The medical interview: differences between adult and geriatric outpatients.

BACKGROUND

There is a perception that primary care physicians spend less time with older patients and little is known about physician and older patient satisfaction during clinical encounters.

OBJECTIVE

To determine how primary care interviews of geriatric patients differ from those of other adults.

DESIGN

Descriptive, analytic study.

SETTING

Ten primary care sites in the United States and one in Canada, including public, voluntary, and private clinics and practices.

PARTICIPANTS

Of the 544 patients, 45.6% were 65 and older and 17.8% were 75 or older. There were 127 participating physicians.

MEASUREMENTS

Encounters were audiotaped and analyzed. Patients and physicians also completed exit questionnaires.

RESULTS

Interview length increased significantly with age for men but not for women. Physician satisfaction did not change as patient age increased. Patient satisfaction, on the other hand decreased with age among women but not for men. Although physicians' and younger patients' perceptions of health were moderately associated, there was no association for men ages 75 and over.

CONCLUSIONS

There is no evidence that physicians spend less time or are more uncomfortable with older patients. Both physician and male patient satisfaction remain stable with increasing patient age, despite greater disparity in patient and physician perceptions of health. Older female patients are less satisfied with physician visits than their younger counterparts, in the absence of changes in interview length or disparities between older female patients and their physicians in health perception.