Are patients more satisfied when they receive a prescription? The effect of patient expectations in general practice.
OBJECTIVE
To test the hypotheses that patient expectations are a driving force in drug prescribing and that fulfilment of expectations is followed by higher satisfaction.


METHODS
Pre- and post-consultation survey of patients; parallel doctor survey (matched pairs).


METHODS
Primary health care in Göttingen, a town of about 130,000 inhabitants in Germany.


METHODS
Ten general practitioners and 185 randomly addressed patients.


METHODS
Patient expectations with respect to the result of the consultation; doctor's perception of patient expectations; agreement between patient and doctor; patient satisfaction.


RESULTS
Nearly half of the patients (86/185) expected a drug prescription from their doctor; 68% (125/185) received a prescription. The doctors recognized the expectation of a prescription in only 40.7% of the patients. A high percentage (82.6%) of patients expecting a drug were issued a prescription. Nearly all the patients (45/48) who expected a drug according to their doctor's judgement left the surgery with a prescription, and 58.4% of the remaining patients were prescribed a drug. There was no difference in satisfaction scores between patients whose expectations were or were not fulfilled.


CONCLUSIONS
These results are in some contrast to the main hypotheses. As fulfilment of expectations was not associated with higher satisfaction, physicians need not necessarily worry that patients will change their doctor if he or she refuses a pharmacologically dubious prescription.
Himmel
W
W
Department of General Practice, University of Göttingen, Germany.
Lippert-Urbanke
E
E
Kochen
M M
MM
D000328:Adult; D011307:Drug Prescriptions; D005194:Family Practice; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology