Patient counseling by specialists in internal medicine: results of a nationwide survey.
An analysis of patient care data from a national sample of physicians in ten subspecialties of internal medicine was undertaken to determine rates of patient counseling in specialized medical care. The analysis, which was based on 91,226 patient encounters in both ambulatory and hospital settings, revealed that medical specialists employ patient education counseling in 12.3% of encounters, family/social/sexual counseling in 2.7%, and therapeutic listening/reassurance in 14.0%--rates that are 2 to 3 times those for primary care physicians. Among subspecialties, cardiologists have the highest rates of patient education and family/social/sexual counseling, and the second highest rates of therapeutic listening. (Rheumatology is highest in the latter category). Rates of patient education and therapeutic listening are higher for office-based physicians and for ambulatory care (especially ambulatory care provided by board-certified physicians). Patient education is more frequent for ambulatory first visits and consultations, whereas therapeutic listening is more frequent for 'principal care' patients seen in either ambulatory settings or in the hospital. Highest rates of family/social/sexual counseling occur for ambulatory first visits with nephrologists and ambulatory consultations with cardiologists.
D003376:Counseling; D003625:Data Collection; D006801:Humans; D007388:Internal Medicine; D010353:Patient Education as Topic; D010819:Physician's Role; D012380:Role; D014481:United States