title: Patient expectations at a multicultural out-patient clinic in Switzerland.
abstract: BACKGROUND
  Recognizing patient expectation is considered as an important objective for primary care physicians. A number of studies suggest that failure to identify patient expectations can lead to patient dissatisfaction with care, lack of compliance and inappropriate use of medical resources. It has been suggested that identifying patient expectations in multicultural contexts can be especially challenging.
  
  
  OBJECTIVE
  The aim of the study was to compare health care expectations of Swiss and immigrant patients attending the out-patient clinic of a Swiss university hospital and to assess physicians' ability to identify their patients' expectations.
  
  
  METHODS
  Over a 3-month period, all patients attending the out-patient clinic at a Swiss university hospital were requested to complete pre-consultation surveys. Their physicians were requested to complete post-consultation surveys. Outcome measures were patients' self-rated health, resort to prior home treatment, patients' expectations of the consultation, physicians' perception of their patients' expectations and agreement between patients and physicians.
  
  
  RESULTS
  We analysed 343 questionnaires completed by patients prior to their consultation (> 50% immigrants) and 333 questionnaires completed by their physicians after the consultation. Most expectations were shared by all patients. Physicians had inaccurate perceptions of their patients' expectations, regardless of patients' origin.
  
  
  CONCLUSIONS
  Our study found no evidence that immigrant patients' expectations differed from those of Swiss patients, nor that physicians had more difficulty identifying expectations of immigrant patients. However, physicians in our study were generally poor at identifying patients' expectations, and therefore inter-group differences may be difficult to detect. Our results point to the need to strengthen physicians' general communication skills which should then serve as a foundation for more specific, cross-cultural communication training.
authors.affiliation: Policlinique médicale universitaire, rue du Bugnon 44, 1011 Lausanne, Switzerland. noelle.junod@hcuge.ch
authors.forename: Noelle Junod
authors.initials: NJ
authors.lastname: Perron
authors.forename: Francoise
authors.initials: F
authors.lastname: Secretan
authors.forename: Marco
authors.initials: M
authors.lastname: Vannotti
authors.forename: Alain
authors.initials: A
authors.lastname: Pecoud
authors.forename: Bernard
authors.initials: B
authors.lastname: Favrat
mesh_terms: D000328:Adult; D018864:Cultural Diversity; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D008297:Male; D010044:Outpatient Clinics, Hospital / Q000592:standards*; D017060:Patient Satisfaction / Q000208:ethnology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013557:Switzerland