March/April 2008 Annals of Family Medicine tip sheet

What Patients Want Most from Their Doctor’s Visit: A Thorough Examination

Although patient-centered care is important to patients, they appear to place a higher priority on the technical quality of the care they receive. According to a survey of 1,193 patients from the United Kingdom, patients value the thoroughness of the primary care consultation most highly, followed by seeing a physician who knows them well, seeing a physician with a warm and friendly manner, having a reduction in waiting time for an appointment, and having flexibility in selecting appointment times. Specifically, patients were willing to pay the most for a thorough examination ($40.87), followed by seeing a physician who knew them well ($12.18), seeing a physician with a friendly manner ($8.50), having a one day reduction in waiting time for an appointment ($7.22) and having flexibility in selecting appointment times ($6.71). Patients placed similar value on the different aspects of patient centered care ($12.06-$14.82).

The authors assert these results can inform policy discussions about issues such as pay for performance and the balance between incentives for technical and nontechnical aspects of care.

What Patients Want From Primary Care Consultations: A Discrete Choice Experiment to Identify Patients’ Priorities
By Sudeh Cheraghi-Sohi, B.Sc., et al

Daily Psyllium Fiber Supplement Not Effective in Reducing Inflammation Associated With Cardiovascular Disease in Overweight Adults

Daily psyllium fiber supplementation by overweight or obese adults does not appear to significantly reduce the levels of inflammatory markers that play a role in cardiovascular risk. These findings contrast with previous research, which demonstrated lower levels of inflammatory markers in people who consume greater than 20 grams of fiber daily. In this new trial involving 158 participants, researchers found no significant differences between the treatment groups (28 grams per day or 21 grams a day of total daily fiber on average) and the control group in the amount of change in C-reactive protein concentration, interleukin-6 levels, fibrinogen levels or white blood cell counts. The authors point out that these findings do not negate the epidemiologic evidence that dietary fiber is a factor in reducing inflammation or the risk of cardiovascular disease, but the data do suggest that fiber supplementation with psyllium does not replicate the results seen with a diet naturally high in fiber.

Effect of Psyllium Fiber Supplementation on C-Reactive Protein: The Trial to Reduce Inflammatory Markers (TRIM)
By Dana E. King, M.D., et al

Large Number of Rural Residents Seek Medical Care Outside Their Local Communities