Becker's Clinical Quality & Infection Control

17 PATIENT EXPERIENCE Younger Physicians Linked to More Patient Complaints Than Older Colleagues By Megan Knowles Y ounger ophthalmologists were more likely to receive patient complaints than their older colleagues, according to a study published in JAMA Ophthalmology. e study gathered data from 1,342 attending ophthalmologists or neuro-ophthalmologists who graduated medical school before 2010. e physi- cians came from 20 healthcare organizations that participate in Nashville, Tenn.-based Vanderbilt University Medical Center's Patient Advocacy Reporting System, a database of complaints and physician specialty data. Physicians were divided into five 10-year age groups. e age groups began with physicians who graduated before 1970, who were assigned ages greater than 70 years, through physicians who graduated between 2000-09, who were assigned ages 31 through 40 years. e median physician age was 47 years and 9 percent of physicians were 71 years or older. Researchers measured the rate of complaints over time by physician age using patient complaints registered between 2002-15 in Vanderbilt's report- ing system. e results revealed that increased physician age was associated with a decreased risk of receiving an unsolicited patient complaint. e youngest physicians of the group were linked to the shortest time until a first complaint was received, and they were significantly more likely to receive a complaint than older physicians. Ophthalmologists older than 70 years had the lowest complaint rate. Limitations of the study included the chance that the participating organizations did not complete their data collection. However, the study authors noted Vanderbilt's Center for Patient and Profes- sional Advocacy provided benchmarks for orga- nizations to minimize this possibility. "Although limitations in the study design could affect the interpretation of these conclusions, the findings may have practical implications for patient safety, clinical education, and clinical practice manage- ment," the authors wrote. n When Physicians Say 'No' to Requests, Patient Satisfaction Suffers By Megan Knowles P atients may report lower satisfaction with their care when physicians deny their requests for referrals, lab tests or prescriptions, according to a study published in JAMA Internal Medicine. Researchers gathered data from 1,141 adults who made a total of 1,319 outpatient visits to 56 family physicians at an academic medical center in Northern California. Patients were 46 years old on average, and approxi- mately 68 percent of patients were female. Nearly two-thirds of the visits included at least one patient request for the physician to provide a specialist referral, a lab test, pain medication or other prescription medication. Physicians said "yes" to these requests 85 percent of the time, according to the study. When physicians denied these requests, scores on patient satisfaction surveys after office visits were significantly lower than when requests were fulfilled. Part of the problem might be how frequently physicians comply with patient requests, lead study author Anthony Jerant, MD, told Reuters. "A request denial, therefore, is quite out of the ordinary and probably likely to invoke a negative reaction," Dr. Jerant said. To improve patient and physician experiences, physicians need to be trained to effectively deal with requests and work to better explain their reasoning for denying a request, the authors concluded. n Patients Find Online Portals Difficult to Understand, Study Finds By Jessica Kim Cohen T he majority of patients find test results difficult to interpret when presented in online portals, according to a study published in the Journal of the American Medical Informatics Association. The researchers — led by Traber D. Giardina, PhD, a researcher at Michael E. DeBakey VA Medical Center and Baylor College of Medicine, both based in Houston — conducted 95 interviews with patients at four outpatient clinics to assess their experiences viewing test results via online portals. The majority of patients (63 percent) did not receive any explanatory information or support interpreting their test results when they checked their online portal. Forty-six percent of patients proceeded to conduct online searches for additional information. Patients who received abnormal results were more likely to call their physi- cian than those who received normal results. However, some patients report- ed experiencing negative emotions even after receiving normal results. "[The] study findings suggest that online portals are not currently de- signed to present test results to patients in a meaningful way," the study authors concluded. "Simply providing access via portals is insufficient; additional strategies are needed to help patients interpret and manage their online test results." n

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