A comparison of initial and established patient encounters using the Davis Observation Code.
BACKGROUND
Previous research has evaluated how communication during medical visits affects patient outcomes such as compliance, recall, and satisfaction. These prior studies generally did not control for new versus established patient visits. The objective of the present research was to explore differences between new and established patient encounters.


METHODS
This research studied 62 new patient and 58 established patient encounters to a university-based family practice clinic. The Davis Observation Code was used to code and evaluate the encounters.


RESULTS
Established patient encounters were shorter and involved more chatting, counseling, discussions of treatment effects, compliance checking, and requests for specific patient behavior changes regarding health promotion. On the other hand, established patient encounters involved less structuring of the interaction with the patient, less history taking, and fewer discussions regarding family information, smoking, and substance abuse.


CONCLUSIONS
The results indicate that what takes place during the medical interview is highly dependent on physician-patient familiarity. Future research on physician-patient interactions should consider whether the interactions represent new or established visits.
Bertakis
K D
KD
Department of Family Practice, University of California, School of Medicine, Davis.
Callahan
E J
EJ
D000328:Adult; D003266:Continuity of Patient Care; D005194:Family Practice; D005260:Female; D006293:Health Promotion; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009819:Office Visits; D010349:Patient Compliance; D010817:Physician-Patient Relations; D012106:Research