Medscape article: The Satisfied Patient: Overprescribed and Costly

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Here is the link to the article.

http://www.medscape.com/viewarticle/720725?src=mp & spon=34 & uac=146408PG

I copied the article in case the link does not work.

" Patient satisfaction is an important outcome of healthcare delivery, and

patient requests for products or services factor into the equation that produces

satisfaction. Research demonstrates that physicians may be too open to requests

for specific medications. In a 2000 study, the satisfaction scores of 200

patients were correlated with disease outcome variables, and patient-centered

care was associated with lower rates of death and in-hospital complications.[1]

However, patient-centered care was also associated with higher healthcare costs.

This review focuses on a 2010 study by Paterniti and colleagues[2] that revealed

surprising prescribing patterns, based on standardized patients' request for

treatment. The researchers also analyzed physicians' responses to these requests

and offers strategies to improve patient satisfaction while practicing

evidence-based medicine.[2]

Communication is at the heart of patient-centered care, but requests for

specific tests or treatments can strain the dialogue between physician and

patient. In a study of 887 patients, 84% reported making at least 1 request

during their office visit with a physician.[3] Approximately 80% of these

requests were granted, and acquiescence to these requests improved patients'

perceptions of their care. Of note, patients who had their requests fulfilled

experienced fewer symptoms and health concerns at follow-up, but denial of

patient requests did not change post-visit outcomes. In another study of patient

and clinician behaviors, patient requests for specialty referrals increased the

odds of referral by more than 4 times, and prescription requests increased the

odds of getting a prescription nearly 3-fold.[4] Physicians noted that visits

with patients were more demanding when patients requested diagnostic tests.

The issue of patient requests for medications is particularly sensitive in this

era of direct-to-consumer advertising for prescription drugs. A study compared

rates of requests for specific prescription drugs in the United States, where

pharmaceutical advertising is legal, with those in Canada, where it is not.[5]

Patients in the United States were more than twice as likely to request specific

pharmaceutical agents, and patients who reported greater exposure to

prescription drug advertising were more likely to request these medications.

How did physicians respond to these requests? They were nearly 17 times more

likely to prescribe new medications to patients who made a request for an

advertised medication, even though many physicians made it clear that they would

not use these same advertised prescriptions for other patients with similar

diagnoses. "

I for one would agree with this article.