Do we talk? Doctors and patients disagree

YONKERS, NY - Patients and doctors disagree on some essential issues according to three new surveys conducted by Consumer Reports National Research Center. The survey of 39,090 patients and 335 primary-care physicians revealed discrepancies between doctors´ and patients´ perceptions of following medical advice, the role of prescription drug ads in the exam room, and the value of online research of medical conditions.

The full results of the survey as well as advice on how consumers can get better care from their doctors appear in the February issue of Consumer Reports. Alas, Consumer Reports does not post articles on their website, so you have to buy a copy or go to the library.

Among the survey´s key findings:
Following doctor´s orders. Patients almost unanimously said they "completely" or "mostly" followed their doctor´s advice. But 59 percent of doctors said their patients often failed to adhere to the prescribed course of treatment. This nonadherence from patients ranked first among troublesome patient behaviors CR asked doctors about.
Ignoring drug ads. Forty percent of doctors said that advertising directly to consumers did not serve the public interest. However, 78 percent of doctors surveyed said that patients asked them at least occasionally to prescribe drugs they have seen advertised on television, and 67 percent said they sometimes did so. However, 54 percent of the doctors surveyed said they sometimes declined to prescribe requested medications.

Getting the right information. Almost 40 percent of patients researched their medical conditions online. But 41 percent of doctors surveyed said their patients often showed up poorly informed because of bad information found online. You can help your patients - and yourself - by putting up a website that contains links to relevant and valid articles.

In total, 39,090 patients were surveyed about their doctor visits in two parts. Consumer Reports asked 25,184 respondents to its 2006 Annual Questionnaire about visiting the doctor for treatment of their most bothersome illness. During the summer of 2006, 13,906 online subscribers were polled about preventive-care visits. (CR acknowledges that its subscribers might not be representative of the population as a whole). Consumer Reports also questioned a random sample of 335 primary-care physicians about how things look from the other side of the table.

Consumer Reports´ survey results also reveal that doctors think the health-care system works much better for drug and health-insurance companies than for primary-care doctors and their patients. CR notes that the pharmaceutical industry spends billions of dollars marketing prescription drugs directly to patients; and wining and dining doctors so they´ll prescribe them.

Knowing the side effects. Among patients who received prescriptions from their doctors, 31 percent reported that their doctor didn´t adequately explain possible side effects, so Consumer Reports recommends that patients should ask questions about drugs prescribed during the visit. Also, nine percent of patients said their doctor did not review their other prescriptions to check for potentially harmful interactions with the newly prescribed drug.
Requesting prescription drugs. According to the survey, patients most frequently ask about advertised drugs for acid reflux, impotence, allergies, and insomnia — mainstays of the television ad lineup. Only seven percent of patients admitted to asking for advertised drugs for their most bothersome conditions.
Knowing the cost. Two-thirds of patients reported that doctors never brought up the costs of treatments and tests.
How to Prepare and Make the Most of a Doctor´s Appointment

Based on these and other findings from this survey, Consumer Reports developed a guide for what patients should do before, during, and after doctor visits — and how to find a doctor in the first place.

Consumer Reports advises patients to avoid picking a doctor at random from their health plan´s list or out of the phone book. Survey results revealed that people who found their physicians through someone they trusted, such as a friend, family member, or another doctor, were more satisfied with their care. For more information on checking up on a doctor´s qualifications, visit www.ConsumerReports.org/doctorlookup.

For the patient who feels rushed during the appointment, Consumer Reports prepared a "10-minute checklist" that features important questions regarding ailments, tests, treatments, and lifestyle changes that will help patients make the most of their time with the doctor.

The report also features ratings for doctors´ attributes as well as what bothered both patients and doctors. For example, 19 percent of patients could not schedule an appointment within a week, while 41 percent of doctors thought their patients often waited too long to make one.

The February 2007 issue of Consumer Reports is on wherever magazines are sold, and in many libraries.