Norman H Rasmussen | PubMed Health

PubMed2006

Innovative reflecting interview: effect on high-utilizing patients with medically unexplained symptoms.

This pilot study was conducted to determine the effect of an innovative reflecting interview on the health care utilization, physical health, mental function, and health care satisfaction of high-utilizing primary care patients with medically unexplained physical symptoms. Twenty-four high-utilizing patients met study selection criteria and were randomly assigned to a no-intervention control group or a reflecting interview intervention group. Outcomes were measured at 4 weeks, 6 months, and 1 year after the date of study enrollment. Results indicated that high-utilizing patients with medically unexplained physical symptoms who participated in a reflecting interview had reduced total health care costs, primarily through the reduction of hospitalization or inpatient expenses, despite a modest increase in outpatient primary care clinic visits. These data suggest that participation in a reflecting interview and regular visits with a primary care clinician can decrease health care utilization without adversely affecting patient satisfaction.

Adult↗

PubMed2006

Assessment and diagnosis of attention-deficit/hyperactivity disorder by family physicians.

In this study, our aim was to determine the extent to which family physicians in Minnesota follow the American Academy of Pediatrics (AAP) guideline in the assessment and diagnosis of attention-deficit/hyperactivity disorder (ADHD) in school-aged children and to identify barriers to using the guideline. We surveyed 1,000 randomly chosen members of the Minnesota Academy of Family Physicians. Of 303 respondents, 36% always referred children for a diagnosis and 99.7% referred children for a diagnosis of ADHD some of the time. Fifty-four percent were unaware of the AAP guideline. However, among those who said they evaluate children for ADHD, most followed the criteria in the AAP guideline. For example, most family physicians (97%) used a child's response to stimulant medication in their assessment. Respondents also said that barriers to ADHD assessment included lack of reimbursement and training.

Attention Deficit Disorder with Hyperactivity↗

PubMed2002

21st-century health care: the effect of computer use by physicians on patient satisfaction at a family medicine clinic.

BACKGROUND AND OBJECTIVES: Trust and satisfaction in the physician-patient relationship is the cornerstone of family medicine. Today, computers are playing an increasingly prominent role in the delivery of health care, yet recent data detailing their effect on the physician-patient relationship are limited. For physicians to "first do no harm," it is critical to determine that computers used at the point of care do not decrease patient satisfaction, because this is a good proxy for the physician-patient relationship. This study assessed patients' views of computer use and its effect on patient satisfaction in a family medicine clinic before and after implementation of an electronic environment developed by our institution. METHODS: A survey was mailed to patients who had been evaluated at a family medicine clinic for hypertension, high blood pressure without hypertension, or hyperlipidemia. These diseases were selected because they are common and require strong physician-patient relationships for successful treatment. The survey assessed patients' overall satisfaction with health care received at the clinic and their opinions about how their physician's computer use affected their visit. This survey was compared with a survey done in 1995 at the same clinic, before adoption of the electronic environment. RESULTS: A total of 478 patients were enrolled in the study; 304 (63.6%) of these returned surveys. A majority of the patients (74.6%) thought that the computer had an overall positive impact on the quality of care provided. There was a positive association between a physician's computer skills, as rated by patients, and the patients' satisfaction with the computer's effect on the visit. There were no differences in overall satisfaction between the 1995 survey and the current survey. CONCLUSIONS: This study shows that physician competence with computers plays an important role in patient satisfaction and that computers can be integrated into the office visit without a detrimental effect on patient satisfaction. Surprisingly, patient familiarity with computers was shown to have a slight negative correlation with patient satisfaction. These findings are significant in view of research indicating that compliance, health outcomes, perception of physician competence, and malpractice suits are all related to physicians' interpersonal skills and patient satisfaction.

Attitude to Computers↗