Agenda Setting During Follow-Up Encounters in a University Primary Care Outpatient Clinic

At the beginning of the medical encounter, clinicians should elicit patients' agendas several times using open-ended questions. Little is known, however, about how many times physicians really solicit a patient's agenda during follow-up encounters. The objective was to analyze the number o...

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Bibliographic Details
Published in:	Health communication Vol. 32; no. 6; pp. 714 - 720
Main Authors:	Rey-Bellet, Sarah, Dubois, Julie, Vannotti, Marco, Zuercher, Marili, Faouzi, Mohamed, Devaud, Karen, Rodondi, Nicolas, Rodondi, Pierre-Yves
Format:	Journal Article
Language:	English
Published:	England Routledge 03-06-2017 Routledge, Taylor & Francis Group
Subjects:	Adult Agenda Communication Cross-Sectional Studies Encounters Female Follow-Up Studies Health care Health services Humans Male Males Medical personnel Middle Aged Office Visits Patients Physician-Patient Relations Physicians Primary care Primary Health Care - methods Regression analysis Regression models Surveys and Questionnaires Universities Videotape Recording
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Summary:	At the beginning of the medical encounter, clinicians should elicit patients' agendas several times using open-ended questions. Little is known, however, about how many times physicians really solicit a patient's agenda during follow-up encounters. The objective was to analyze the number of agenda solicitations by physicians, of agendas initiated by physicians, and of patients' spontaneous agendas during the beginning and the entire encounter. We analyzed 68 videotaped follow-up encounters at a university primary care outpatient clinic. The number of different types of agenda setting was searched for and analyzed using negative binomial regression or logistic regression models. Physicians solicited agendas a mean ± SD of 0.8 ± 0.7 times/patient during the first 5 minutes and 1.7 ± 1.2 times/patient during the entire encounter. Physicians in 32.4% of encounters did not solicit the patient agenda, and there were never more than two physician's solicitations during the first 5 minutes. The mean number of physician's solicitations of the patients' agenda was 42% lower among female physicians during the first 5 minutes and 34% lower during the entire encounter. The number of agendas initiated by physicians was 1.2 ± 1.2/patient during the beginning and 3.2 ± 2.3/patient during the entire encounter. In 58.8% of the encounters, patients communicated their agendas spontaneously. There were twice as many patient spontaneous agendas (IRR = 2.12, p = .002) with female physicians than with males. This study showed that agenda solicitation with open-ended questions in follow-up encounters does not occur as often as recommended. There is thus a risk of missing new agendas or agendas that are important to the patient.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1041-0236 1532-7027
DOI:	10.1080/10410236.2016.1168003