title: [Customer orientation in ambulant medicine].
abstract: BACKGROUND
  Due to developments of the health market, economic aspects of the health system are more relevant. In this upcoming market the patient is regarded as customer and the doctor as provider of medical services. Studies on customer orientation in the ambulant medicine lag behind this dynamic. An aim of the study is to comprehend the attitudes of the doctors referring to the customer orientation. In a second step the findings are discussed according to statements of health-care paticipants. Developments in role comprehension of doctor and patient are focused to gain results in scientific and practical applications.
  
  
  METHODS
  Guideline-supported, partly narrative interviews with n=9 gynaecologists and n=11 general practitioners in Freiburg/Germany are recorded, transcribed and reviewed in a qualitative analysis.
  
  
  RESULTS
  The statements of the doctors show patient satisfaction has an incremental meaning sspecially regarding the sequence of patient relationship and economic management of the doctor's workplace. The doctor's role comprehension meets with a refusal of the role of salesman and the patient as customer.
  
  
  CONCLUSIONS
  The method of interviews is suitable to gather empirical impressions of the doctors. The control sample is adequate, however a bias due to inhomogeneous thematic affinitiy and local social-demographics might be possible. The customer orientation has become an important factor in doctor-patient relationtships. The relevance of the doctor-patient conversation and the risk of misuse of the patient confidence are mentioned by the doctors. The doctor as paternalistic care provider gives way to the customer-focused service provider. The doctor's necessity of autonomyssss and dependency on patient satisfaction have potential for conflict.
  
  
  CONCLUSIONS
  Intensive mention of customer orientation in medicine in the media emphasises its importance. Rational handling with the possibilities of individual health markets is a prospective challange. Further research could be established in all aspects of customer orientation, especially the changing relevance of ethical responsibility. An enlargement or comparison with other control samples (n>20, other medical subfields, structurally weak areas) could be illuminating. The results of this qualitative study can be used to develop quantitative inquiries.
authors: Medizinische Soziologie Universität Freiburg, Medizinische Fakultät der Albert-Ludwigs-Universität Freiburg, Freiburg.
authors: M
authors: M
authors: Heinrich
mesh_terms: D000553:Ambulatory Care / Q000145:classification / Q000191:economics* / Q000706:statistics & numerical data; D001291:Attitude of Health Personnel; D003256:Community Participation / Q000191:economics / Q000706:statistics & numerical data; D003254:Consumer Advocacy / Q000191:economics* / Q000706:statistics & numerical data; D003258:Consumer Behavior / Q000191:economics* / Q000706:statistics & numerical data; D003625:Data Collection; D005858:Germany; D006801:Humans; D017060:Patient Satisfaction / Q000191:economics* / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D010820:Physicians / Q000191:economics* / Q000706:statistics & numerical data