J Korean Med Sci.  2019 Apr;34(15):e119. 10.3346/jkms.2019.34.e119.

Patient-Centeredness during In-Depth Consultation in the Outpatient Clinic of a Tertiary Hospital in Korea: Paradigm Shift from Disease to Patient

• Sohn KH
• Nam S
• Joo J
• Kwon YJ
• Yim JJ

• KMID: 2443207
• DOI: http://doi.org/10.3346/jkms.2019.34.e119

Abstract

BACKGROUND
Patient-centered care (PCC) and integrative care approach are widely advocated. However, their implementation usually requires an extended consultation time. Despite significant advances in medical diagnosis and treatment, no studies have examined consultation time and patient centeredness in Korea.
METHODS
We conducted a "15-Minute Consultation" for first-time patients in outpatient clinics of 13 departments. A control group was selected from the same physicians' first-time patients, adjusting for age and gender. A total of 275 patients were selected for receiving in-depth consultation and 141 control patients were selected for regular consultation. Data were collected from patients using a questionnaire comprising a patient-centeredness scale and items on potential predictors such as socio-demographic and clinical factors. We also investigated the participating physician's professionalism.
RESULTS
As compared to the control group, the in-depth consultation group scored higher on 5 variables associated with PCC, including (patients' perception of) medical professionals, wait and consultation times, treatment, patient advocacy, and patient satisfaction. While 92.4% of patients in the in-depth consultation group reported that the consultation time was sufficient, only 69.0% of those in the control group reported the same (P < 0.01). In the in-depth consultation group, scores on satisfaction level were the highest for the department of internal medicine, followed by departments of surgery and pediatrics. Participating physicians' improved satisfaction following the intervention proved that in-depth consultation facilitated building a rapport with patients.
CONCLUSION
This study illustrated that the provision of sufficiently long consultation for serious and rare diseases could improve PCC and physicians' professionalism. Health authorities should reshuffle the healthcare delivery system and provide sufficient consultation time to ensure PCC and medical professionalism.

Keyword

Patient-Centered Care; Consultation; Satisfaction; Medical Professionalism

MeSH Terms

Ambulatory Care Facilities*
Delivery of Health Care
Diagnosis
Humans
Internal Medicine
Korea*
Outpatients*
Patient Advocacy
Patient Satisfaction
Patient-Centered Care
Pediatrics
Professionalism
Rare Diseases
Tertiary Care Centers*