Denial of Patient’s Test Requests Affects Patient Satisfaction

Patient satisfaction was reportedly worse with clinicians denying certain requests, including laboratory test, referrals, pain medications, and other tests.

Patient satisfaction was reportedly worse with clinicians denying certain requests, according to findings from an observational study published in JAMA Internal Medicine.

Study authors from The University of California Davis School of Medicine, Sacramento, CA, sought to evaluate how patient satisfaction with the clinician was affected by clinician denial of certain types of patient requests. They conducted a cross-sectional observational study including 1319 outpatient visits to family physicians (n=56) by 11,141 adults at an academic health center.

Data from the 6 Consumer Assessment of Healthcare Providers and Systems Clinician and Group Adult Visit Survey were used to measure patient satisfaction with the visit physician.

Different mixed-effects models looked at the adjusted mean differences in patient satisfaction percentile associated with denial vs. fulfillment of each of the following patient requests (if present): referral, pain medication, antibiotic, other new medication, laboratory test, radiology test, or other test. Patients’ weight, health status, sociodemographics, personality, worry over health, prior clinician visit, and other request categories and dispositions were taken into account. 

At least 1 request was presented in 68.0% of the total visits and 85.2% were fulfilled. The most common request was for a laboratory test (34.0%), followed by a referral (21.1%), pain medication (20.5%), other new medication (20.5%), radiology test (11.6%), other tests (11.1%), and antibiotic (8.1%).

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Denials for requests of referral (adjusted mean percentile difference -19.75), pain medication (-10.72), other new medication (-20.36), and laboratory test (-9.19) were linked to worse satisfaction compared with fulfillment. 

“In an era of patient satisfaction-driven compensation, the findings suggest the need to train clinicians to deal effectively with requests, potentially enhancing patient and clinician experiences,” concluded lead author,  Anthony Jerant, MD.

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Jerant A, Fenton JJ, Kravitz RL, et al. Association of clinician denial of patient requests with patient satisfaction [published online November 27, 2017]. JAMA Intern Med. doi: 10.1001/jamainternmed.2017.6611

This article originally appeared on MPR