CONCERNS AND EXPECTATIONS IN PATIENTS PRESENTING WITH PHYSICAL COMPLAINTS - FREQUENCY, PHYSICIAN PERCEPTIONS AND ACTIONS, AND 2-WEEK OUTCOME

Background: Specific concerns and expectations may be a key reason tha t people with common physical complaints seek health care for their sy mptoms. Objectives: To determine the frequency of symptom-related pati ent concerns and expectations, physician perceptions and actions, and the relationship of these factors to patient satisfaction and symptom outcome. Methods: This was a prospective cohort study of 328 adult out patients presenting for evaluation of a physical complaint. The settin g was a general medicine clinic in a teaching hospital. Measures inclu ded previsit patient questionnaire to identify symptom-related concern s and expectations; a postvisit physician questionnaire to determine p hysician perceptions and actions; and a 2-week follow-up patient quest ionnaire to assess symptom outcome and satisfaction with care. Results : Pain of some type accounted for 55% of common symptoms, upper respir atory tract illnesses for 22%, and other physical complaints for 73%. Two thirds of patients were worried their symptom might represent a se rious illness, 62%, reported impairment in their usual activities, and 78%, 46%, and 41% hoped the physician would prescribe a medication, o rder a test, or provide a referral. Physicians often perceived symptom s as less serious or disabling and frequently did trot order anticipat ed tests or referrals. While symptoms improved 78% of the time at 2-we ek follow-up, only 56% of patients were fully satisfied. Residual conc erns and expectations were the strongest correlates of patient satisfa ction. Conclusions: Improved recognition of symptom-related concerns a nd expectations might improve satisfaction with care in patients prese nting with common physical complaints.