Patients and doctors: what kind of changes in outpatient clinic services can be made in concert?

Abstract

Abstract Background Search for possible improvements in outpatient clinic services is a key task for health care professionals worldwide. It is important to consider the satisfaction of the main participants in primary care: patients and doctors. If patients unsatisfied with primary care will not seek help again, this will reduce their life quality and life expectancy. Unsatisfied doctors will work not efficiently nor for a long time. The work is devoted to the search for possible factors, which change may affect the improvement of the situation in clinics in terms of both doctors and patients. Methods The opinions of 1672 patients of Krasnoyarsk outpatient clinics were investigated with the usage of semi-structured interviews. The opinions of 283 physicians of the city were collected using an anonymous questionnaire. Data were analyzed using SPSS 22 by the following methods (p < 0.05): descriptive statistics, U test, χ2-test. Results Coherence of doctors' and patients' opinions investigated in different ways such as primary care satisfaction, desirable main changes, optimal time, duration and structure of appointment, physician's mission, the possibilities of additional medical remote consultations and difficulties in doctors' access. At some points, the answers were consistent; at some, a compromise or new ways of the solutions were required. Conclusions Almost 61% of the doctors prefer morning work time (8-12 am) and 15.5% prefer work in the evenings (18-20 pm) while only 38.1% of patients can visit a doctor in the morning time and 39.5% in the evening. The main changes to be made according to the general opinion of doctors and patients is a reduction of a waiting time of doctors' appointment (38.1% and 38.5% respectively) and the creation of an electronic queue (26.5% and 30.5% respectively). Remote consultation service have to be organized for patients: phone service is more appropriate as for the doctors (30.5%) so as for the patients (34.7%). Key messages The reduction of a waiting time of doctors’ appointment, creations of an electronic queue and a remote consultation service have to be organized to improve primary care system. There is inconsistency in time preferences that have to be solved: doctors prefer to work in morning time and many patients can visit clinics only in the evenings.