title: Agenda-setting revisited: When and how do primary-care physicians solicit patients' additional concerns?
abstract: OBJECTIVE
  Soliciting patients' complete agendas of concerns (aka. 'agenda setting') can improve patients' health outcomes and satisfaction, and physicians' time management. We assess the distribution, content, and effectiveness of physicians' post-chief-complaint, agenda-setting questions.
  
  
  METHODS
  We coded videotapes/transcripts of 407 primary-, acute-care visits between adults and 85 general-practice physicians operating in 46 community-based clinics in two states representing urban and rural care. Measures are the incidence of physicians' questions, their linguistic format, position within visits, likelihood of being responded to, and the nature of such responses.
  
  
  RESULTS
  Physicians' questions designed to solicit concerns additional to chief concerns occurred in only 32% of visits (p<.001). Compared to questions whose communication format explicitly solicited 'questions' (e.g., "Do you have any questions?"), those that were formatted so as to allow for 'concerns' (e.g., "Any other concerns?") were significantly more likely to generate some type of agenda item (Chi(2) (1, N=131)=11.96, p=.001), and to do so more frequently when positioned 'early' vs. 'late' during visits (Chi(2) (1, N=73)=4.99, p=.025).
  
  
  CONCLUSIONS
  Agenda setting is comparatively infrequent. The communication format and position of physicians' questions affects patients' provision of additional concerns/questions.
  
  
  CONCLUSIONS
  Physicians should increase use of optimized forms of agenda setting.
authors.affiliation: Portland State University, Department of Communication, University Center Building, 520 SW Harrison Street, Suite 440, Portland, OR 97201, USA. Electronic address: jeffreyr@pdx.edu.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Robinson
authors.affiliation: University of California, Los Angeles, Department of Sociology, Los Angeles, CA, USA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Tate
authors.affiliation: University of California, Los Angeles, Department of Sociology, Los Angeles, CA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Heritage
mesh_terms: D000328:Adult; D003142:Communication; D006801:Humans; D008297:Male; D008487:Medical History Taking / Q000379:methods*; D009819:Office Visits; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care; D011320:Primary Health Care / Q000379:methods; D011795:Surveys and Questionnaires; D014743:Videotape Recording
keywords: Agenda setting; Communication; Conversation analysis; Patient; Physician; Question asking