Survey Explores Patient-Physician Conversations, Trust

Sharp Rees-Stealy Medical Group, a Choosing Wisely grantee partner in California, was interested in patients’ perspectives about medical overuse and created a survey to learn more.

Elena Cardenas, a consumer research analyst at Sharp Rees-Stealy, worked with Anne Hopkins, a project manager in the health services data management department, to build questions that would help the team get to know their patient base and learn what patients thought about before, during and after a doctor’s visit.

“We wanted to know if patients are trusting physicians or if they are coming in with pre-conceived notions about what is wrong with them and what treatment they might need,” Cardenas said.

Sharp Rees-Stealy had a willing group of survey participants through its online Sharp Insight Community, which was established a year and a half ago to engage patients, employees and physicians in all aspects of care, from health campaigns to hospital layout maps.

The consumer research team invited the community of almost 4,000 participants to complete the survey, and 1,020 – a fourth of all members – responded.

One finding that stood out was that 93 percent of patients do online research about a condition before a doctor’s visit.

“I was surprised that a majority of patients still trust physicians and value time with physicians even though they were likely to research their condition in advance,” Cardenas said. “Even though we all have the Internet at our fingertips, we still do value and need those conversation with physicians.”

Hopkins was also interested in this finding, as it presents an opportunity to drive patients toward vetted research materials.

“We are going to see what we can do with our patient portal to link patients to evidence-based research materials before or at their appointments.”

Since she has done a lot of work with Choosing Wisely through physician education and collaboration, Hopkins was also intrigued that the survey showed that only half of clinicians were comfortable discussing the value and costs of tests, while a third of patients requested more time to talk to their doctor about what tests might be appropriate.

“We still have room for improvement in education and dialogue,” she said. “We have to figure out how to support good conversations. We can show physicians that they are trusted and that patients are open to having conversations, which might make them more comfortable.”

The Sharp Rees-Stealy team created an infographic based on the survey results to help people process the findings quickly and easily. They also created a written report that goes into detail about the findings and will be presenting their data to others in their statewide collaborative.

In addition to making evidence-based resources available to patients, Sharp Rees-Stealy also wants to continue fostering an atmosphere in which doctors and patients can discuss the most appropriate care and review Choosing Wisely.

“If you build a survey, you have to make sure you think about what you do with the information you get and how you will translate that into a plan for action afterward,” Hopkins said. “It would also be interesting to revisit this to see if patients use the educational materials and if there is any change in how comfortable physicians are with talking about overuse.”