Where’s my doctor? the impact of the primary oncologist’s visit with their hospitalized patients.

Abstract

6603 Background: Continuity of care is a cornerstone of the patient-practitioner relationship and patient satisfaction. The inpatient continuity visit (ICV), a face-to-face patient-provider interaction, involves a discussion regarding hospital course and care goals and decisions. We theorize that the ICV influences patient satisfaction. Previously, patient satisfaction has been related to patient perception of physician conduct, including communication skills. Currently, there are no studies investigating the impact of an ICV on inpatient oncology patients on a hospitalist service. Objectives: To assess the relationship between the ICV and patient satisfaction. We hypothesized that one or more visits by the outpatient oncologist would enhance satisfaction of oncology inpatients. Methods: Subjects (N=82) were comprised of adult inpatients on the oncology unit at Miriam Hospital, a teaching hospital of the Alpert Medical School of Brown University. All participants had an oncologist at the hospital based cancer center. A survey, given at discharge, included a 5-point Likert scale ranging from greatly worsened to greatly improved to assess the impact of the ICV on patient satisfaction. Results: Of 82 participants, 46 reported a visit by their outpatient oncologist. Forty-two (91.3%) reported that this visit either greatly or somewhat improved satisfaction with their hospital stay, while 8.7% reported no impact. Of patients whose oncologist visited once, 94.4% reported either greatly or somewhat improved satisfaction compared to 89.3% who had more than one visit. Out of 36 subjects who did not receive a visit, 16.7% reported that the lack of visit either greatly or somewhat worsened their hospital stay, while 83.3% reported no impact. Conclusions: Our study suggests that an ICV improves satisfaction of care in cancer patients on a hospitalist service. Furthermore, one of every six subjects who did not receive an ICV reported a negative impact on satisfaction. Results highlight a possible intervention to the discontinuity of care that may be perceived by patients. While the practicality of this intervention requires evaluation, the efficacy of a single continuity visit to improve satisfaction is reassuring.