Understanding patients' views of a surgical outpatient clinic.

Abstract

For many people, the outpatient clinic is the first point of contact with a hospital. As clinical management moves from the in-patient setting, it is taking on a much greater importance. Yet there are still many gaps in our knowledge about how those who interact with it, whether as staff or patients, view it. This study sought to describe patients' perceptions and to explore some of the socio-demographic characteristics associated with these differing perceptions. The study took place in a district general hospital in southern England. A questionnaire seeking the experiences and views of patients was developed. After piloting, it was administered to patients attending surgical outpatient clinics. The results were supplemented by those of a study of times that the same patients waited to be seen and the duration of their consultations. We found that 288 patients attended the clinics of four consultant general surgeons in a week chosen to be typical of those throughout the year and, of these, 188 (76%) returned questionnaires. As far as could be ascertained, responders did not differ from non-responders. New patients only were asked about the time they had waited for an appointment and 32% felt that this had been excessive. Young patients were more likely to feel that the wait had been too long. Patients were more likely to overestimate the time that they waited than to underestimate it and 27% thought the time spent with the doctor had been too short. The perception of inadequate time was greatest among those attending clinics where the actual time available was least. Of the patients, 30% had questions they would have liked to have asked but did not, 32% of patients would definitely have liked a leaflet explaining their treatment, 44% of patients were very satisfied with how they were treated by the doctor and 3% were dissatisfied. Non-white patients tended to be less satisfied with both the overall attendance and the length of consultation, although the actual times spent with doctors were the same for both groups. Seventy-eight per cent of patients had no preference for being seen by a male or female doctor. Those expressing a preference tended to prefer a doctor of their own sex. We found that while many patients are satisfied with the outpatient experience, there are several issues that require attention. Patient's perceptions are often as important as more objective measures in determining whether an attendance is considered satisfactory.