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Biomedical subjects

L L Morlock

Publications and source records attributed to L L Morlock.

26 records · Page 2Linked to original sources
PubMed1981

Do prescriptions adversely affect doctor-patient interactions?

The purpose of this study was to assess the impact of the prescription on the doctor-patient interaction. Data were collected during ongoing quality assessment studies at a prepaid group practice of about 19,000 enrollees. Adult patients and their providers completed forms on all visits to the Department of Medicine and Urgent Care Center during a two-week period. A 50 percent random sample of patients was interviewed by telephone one week after the index visit. Patients who did not receive prescriptions reported more satisfaction with the communicative aspects of their visits to physicians than patients who did receive prescriptions. We suggest that prescriptions may hinder patient satisfaction with the doctor-patient interaction by substituting for other, more "meaningful" communication between patient and provider.

Adolescent↗
PubMed1976

The role of new health practitioners in a prepaid group practice: provider differences in process and outcomes of medical care.

Practice patterns and patient-reported outcomes of care are compared in detail for ten physicians and 12 new health practitioners delivering ambulatory care in two departments of a prepaid group practice, the Columbia Medical Plan (CMP). All providers completed questionnaires for a 50 per cent random sample of patients seen during a two-week period. Patients completed questionnaires prior to receiving care and were interviewed one week and one month after their clinic visits. New health practitioners deliver approximately 75 per cent of well-person care, 56 per cent of problem-oriented care in adult medicine, and 29 per cent of problem care in pediatrics. They have become increasingly involved over time in the treatment of acute conditions and injuries while physicians have retained their predominant role in treating patients with chronic conditions. Thirty-two per cent of visits with new healh providers involved a physician in one or more of the following: decision-making, direct supervision, consultation, or seeing the patient as a second provider of care. Degree of autonomy varied by type of task performed, category of problem treated, and specialty. The following outcomes of care were examined by type of provider: patient-reported change in problem status,including frequency and intensity of pain or discomfort, level of anxiety, and degree of activity limitation; the degree to which physician-specified criteria for the most commonly occurring conditions were met with respect to change in problem status; and patient satisfaction with a number of dimensions of the clinic visit. The analysis suggests that the new health practitioners at the CMP are providing care, within their areas of responsibility, of comparable quality to that delivered by physicians.

Acute Disease↗
PubMed1976

Unaccepted applicants to medical school as a health resource.

The career decisions of national samples of male and female unaccepted applicants to the 1971-72 entering U.S. medical school class are studied in order to determine whether the increasing number of unaccepted applicants is a potential manpower pool for alternative health occupations. The dominant response to rejection among respondents is reapplication to medical school in subsequent years, and the principal determinant of reapplication is receiving postrejection support (usually from family or friends) of the original career intentions. Most of the respondents who do not gain admittance to medical school on reapplications still aspire to doctoral-level degrees, but only half remain in the health area. Those respondents who had formulated contingency career plans in the professions and who had high science aptitude but low math aptitude tended to remain in the health area. A service orientation toward occupations is not associated with remaining in the health area.

Career Choice↗
PubMedDate not supplied

Impact of divergent evaluations by physicians and patients of patients' complaints.

Physicians' estimates of patients' anxiety, discomfort or pain, and activity limitation were compared with reports by their patients on the same dimensions. The data were collected as part of a series of quality assessment studies at a prepaid group practice serving 19,000 people in a Mid-Atlantic metropolitan area. Analysis of the data showed that physicians underestimated the three dimensions 35 percent of the time and that activity limitation was the dimension most often underestimated. Patients whose physicians correctly estimated their discomfort or pain were more likely to receive prescriptions than patients whose physicians underestimated their discomfort or pain. Patients whose physicians underestimated their activity limitation were most likely to report dissatisfaction with the treatment given. The results are consistent with a growing body of evidence suggesting that physicians who show concern about their patients and a desire to understand their problems establish better therapeutic relationships.

Adult↗