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- Title
Failure of physicians to recognize functional disability in ambulatory patients.
- Authors
Calkins, David R.; Rubenstein, Lisa V.; Cleary, Paul D.; Davies, Allyson R.; Jette, Alan M.; Fink, Arlene; Kosecoff, Jacqueline; Young, Roy T.; Brook, Robert H.; Delbanco, Thomas L.; Calkins, D R; Rubenstein, L V; Cleary, P D; Davies, A R; Jette, A M; Fink, A; Kosecoff, J; Young, R T; Brook, R H; Delbanco, T L
- Abstract
<bold>Objective: </bold>To assess the ability of internists to identify functional disabilities reported by their patients.<bold>Design: </bold>Comparison of responses by physicians and a random sample of their patients to a 12-item questionnaire about physical and social function.<bold>Setting: </bold>A hospital-based internal medicine group practice in Boston, Massachusetts, and selected office-based internal medicine practices in Los Angeles, California.<bold>Subjects: </bold>Five staff physicians, three general internal medicine fellows, and 34 internal medicine residents in the hospital-based practice and 178 of their patients. Seventy-six physicians in the office-based practices and 230 of their patients.<bold>Measurements and Main Results: </bold>Physicians underestimated or failed to recognize 66% of disabilities reported by patients. Patient-reported disabilities were underestimated or unrecognized more often in the hospital-based practice than in the office-based practices (75% compared with 60%, P less than 0.05). Physicians overstated functional impairment in 21% of paired responses in which patients reported no disability.<bold>Conclusions: </bold>Physicians often underestimate or fail to recognize functional disabilities that are reported by their patients. They overstate functional impairment to a lesser degree. Because these discrepancies may adversely affect patient care and well-being, medical educators and clinicians should pay more attention to the assessment of patient function.
- Subjects
INTERNISTS; DIAGNOSIS; CHRONIC diseases
- Publication
Annals of Internal Medicine, 1991, Vol 114, Issue 6, p451
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-114-6-451