Direct-to-consumer advertising: Physicians' views of its effects on quality of care and the doctor-patient relationship
Direct-to-consumer advertising: Physicians' views of its effects on quality of care and the doctor-patient relationship
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DOI：
10.3122/jabfm.16.6.513
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发表时间：
2003-11-01
期刊：
影响因子：
--
通讯作者：
Donelan, K
中科院分区：
文献类型：
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作者：
Murray, E;Lo, B;Donelan, K
背景：本研究的目的是确定医生对直接面向消费者广告（DTCA）对医疗服务利用、护理质量和医患关系的影响的看法。方法：对具有全国代表性的美国医生样本进行横断面调查，以确定他们对患者讨论DTCA信息对时间效率的影响的看法；要求采取具体干预措施；健康状况;还有医患关系。结果：医生报告说，超过一半（56%）的患者在就诊时讨论DTCA信息是因为他们想要进行特定的干预，如检查、更换药物或专科转诊。医生认为49%的请求在临床上是不合适的。医生满足了69%他们认为临床不合适的请求；39%的医生认为DTCA损害了就诊的时间效率，13%的医生认为它有帮助。33%的医生认为讨论DTCA改善了医患关系；8%的人认为情况恶化了。对关系的影响与做病人想做的事情密切相关。结论：DTCA对医疗服务质量、医患关系和卫生服务利用有积极和消极的影响。通过提高广告信息的准确性，可以使利益最大化，危害最小化；提高医生的沟通和谈判技巧；并鼓励患者尊重医生的临床专业知识。
Background: The objective of the study was to determine physicians' views of the effects of Direct-to-Consumer Advertising ( DTCA) on health service utilization, quality of care, and the doctor-patient relationship.Methods: Cross-sectional survey of a nationally representative sample of US physicians to determine their perceptions of the effects of patients discussing information from DTCA on time efficiency; requests for specific interventions; health outcomes; and the doctor-patient relationship.Results: Physicians reported that more than half (56%) of patients who discussed information from DTCA in a visit did so because they wanted a specific intervention, such as a test, change in medication, or specialist referral. The physician deemed 49% of these requests clinically inappropriate. Physicians filled 69% of requests they deemed clinically inappropriate; 39% of physicians perceived DTCA as damaging to the time efficiency of the visit, and 13% saw it as helpful. Thirty-three percent of physicians thought discussing DTCA had improved the doctor-patient relationship; 8% felt it had worsened it. The effect on the relationship was strongly associated with doing what the patient wanted.Conclusions: DTCA can have good and bad effects on quality of care, the doctor-patient relationship, and health service utilization. The benefits might be maximized, and the harms minimized, by increasing the accuracy of information in advertisements; enhancing physicians' communication and negotiation skills; and encouraging patients to respect physicians' clinical expertise.