The medical interview: Differences between adult and geriatric outpatients

BACKGROUND: There is a perception that primary care physicians spend less t ime with older patients and little is known about physician and older patie nt satisfaction during clinical encounters. OBJECTIVE: To determine how primary care interviews of geriatric patients d iffer from those of other adults. DESIGN: Descriptive, analytic study. SETTING: Ten primary care sites in the United States and one in Canada, inc luding public, voluntary, and private clinics and practices. PARTICIPANTS: Of the 544 patients, 45.6% were 65 and older and 17.8% were 7 5 or older. There were 127 participating physicians. MEASUREMENTS: Encounters were audiotaped and analyzed. Patients and physici ans also completed exit questionnaires. RESULTS: Interview length increased significantly with age for men but not for women. Physician satisfaction did not change as patient age increased. Patient satisfaction, on the other hand decreased with age among women but not for men. Although physicians' and younger patients' perceptions of heal th were moderately associated, there was no association for men ages 75 and over. CONCLUSIONS: There is no evidence that physicians spend less time or are mo re uncomfortable with older patients. Both physician and male patient satis faction remain stable with increasing patient age, despite greater disparit y in patient and physician perceptions of health. Older female patients are less satisfied with physician visits than their younger counterparts, in t he absence of changes in interview length or disparities between older fema le patients and their physicians in health perception.