The effect of patient health status on physician practice style.

BACKGROUND

The recent development of health status measures now facilitates the study of how patient health influences physician practice style.

METHODS

The health status of 150 new patients at a university primary care center was assessed using the Medical Outcomes Study Short-Form General Health Survey. Videotapes of the physician-patient encounter were analyzed with the Davis Observation Code to explore the effect of patient health status on physician practice style.

RESULTS

Regression analyses demonstrated that better health was predictive of a greater portion of the visit being spent on physical examination and chatting and a smaller portion of the visit on history taking. Counseling was predicted by diminished patient mental health scores. Preliminary evidence was found for different practice styles based on patient characteristics such as sex, age, education, and income.

CONCLUSIONS

Results suggest that the physician-patient encounter is strongly influenced by health status. It will be crucial for future studies of physician-patient interaction to include an assessment of the patient's health status.