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The Journal of the American Board of Family Practice 17:19-25 (2004)
© 2004 American Board of Family Practice

Physician-Elder Interaction in Community Family Practice

Edward J. Callahan, PhD, Kurt C. Stange, MD, PhD, Stephen J. Zyzanski, PhD, Meredith A. Goodwin, MS, Susan A. Flocke, PhD and Klea D. Bertakis, MD, MPH

From the Department of Family and Community Medicine (EJC, KDB), Center for Health Services Research in Primary Care, University of California, Davis (EJC, KDB); Departments of Family Practice (KCS, SJZ, MAG, SAF), Biostatistics and Epidemiology (KCS, SJZ, MAG), and Sociology (KCS, SJZ), University Hospitals of Cleveland; and Case Western Reserve University Ireland Cancer Center (KCS, SJZ, SAF), Case Western Reserve School of Medicine, Cleveland, Ohio. Address correspondence to Edward J. Callahan, PhD, Department of Family and Community Medicine, University of California, Davis, 4860 "Y" Street, Sacramento, CA 95817 (e-mail: ejcallahan{at}ucdavis.edu)

Objective: To determine whether outpatient visits by elders seeing community family physicians differ in length or content from visits by younger patients; socioemotional preferences predict visit content; and satisfaction correlates with visit content differentially across age.

Methods: In a multimethod cross-sectional study of 84 community family practices in northeastern Ohio, 3453 adult patient visits with 138 community family physicians were observed; 2362 of these patients completed self-report questionnaires. Three age groups were compared: 18 to 64, 65 to 74, and over 74 years. Length and content of the physician-patient encounter was determined using the Davis Observation Code (DOC); satisfaction was assessed using the MOS 9-item Visit Rating Scale.

Results: Controlling for reason for visit and demographics, visit length averaged 10.7 minutes for each group. Visit content differed significantly on 13 of 20 DOC codes between one of the older groups and the younger group; in 4 instances, content varied between the 2 older groups. Although visit content varied as predicted by socioemotional theory, no consistent patterns of association between visit content and satisfaction emerged.

Discussion: Older patient visits differ from those of younger patients as might be predicted by socioemotional selectivity theory; however, there was little association of visit content with patient satisfaction.






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Copyright © 2004 by the American Board of Family Medicine.