Journal of general internal medicine
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Multicenter Study Clinical Trial
Promoting advance directives among elderly primary care patients.
To determine efficient ways of promoting advance directives among heterogeneous populations of elderly ambulatory patients. ⋯ A replicable intervention largely targeting doctors achieved a modest increase in advance directives among elderly ambulatory patients. Future interventions may need to target lower-income patients, "younger" elderly, and more specifically address doctors' attitudes and comfort discussing advance directives.
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Physician self-disclosure has been viewed either positively or negatively, but little is known about how patients respond to physician self-disclosure. ⋯ Physician self-disclosure is significantly associated with higher patient satisfaction ratings for surgical visits and lower patient satisfaction ratings for primary care visits. Further study is needed to explore these intriguing findings and to define the circumstances under which physician self-disclosure is either well or poorly received.
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Multicenter Study Comparative Study
Race and patient refusal of invasive cardiac procedures.
To determine whether patients' decisions are an important determinant of nonuse of invasive cardiac procedures and whether decisions vary by race. ⋯ Patient decisions to decline recommended invasive cardiac procedures were infrequent and may explain only a small fraction of racial disparities in the use of invasive cardiac procedures.