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Older patients' experiences of care in resident and practicing physician outpatient clinics.


Hess BJ, Lynn LA, Conforti LN, Lipner RA, Holmboe ES. — American Board of Internal Medicine

Presented: Association of Medical Education in Europe Conference, September 2009

Background: Little is known about older patients’ perceptions of and experiences with care in residency training clinics.

Work Done: We compared performance on a patient survey from a comprehensive Web-based assessment tool, the Care of Vulnerable Elderly Practice Improvement Module, to evaluate quality of care for patients 65 and older delivered by residents in 41 U.S. internal and family medicine training programs (2,317 patients) versus 134 practicing internists and geriatricians (4,204 patients).

Patients seen in training program clinics were less likely to report receiving advice about exercise/physical activity (52% versus 62% for patients of practicing internists/geriatricians), or be queried about concerns regarding memory (26% versus 44%) or hearing (36% versus 52%). Patients were less likely to rate the clinic very good/excellent at providing information on taking medications properly (72% versus 80%) or medication side effects (57% versus 70%). All differences are statistically significant (p<.05).

Conclusions: Patient surveys targeting older adults reveal important deficiencies in care which are more pronounced for those cared for in training programs.

Take-Home Messages: Surveys of older adults can highlight processes of care that need improvement. Faculty development and system redesign will be needed to assure that care needs of older adults are met.

For more information about this presentation, please contact Research@abim.org.