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Ann Intern Med. 1991 Mar 15;114(6):451-4.

Failure of physicians to recognize functional disability in ambulatory patients.

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  • 1Department of Medicine, Beth Israel Hospital, Boston, MA 02215.

Abstract

OBJECTIVE:

To assess the ability of internists to identify functional disabilities reported by their patients.

DESIGN:

Comparison of responses by physicians and a random sample of their patients to a 12-item questionnaire about physical and social function.

SETTING:

A hospital-based internal medicine group practice in Boston, Massachusetts, and selected office-based internal medicine practices in Los Angeles, California.

SUBJECTS:

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.

MEASUREMENTS AND MAIN RESULTS:

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.

CONCLUSIONS:

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.

Comment in

PMID:
1825267
[PubMed - indexed for MEDLINE]
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