The physical examination: a survey of patient preferences and expectations during primary care visits

ABSTRACT

Background: Little is known about patient preference regarding the physical exam in non-urgent primary care settings.

Objective: To determine the differences between a patient’s expectations of the physical exam and the actual components of the physical examination performed during a non-urgent visit.

Design: A total of 452 surveys administered in the waiting room of a VA primary care clinic in West Haven, CT.

Key results: The response rate was 91.6% (n = 414). For 15 of 16 maneuvers on the survey, more respondents believed a reasonable provider should conduct it than received it at their annual physical exam; for 7 of them (breast, axillary, rectal, pelvic, total body skin exam, electrocardiogram, and stress test), over twice as many respondents believed they should be done than received them. There was an association between a patient’s perception of their primary care provider and the number of maneuvers recalled at their annual exam (P < 0.001), and a gap in the number of maneuvers expected from a reasonable provider by nonwhite and white patients (P < 0.001).

Limitations: Convenience sample, response bias (healthy patients are more likely to respond) and recall bias.

Conclusion: Patient perception of their primary care provider is strongly associated with the number of maneuvers recalled during an annual physical. Furthermore, the number of maneuvers expected by a patient is influenced by race, with nonwhite patients desiring more. This suggests the need for further research on the role of race in the expectations of healthcare providers.

KEYWORDS:

• Patient preferences
• physical examination
• doctor–patient relationship

Acknowledgments

The authors would like to thank Jerry Du, MD (Case Western Reserve University School of Medicine) for advice in preparing the manuscript.

Declaration of interest

The authors declare no conflict of interest.

Reviewers' disclosure

The peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases, grant number [T35DK104689].