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December
1996
More or better - educating the patient about the anesthesiologist's
role as perioperative physician
Klock PA, Roizen MF Anesthesia and Analgesia 1996;83:671-672.
[ see abstract below ]
The anesthesiologist as "perioperative physician" is a common catch-phrase
in today's uncertain medical climate, as anesthesiologists struggle to
establish a secure place in the new firmament of Managed Care. So we can
expect increasing attention to be given to ways in which the anesthesiologist
can be perceived as a "real doctor" and not just a technician by his or
her patients and medical colleagues.
In an attempt to explore ways in which the anesthesiologist can foster
the doctor-patient relationship, Zwara et al performed a study at Bowman
Gray University reported in the October 1996 edition of ANESTHESIA AND
ANALGESIA. Patients were visited by an anesthesiologist one, two or three
times in the postoperative period. The authors appeared somewhat surprised
to find that not only did an increasing number of postoperative visits
not increase the patients' poor name recognition of their anesthesiologist
(particularly in comparison with their surgeon), but it did little to
improve their perception of the anesthesiologist as helpful, their anxiety
about future anesthetics or their understanding of the anesthesiologist's
role in their surgery.
In the accompanying editorial, Klock and Roizen suggest that the quality
of the anesthesiologist's visit is likely to be more important than the
quantity. They also point out the importance of a good preoperative visit
with postoperative visits really being a component of the continuum of
care. Nonetheless, they suggest that this study is a "wake up call" for
anesthesiologists, and points to the need for investigating measures of
patient satisfaction with such issues as postoperative pain, nausea and
vomiting, return of bowel function etc. Clearly, in the current era of
managed competition, the anesthesiologist needs to be attuned to consumer
satisfaction as well as to the technical and professional obligations
to the job at hand!
Return to the Current Literature Review Front
Page, or read the abstract:
ABSTRACT
The importance of the postoperative anesthetic visit: do repeated visits
improve patient satisfaction or physician recognition?
Zwara DA, Nelson JM, Brooker RF et al; Anesthesia and Analgesia
1996;83:793-797.
This study
evaluates whether repeated postoperative visits by the anesthesiologist
improve patient ability to recall the anesthesiologist's name and the patient's
perception of and satisfaction with anesthesia services. In a randomized
prospective trial, 144 patients with an anticipated postoperative length
of stay of at least three days were enrolled in three groups: Group A patients
(n=48) had one postoperative visit, Group B (n=48) had two postoperative
visits, and Group C (n=48) had three postoperative visits.
All postoperative visits were performed by the attending anesthesiologist
on consecutive postoperative days. Patients were contacted two days after
their last postoperative visit to complete a study questionnaire. Patients
were able to recall the anesthesiologist's name significantly less frequently
than surgeon's name, and there was no difference in name recall among groups.
Recall was not affected by patient age, sex, or ASA physical status; the
mode of contact (telephone versus personal visit); the anesthesiologist's
gender; the presence of perioperative medication; or the identity of the
preoperative evaluator.
Patients could identify the anesthesiologist's gender approximately 85%
of the time, regardless of group, and were more likely to identify female
anesthesiologists (P = 0.026, odds ratio 3.3). Patient evaluation of hospital,
surgical, and anesthesia care was favorable in all groups and did not vary
with group. Increasing the number of postoperative visits does not improve
patient name recognition of the anesthesiologist or increase patient satisfaction
with or perception of anesthesia services.
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