Does a higher frequency of difficult patient encounters lead to lower quality care?

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Title: Does a higher frequency of difficult patient encounters lead to lower quality care?
Authors: An PG (AUTHOR), Manwell LB (AUTHOR), Williams ES (AUTHOR), Laiteerapong N (AUTHOR), Brown RL (AUTHOR), Rabatin JS (AUTHOR), Schwartz MD (AUTHOR), Lally PJ (AUTHOR), Linzer M (AUTHOR), An, Perry G (AUTHOR), Manwell, Linda Baier (AUTHOR), Williams, Eric S (AUTHOR), Laiteerapong, Neda (AUTHOR), Brown, Roger L (AUTHOR), Rabatin, Joseph S (AUTHOR), Schwartz, Mark D (AUTHOR), Lally, P J (AUTHOR), Linzer, Mark (AUTHOR)
Source: Journal of Family Practice. Jan2013, Vol. 62 Issue 1, p24-29. 6p.
Abstract: Background: Difficult patient encounters in the primary care office are frequent and are associated with physician burnout. However, their relationship to patient care outcomes is not known.Objective: To determine the effect of difficult encounters on patient health outcomes and the role of physician dissatisfaction and burnout as mediators of this effect.Design: A total of 422 physicians were sorted into 3 clusters based on perceived frequency of difficult patient encounters in their practices. Patient charts were audited to assess the quality of hypertension and diabetes management and preventive care based on national guidelines. Summary measures of quality and errors were compared among the 3 physician clusters.Results: Of the 1384 patients, 359 were cared for by high-cluster physicians (those who had a high frequency of difficult encounters), 871 by medium-cluster physicians, and 154 by low-cluster physicians. Dissatisfaction and burnout were higher among physicians reporting higher frequencies of difficult encounters. However, quality of patient care and management errors were similar across all 3 groups.Conclusions: Physician perception of frequent difficult encounters was not associated with worse patient care quality or more medical errors. Future studies should investigate whether other patient outcomes, including acute care and patient satisfaction, are affected by difficult encounters. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Family Practice is the property of Frontline Medical Communications and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Does a higher frequency of difficult patient encounters lead to lower quality care?
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  Data: <searchLink fieldCode="AR" term="%22An+PG%22">An PG</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Manwell+LB%22">Manwell LB</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Williams+ES%22">Williams ES</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Laiteerapong+N%22">Laiteerapong N</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Brown+RL%22">Brown RL</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rabatin+JS%22">Rabatin JS</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Schwartz+MD%22">Schwartz MD</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lally+PJ%22">Lally PJ</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Linzer+M%22">Linzer M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22An%2C+Perry+G%22">An, Perry G</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Manwell%2C+Linda+Baier%22">Manwell, Linda Baier</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Williams%2C+Eric+S%22">Williams, Eric S</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Laiteerapong%2C+Neda%22">Laiteerapong, Neda</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Brown%2C+Roger+L%22">Brown, Roger L</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rabatin%2C+Joseph+S%22">Rabatin, Joseph S</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Schwartz%2C+Mark+D%22">Schwartz, Mark D</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lally%2C+P+J%22">Lally, P J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Linzer%2C+Mark%22">Linzer, Mark</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Family+Practice%22">Journal of Family Practice</searchLink>. Jan2013, Vol. 62 Issue 1, p24-29. 6p.
– Name: Abstract
  Label: Abstract
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  Data: <bold>Background: </bold>Difficult patient encounters in the primary care office are frequent and are associated with physician burnout. However, their relationship to patient care outcomes is not known.<bold>Objective: </bold>To determine the effect of difficult encounters on patient health outcomes and the role of physician dissatisfaction and burnout as mediators of this effect.<bold>Design: </bold>A total of 422 physicians were sorted into 3 clusters based on perceived frequency of difficult patient encounters in their practices. Patient charts were audited to assess the quality of hypertension and diabetes management and preventive care based on national guidelines. Summary measures of quality and errors were compared among the 3 physician clusters.<bold>Results: </bold>Of the 1384 patients, 359 were cared for by high-cluster physicians (those who had a high frequency of difficult encounters), 871 by medium-cluster physicians, and 154 by low-cluster physicians. Dissatisfaction and burnout were higher among physicians reporting higher frequencies of difficult encounters. However, quality of patient care and management errors were similar across all 3 groups.<bold>Conclusions: </bold>Physician perception of frequent difficult encounters was not associated with worse patient care quality or more medical errors. Future studies should investigate whether other patient outcomes, including acute care and patient satisfaction, are affected by difficult encounters. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of Journal of Family Practice is the property of Frontline Medical Communications and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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