 1). Doctor patient communication, Patient centeredness, Patients expectations, Doctors perceptions. We aimed to examine existing models and definitions of patient expectations in the literature; to explore expectations with patients; and to develop and test an expectations questionnaire, informed by both approaches. Doctors’ views towards patients’ expectations and requests in the consultation process (N = 1111). Compared to those who did not report a need for profit-making, doctors who did were significantly more likely to perceive that their patients expected medication-based treatments (AOR = 1.62, P < 0.001), IV therapy (AOR = 1.32, P = 0.037), the arrangement of tests (AOR = 2.06, P < 0.001), and consultation fee refunds when no prescriptions were made (AOR = 1.92, P < 0.001). Allowing the patient to express their views and opinions about the disease is not useful. Although patients brought expectations to the consultation regarding medication, it was the doctors' opinions about patients' expectations that were the strongest determinants of prescribing With the increasing promotion of rational prescribing, practitioners need to … Training could enhance efficacy, effectiveness and supportiveness of communication [1]. Some doctor’s work considering patient’s problem as their problem. Patient expectations refer to the anticipation that given events are likely to occur during or due to medical care . ‘If you cannot cure me, return the money to me. Himmel W, Lippert-Urbanke E, Kochen MM. Table 1 shows the characteristics of the study sample. As noted in Table 4, 92.8% of respondents perceived that patients often expected doctors to explain the exact cause(s) of their illnesses, and 48.2 and 29.7% reported that their patients often demanded drugs or arrangement of tests, respectively. It is related to the education level. Patient pressure may be stronger in the doctor's mind than in the patient's Although patients' expectations of general practice consultations influence outcomes, they are not as influential as doctors' assessments. Doctors sharing their experiences with patients and involving relatives in planning care was a need of patients. There is evidence that physicians who regularly use e-mail in communicating with colleagues overwhelmingly refrain from doing so with patients [24]. In total, 32 PCPs joined group discussion (1 group with 4, 2 groups with 6, 2 groups with 8), and 14 specialists joined group discussion (1 group with 6 and another with 8). The information comes mostly from the internet and through smart phones. The infectious diseases doctors that we interviewed work in the HIV/AIDS Regional Center in Iaşi. Doctors should get engaged in a small talk with the patients before starting the consultation. Respondents perceived that their patients expected either drug prescriptions (48.2%) or intravenous (IV) therapy (45.2%). Meeting patient expectations is ‘biggest problem’ facing nursing. Seven focus groups and 21 individuals were interviewed. Some researchers say female doctors spend more time with their patients, because patients have higher expectations of them. Accepting reasonable expectations can change the game for patients and their families. Effects of profit-orientation on medical professionals’ perceptions of patients’ expectations. Translation and validation of patient-practitioner orientation scale in Sri Lanka. Patients were considered to treat healthcare services as commodities (Table 2, Quote 7 and 8), and participants blamed the system for producing and sustaining this ideological stance. 381, 1994, pp. Central Hangzhou, with a population of 6.95 million, consists of eight districts. Doctors were shown letters from their own sabotaged: doctors felt that they usually release information in department to the patients' general practitioner and asked about a calculated and gradual way, to suit the needs of the individual any changes that they would.have made as a result of knowing patient, as seen by the doctors. Perceived patients’ expectation of clinical performance, 1. This is unavoidable, but if you are aware of it, you can anticipate concerns and prevent them from arising, and as a result, improve your patients' confidence in the care you provide. Ethical approvals were obtained from the Review Boards of The University of Hong Kong/Hospital Authority Hong Kong West Cluster (UW14-567) and Zhejiang University (ZGL201410H) respectively. Consent was obtained before the interviews. Participants attributed patients’ request for IV infusion to a widespread public misconception about the effectiveness of this particular method of drug administration. It is a commercialized society. This study will explore patient expectations and doctors perceptions about patient expectations during doctor patient encounters. Patients were positioned as purchasers of medical services in a highly commercialized health market. A questionnaire with 26 items to evaluate communication expectations of patients was developed by literature survey, expert opinion and several small group discussions. . They feel that they are safe once they enter a big hospital. Family Practice 2002; 19:333–338. What factors influence patients' expectations and general practitioners' actions? Only 50% of doctors have realized this need. Advantages of good communication like patient satisfaction, treatment adherence, therapeutic efficacy, cost effectiveness in care, doctors satisfaction and less chances of vicarious trauma has been documented [7]. At the end of each item space was provided to express free opinion and such data collected was analysed in a separate study. Read on to find out three of the most common. Perceived patient expectations of an arrangement of tests and consultation fee refunds if no prescriptions were made were reported by 29.7 and 22.7%, respectively. Missing responses were not presented in this Table 1. Doctors' advice 30, 35 is balanced with personal and vicarious experiences, 25 whereas academics and pharmaceutical industry are seen as less reliable sources. 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Therefore only general analysis was done rather than an exploratory evaluation of data. In response, the central government has launched initiatives targeting the overuse of IV antibiotics [15]. Evidence-based patient empowerment. The factors that contributed to patients’ high expectations of their doctors were discussed. First, the consequences of doctors’ perceptions and whether they offer an accurate representation of patients’ beliefs remain unexplored, thus warranting further research. There is a lack of public health education campaigns. The doctor should avoid expression of his/her feelings when they come across emotional situations regarding their patients. BACKGROUND. Our doctors use language and word that is familiar to their patients. However in contrast to the perception of the majority of doctors, majority of our patients do not expect doctors to express their feelings. 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