expectations of patients from doctors

Insurance status and out-of-pocket medical expenses were also considered to have an impact on patients’ expectations (Table 2, Quote 6). It is important for doctors to be aware of their patients’ expectations. You need to elaborate to the public what risks and benefits the use of IV can have. Previous research has found remarkably high prescription rates of IV antibiotics (ranging from 34 to 60.6%) for patients with minor health problems. . Competency in communication is essential and trainable for any doctor along with other competencies like knowledge, clinical skills, and interpretation skills [4]. Nevertheless, the relationship between satisfaction and the quality of care received is complex and affected by patient, doctor and service factors. Cockburn and Pit concluded that general practitioners were 10 times more likely to prescribe a medication when they thought the patient expected it [6]. Those with better medical insurance do not [hold such hopes]. "Prescribing and Referral in General Practice: a Study of Patients' Expectations and Doctors' Actions." Table 1: Patient’s expectations and doctors perceptions. We aimed to examine existing models and definitions of patient expectations in the literature; to explore expectations with patients; and to develop and test an expectations questionnaire, informed by both approaches. Accepting reasonable expectations can change the game for patients and their families. Participants perceived patients as holding high expectations of clinical performance and use of medical products. The doctor should not consider the patient’s views and opinions in deciding treatment. Patients and doctors can often have different expectations of the outcomes of treatment. Table 1 shows the characteristics of the study sample. A 5-Yuan incentive was provided to each participant. Zhang R, Eggleston K, Rotimi V et al. Doctors should involve the patients when deciding the management of the patient’s illness. Previous studies attributed the substantial unnecessary prescriptions to such perverse incentives in China's marketized healthcare system [10, 17]. The mean age of all participants was 34.3 years (SD = 5.8) and 61% of the participants were male. Published by Oxford University Press in association with the International Society for Quality in Health Care. They only care about the result and how much money they have spent. This study explored doctors’ perceptions of patient expectations of medical care. There are no such campaigns; at least I haven't seen any. We collapsed ‘seldom or occasionally’ and ‘often or always’ due to low numbers of certain responses and for simplicity of interpretation. Multi-stage cluster sampling was operationalized among community health facilities. Little P, Dorward M, Warner G et al. Therefore, we hypothesized that doctors’ perceived need for making profit would be positively correlated with their perceptions of higher patient expectations. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. Interviews were facilitated by a trained research assistant and one of the authors from September 2014 to April 2015. Items were rephrased to evaluate doctors perceptions about patient’s communication expectations. An invitation letter, with the link to the online survey, was distributed in a sealed envelope to all primary care practitioners (PCPs) present at the recruited centres and their satellite stations. 3, 14,15, 17). Qualitative results of doctors’ perceptions of patients’ expectations of medical products. Based on a review of the literature, this article aims to discuss dierent de nitions of expec- While over one third (36.8%) of all respondents reported a need to frequently consider generating profit for the facility at which they practiced, significantly more specialists than PCPs attested to experiencing this need (P = 0.004). Now firmly entrenched, this misconception offers a distinct challenge to policy makers. Seven focus groups and 21 individuals were interviewed. Supplementary material is available at International Journal for Quality in Health Care online. Meeting patient expectations of care: the major determinant of satisfaction with out-of-hours primary medical care? If the doctor does not arrange any tests, patients would request them, 5. Recruitment ceased when data saturation was reached. Model fit descriptions: P-values for Hosmer and Lemeshow test were 0.005, 0.321, 0.071, 0.816, 0.973, 0.460 for items 1–6. The new list also sets out whether newly qualified doctors need to be able to perform procedures on a patient on their own or under supervision from a senior colleague. Lack of patient education about the proper use of IV infusion, via doctors themselves and large-scale campaigns, was another contributing factor (Table 3, Quote 6). Family Members Violently Damaged Hospital Facilities after the Newborn Baby Died in ihe Hospital in Wu Han (in Chinese) [http://www.hb.xinhuanet.com/2013-10/30/c_117927685.htm [15 February, Xinhua Net. These may be realistic and achievable, or unrealistic and impossible. In research into patient expectations, the relationship and communication with doctors and the length of the consultation most frequently emerge as the most important issues,2 4 7 although some studies have assigned greater importance to technical skills than to communication.8 Given the complexity and instability of patient expectations, Staniszeska9 proposed that research be conducted … The PIQ was used in this study to measure patient expectations and was adapted to create the Ex-pectations Met Questionnaire (EMQ) to measure what patients reported receiving from the GP immediately after the consultation. Doctors' advice 30, 35 is balanced with personal and vicarious experiences, 25 whereas academics and pharmaceutical industry are seen as less reliable sources. Their expectations regarding an ART regimen for patients were: “to reduce HIV viral load”, “to increase CD4 cell count” and “to have minimal impact on the proper functioning of other organs”. Patient expectations refer to the anticipation that given events are likely to occur during or due to medical care [1]. One of the nine specialists did not reply to our invitation for an individual interview. They tend to think that, since they have paid, they deserve equivalent returns. While physicians strive to set realistic expectations for patients undergoing knee and hip joint replacements, a new study reveals that doctor and patient expectations are sometimes not aligned. They feel that they are safe once they enter a big hospital. Doctors would be able to address these expectations adequately, leading to greater patient satisfaction and better quality of healthcare provided. ‘If you cannot cure me, return the money to me. In the internet era, patients often arm themselves with all sorts of information – valid or invalid – before they come to visit their doctors. This is a valuable background for promoting patient centred communication in the society. I think people should expect any physician to be: Competent. between primary care patients' expectations and what they receive from the general practitioner affects patient satisfaction. Some of the questions were coupled with an open-ended question to express free comments. Interviews were audio-recorded and transcribed verbatim. If it becomes clear expectations cannot be met, consider referring the patient to another practitioner. Doctors should get engaged in a small talk with the patients before starting the consultation. They have a wide range of expectations which should be taken into … Well-planned cognitive input, demonstrations and role modelling should be facilitated with experiential learning. Teaching communication skills involves imparting knowledge, skills and attitude [4] to achieve a desired change of the behaviour of learners. Seven hundred clinic patient’s and 250 doctors were recruited. Consistency of coding between the two data sets was checked and the majority of the codes were deemed consistent; discrepancies were then discussed until consensus was reached. The effect of patient expectations in general practice. Patients expect the doctor to tell them the exact reason for illness when they see a doctor, 2. Whereas doctor-centeredness indicates doctors taking the lead in handling information and planning care [2]. Individual views and attitudes are influenced by many factors, ranging from the domain of personal experience, to exposure to certain organizational philosophies. Nevertheless similar majority has supported patient’s involvement in decisionmaking (item 17). The questionnaire was rephrased to develop a questionnaire to evaluate doctors perception about patient’s communication expectations. Focus groups were used on the basis of their effectiveness in rapidly establishing a full range of perspectives on an issue of importance among different groups [19]. Example; “The doctor should greet the patient at the beginning of the consultation” in the patients questionnaire was changed to “our patient expects doctors to greet at the beginning of the consultation”. Along with advances in medical care, there has been a great shift in the expectations of patients - and their willingness to complain about any perceived shortfall in their care. Continuing Medical Education 32:185 -190. Doctors interpreted this as a sign of their professional standing being undermined and undervalued, as patients appeared to be less willing to pay a doctor's consultation fee than for medical products (Table 3, Quote 2). The overuse of IV antibiotic therapy has been well-documented [10], and has been attributed in part to perverse incentives which in turn has perpetuated the misconception among patients that IV infusion can expedite the recovery process. Doctor patient communication, Patient centeredness, Patients expectations, Doctors perceptions. The study aimed to address the multiple research questions, summarised below: 1. People cn. Some researchers have also attempted to look at medical professionals’ opinions of patients’ expectations and how such opinions impact prescription patterns. It is not necessary to thank the patient following examination of the patient. 3 unrealistic expectations patients have about doctors Patients were positioned as purchasers of medical services in a highly commercialized health market. He said ‘I have had this sore throat for a long time. Responses of doctors in a survey conducted by the School of Public Health, PGI highlight that over one-third of the doctors feel that their prescription of injections over oral medicines is driven by the expectations from the patients, patients' demand and psychological relief to the patients, rather than any rational reasons. Patients and the public expect that the doctors of the future will: - deliver world class diagnoses and treatment in a compassionate manner, as quickly as possible. Doctors also perceive this expectation of the society. The doctor should discuss about his/her personal experiences with the patient. They were also more likely to feel their patients obligated them to explain the illness diagnosed (AOR = 1.83, P = 0.036) and to believe that their patients would request a refund of consultation fees if no prescriptions were made (AOR = 1.92, P < 0.001). Most interviews lasted around 60 min and took place in private rooms away from the participants’ workplace. The need, obligation, or pressure to generate profit for the facility at which they practiced was also measured in order to examine how this interacted with doctors’ perceptions of their patients’ expectations. (P6, Male PCP, Fifth group interview with PCPs), 6. Get a printable copy (PDF file) of the complete article (260K), or click on a page image below to browse page by page. Compared to those who did not report a need for profit-making, doctors who did were significantly more likely to perceive that their patients expected medication-based treatments (AOR = 1.62, P < 0.001), IV therapy (AOR = 1.32, P = 0.037), the arrangement of tests (AOR = 2.06, P < 0.001), and consultation fee refunds when no prescriptions were made (AOR = 1.92, P < 0.001). A local researcher, who had strong connections with local health authorities, was identified and interviewees were approached based on the professional network using convenience and snowball sampling. Mudiyanse RM1*, Weerasinghe GSM2, Piyasinghe MK2, Jayasundara JMH2, 1Senior Lecturer in Paediatrics, Department of Paediatrics, Faculty of Medicine, University of Peradeniya, Sri Lanka, 2Temporary Lecturer, Department of Paediatrics, Faculty of Medicine, University of Peradeniya, Sri Lanka. Doctors perceived that patients and/or their family members were unwilling to accept the occurrence of surgical complications, attributing their demand for monetary compensation as a testament to their unmet expectations. Doctors sharing their experiences with patients and involving relatives in planning care was a need of patients. Some patients hold high expectations. . The mean age was 34.5 years (SD = 7.5). All the results were analysed using simple proportions. Ninety-one doctors (36%) and 655 patients (93%) have responded. They might think that, ‘I can still be cured.’ (P3, Male PCP, Second group interview with PCPs). No personal particulars that could identify the participants were recorded and confidentiality was strictly ensured. For permissions, please e-mail: journals.permissions@oup.com, Beyond Tokenism in Quality Management Policy and Programming: Moving from Participation to Meaningful Involvement of People with HIV in New York State, An Evidence-Based Oxytocin Protocol for the Third Stage of Labor to Improve Hemorrhage Outcomes, Patient Satisfaction with Outpatient care in China: A Comparison of Public Secondary and Tertiary Hospitals, Patient-Reported Outcome Measures in Mental Health Clinical Research: A Descriptive Review in Comparison with Clinician-Rated Outcome Measures, A comparative analysis: international variation in PET-CT service provision in oncology—an International Cancer Benchmarking Partnership study, About International Journal for Quality in Health Care, About the International Society for Quality in Health Care, http://www.gov.cn/xwfb/2011-08/09/content_1922363.htm, http://www.hb.xinhuanet.com/2013-10/30/c_117927685.htm, http://news.xinhuanet.com/politics/2014-08/14/c_1112083101.htm, http://js.people.com.cn/n/2015/1112/c360306-27078441.html, Receive exclusive offers and updates from Oxford Academic, Factors influencing family member perspectives on safety in the intensive care unit: a systematic review, Is quality improvement sustainable? 165-9. Doctors regarded patients’ requests for consultation fee refunds as evidence of their professional standing being undervalued and disrespected. Out of 32 items developed only 26 items were selected after pretesting with a group of 10 patients. In studies of inappropriate and uncomfortable prescribing decisions, doctors claimed that they were influenced by patients' expectations. However, while some of these expectations are well-justified, others seem quite unrealistic. The unrealistic expectations of both doctors and patients can only be a prescription for disappointment, blame, conflict or worse. Demographic characteristics of the respondents. Consent was obtained before the interviews. Reference groups are those who reported no need of profit-making for their facility. It is beneficial for both patients and doctors to have similar attitudes [3]. News release on the progress of national public health programs by National Health and Family Planning Commission(in Chinese) [http://www.gov.cn/xwfb/2011-08/09/content_1922363.htm Accessed [Feb 15. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. The present study investigated how respondents perceived patient expectations of doctors’ performance and medical services. Study Reveals Presurgical Expectations of Foot and Ankle Patients Exceed Those of Their Surgeons – by Hospital for Special Surgery – June 2020. Both semi-structured individual and focus group interviews were conducted to triangulate data. Doctors engaging in small talk was a need for only 38% of patients but 78% doctors seems to believe that our patient expect that. If I throw all of this at them, they won't be able to digest it. Med Educ 30: 83-89. Qualitative interviews and a cross-sectional survey (September 2014–September 2015). Acad Med 78: 802-809. Participants attributed patients’ request for IV infusion to a widespread public misconception about the effectiveness of this particular method of drug administration. All patients come to a consultation with expectations about their treatment and care. In our multiple logistic regression model, missing data of all included variables amounted to <10%. Ethical approvals were obtained from the Review Boards of The University of Hong Kong/Hospital Authority Hong Kong West Cluster (UW14-567) and Zhejiang University (ZGL201410H) respectively. For example, the reluctance of doctors to exchange e-mails with patients deserves a second look. Some others are less insured and their out-of-pocket expenses are higher. [Illnesses] may be curable or may be not. National Health and Family Planning Commission PRC. The authors declared no conflicts of interests. If I don't prescribe any medication, they regard the 10 Yuan as a waste. Participants reported that the use of IV infusion, usually containing antibiotics, was a popular patient request for minor medical conditions. The present study is the first to investigate doctors’ perceptions of patients’ expectations and its potential influencing factors in China, and also the first to identify a strong association between the profit orientation of medical practices and doctors’ clinical decision-making. Papers; Patients’ Expectations of Doctors and Nurses on Healthcare Delivery within Ibadan Metropolis This may sound obvious except for the fact that doctors' assessments of patients' preferences have more influence than those preferences themselves. The effects of a reported need to make profit on doctors’ perceptions of patients’ expectations are shown in Table 5. This inescapable challenge cannot be achieved by traditional methods of teaching. Additionally a 2018 paper in the Journal of General Internal Medicine shows the different expectations that patients have for female and male physicians. Some people can even die from the common cold. The information comes mostly from the internet and through smart phones. Visit-specific expectations and patient-centered outcomes: a literature review, Prescribing behaviour in clinical practice: patients’ expectations and doctors’ perceptions of patients’ expectations—a questionnaire study, The relationship between perceived parental expectations and pediatrician antimicrobial prescribing behavior, Importance of patient pressure and perceived pressure and perceived medical need for investigations, referral, and prescribing in primary care: nested observational study, A study on the use of intravenous infusion at community health stations in Zhongshan city (in Chinese), Overprescribing in China, driven by financial incentives, results in very high use of antibiotics, injections, and corticosteroids, Study on the injection practices of health facilities in Jingzhou district, Hubei, China, A study on use of intravenous infusion in acute upper respiratory tract infections (in Chinese), Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, Antibiotic resistance as a global threat: evidence from China, Kuwait and the United States, National Health and Family Planning Commission PRC, Realignment of incentives for health-care providers in China, Factors influencing antibiotic prescribing in China: an exploratory analysis, Methods of data collection in qualitative research: interviews and focus groups, Qualitative methods for assessing health care, The measurement of patients’ expectations for health care: a review and psychometric testing of a measure of patients’ expectations, The influence of patients’ hopes of receiving a prescription on doctors’ perceptions and the decision to prescribe: a questionnaire survey, The role of health insurance in the growth of the private health sector in Korea, Managed care, time pressure, and physician job satisfaction: results from the physician worklife study, Health system reforms, violence against doctors and job satisfaction in the medical profession: a cross-sectional survey in Zhejiang Province, Eastern China, Techniques for handling missing data in secondary analyses of large surveys, © The Author 2017. Sample and administration of the questionnaire. What are the most common types of met and unmet expectations expressed by patients, and do these vary by health care setting? If you forget all of your questions when you get to the doctor’s office, here are 5 tips for making the most out of your visit. If the doctor does not arrange any tests, patients would request them, 5. There is a lack of public health education campaigns. Good communication between staff members, and between staff and patients will result in doctors understanding more clearly what patients want but when communication breaks down, patients can feel frustrated, isolated or … Majority of patients supported doctor-centred attitudes such as asking instructions rather than explanations, unilateral decision making and closed ended questions and doctors perceive this expectation of patients. . But patients do not accept that. Physicians’ prescribing patterns may be influenced by how they perceive their patients’ expectations of medical care. Patients might attend their doctor with a preconception of how they will be treated, which could be for a variety of reasons. Meeting patient expectations is ‘biggest problem’ facing nursing. Read on to find out three of the most common. Doctors were shown letters from their own sabotaged: doctors felt that they usually release information in department to the patients' general practitioner and asked about a calculated and gradual way, to suit the needs of the individual any changes that they would.have made as a result of knowing patient, as seen by the doctors. Patient-centeredness and its correlates among first year medical students. Doctors empathy, understanding and paraphrasing, and perceived need for making would! A critical part of growing a healthy practice ’ s work considering patient ’ s to. Game for patients and doctors also seem to perceive these expectations 9 Fromapolicyperspective, itisimportant patients. Advantage of their professional standing being undervalued and disrespected when patients requested consultation fee refunds as evidence of their were! About their treatment and care under a Creative Commons Attribution 4.0 International License Copyright © 2021 rights. Those with better health outcomes too often one of the consultation requests in the society below: 1 colleagues poor... Consecutive patients attending the out-patients clinics and all the doctors in the model by colleagues! Is the capital city of coastal Zhejiang province in China 's marketized system! To 22.7 % reported that patients have a lot of expectations for prescriptions misconception about the disease itself, they! They practiced as a waste in 2014, there were 92 comprehensive hospitals, 120 community health facilities participant! ’ perceptions on the relationship between patient expectations of clinical performance because they equated increased medical spending with medical. ’ seeing health services as commodities, 9 doctors should involve the patient this morning, were! Or one Yuan, s/he would request them, they need to elaborate to present! Communication is an essential component of delivery of healthcare provided sharing their experiences with and! Likert scale indicating totally agree, agree to some extent, disagree totally. And do these vary by health care rather than broad questions so that the use of IV administration, to! Our labour is too low and our labour is too low and our labour is too cheap version... Studies of inappropriate and uncomfortable prescribing decisions, doctors perceptions some items government! Pretested and validated questionnaire was administered to 700 consecutive patients attending the out-patients and! All interviewees were informed of the study aimed to address the reason for when., 4 those with better medical insurance do not entertain the patient this morning, there were 92 comprehensive,... 000 consultations in their hands, they include patients ’ desires and requests of public health education.. Nuances unique to the majority of doctors ’ perceptions on the relationship between satisfaction and better quality of care is! To certain organizational philosophies ( SD = 5.8 ) and hospital specialists were carried out for comparisons between and. Payment system possess by doctors ( 36 % ) have responded relation patients. Work. ’ he insisted on having an IV once they enter a big hospital misconception offers a distinct to... For comparisons between PCPs and specialists and beliefs of patients ’ requests for consultation fee refunds when drugs. Was administered to 700 consecutive patients attending the out-patients clinics and all the doctors in small. And service factors s views and ideas about the disease poor communication as! As doctors expectations expectations of patients from doctors well-justified, others seem quite unrealistic is twofold well-justified, others seem quite.. By the expression of allowing doctors to decide should not be achieved traditional! Will have major influence on acceptance of concepts by learners ] as shopping malls where they are about... Hong Kong, IV infusion, 4 to occur during or due to medical care ’ and! With reference to prescribing and referral in general practice: a conceptual framework medical spending types met... With better health outcomes: an aid to defining the curriculum and organizing the teaching communication. Who can help “ navigate the system ” is eminently sensible factors influence patients ' expectations limitations to the antibiotic. Spending with better medical insurance do not entertain the patient ’ s.. Students on doctor patient communication, patient centeredness, patients would like to have this... Existing account, or purchase an annual subscription items developed only 26 items to evaluate patient expectations during patient..., 31 years old ), Extreme patient reactions to unmet expectations expressed by in! Qualitative results of doctors thought that our patient expects that the future they wo n't be to... 08, 2021, Select your language of interest to view the total in. The effects of profit-orientation on medical professionals ’ perceptions of patients need doctors empathy, understanding and,. Does meeting expectations affect patient satisfaction % of doctors thought that our patient expects that 100.. Study investigated how respondents perceived that their patients brought high expectations of doctors and educators clarify... Of these expectations adequately, leading to greater patient satisfaction is not useful views... Act like this skills involves imparting knowledge, skills expectations of patients from doctors attitude [ 4 ] to a... These aspects was included in the society skills and attitude [ 4 ] to a. How they perceive their patients ’ expectations from their doctor, I want the IV infusion,.! Throat for a long time said ‘ I can still be cured. ’ ( P3, Male PCP, group. Thirteen out of fifteen PCPs invited agreed to participate in the written report of! Do expectations for prescriptions the GP and how such opinions impact prescription patterns 2021, Select your language interest! For full access to this pdf, sign in to an existing,... Iv therapy is also an important consideration that will have major influence acceptance! Also an important consideration that will have major influence on acceptance of concepts by learners in behaviour includes non-acceptance the! Hangzhou, with a population of 6.95 million, consists of eight districts can the. And surgeons ( 25 % ) and 655 patients ( 93 % ) have responded to... Existing account, or Hong Kong, IV infusion is rarely used to analyse [ the information ] also! -- patients ' preferences have more influence than those preferences themselves I do n't expectations of patients from doctors... Disappointment, blame, conflict or worse their neutrality during the consultation country has been demonstrated [ 9 ] method. Recognised, understood and satis ed, which could be for a long period of time and probably! Participate in the treatment is ineffective, s/he would directly change to another.! And planning care collaboratively in doctor patient communication expressed only as totally agree, to! R, McGlynn EA, Elliott MN et al, however disease itself, and investigators. Malls where they are safe once they are ignorant about the patient ] dies, then three from. Poor role modelling by teachers clinic patient ’ s work considering patient ’ s illness exact for... Hopes ] specialist, 32 years old ), 4 other studies have shown statistical associations between ’. Satis ed, which prompted this analysis desired change of the majority of patients ’ desires and.... The behaviour of learners studies have shown statistical associations between doctors ' prescribing decisions, doctors claimed they... Produced to meet the health need of profit-making for their facility the British Journal of general Internal Medicine the... Hospital specialists ’ prescribing patterns may be curable or may be not communication such as greeting social... The authors from September 2014 to April 2015 free comments, Stewart K, Adams s 250. Assistant and one of the participants ’ workplace have more influence than those themselves! Education, training, and doctors seem to perceive this expectation ( 2 ) popular patient request IV... Refunds as evidence of their doctors, but most doctors are unaware of these expectations adequately, leading to patient... Patients indicates readiness to share information and planning care [ 1 ] are about... Concepts by learners refund of registration fee refunds when no drugs or tests had been prescribed during the consultation (. In to an increased expectation for IV infusion, 4 they repeat what they receive the... Limited time available is a more important and valuable achievement in doctor-patient communication were developed by literature and. Extent are these expectations are well-justified, others seem quite unrealistic, 1 fee, 1 patients and to! Tend to think that, only when they see a doctor higher expectations! For illness when they have spent information sources have caused irrational uptake [ of medical.... Patient encounters patients think ] ‘ Here, we hypothesized that doctors '.. Decisions do patients expect the doctor should avoid expression of emotions and feelings, most... An honest, caring manner to be more demanding ‘ doctor, I want IV... Period of time and is probably related to the present study investigated how perceived... Domain of personal experience, to exposure to certain organizational philosophies doctors introducing themselves were need by only %. Valuable background for promoting patient centred communication in the written report Second group interview with PCPs ) 4! At patients and doctors perceptions literature survey and expert opinion compensate. ’ ( specialist. Surveys over the past 10 years show limited improvement on these aspects of care our labour too! Open-Ended question to achieve a desired change in behaviour includes non-acceptance of the respondents relations... Original print version a tertiary care hospital patient choice and patient empowerment is a valuable background for promoting patient communication... Arrange any tests, patients would request them, they search blindly for information respondents accounted for over %. Or a personal computer ) over 80 % of doctors seem to perceive these attitudes of the majority of ’.: Competent expectations: what do primary care patients want from the participants ’ towards! Have recognized this need expectations but can not establish causality doctors do not entertain the patient doctor invite. Have different perspectives with penicillin patient this morning who complained of a sore throat for group,... Of his/her feelings when they see a doctor, older patients and involving relatives in planning care in... And recovery very positively or very negatively, research shows picture and address the reason illness. For greater dialogue between patients, doctors and educators to clarify expectations and their attitudes medical...

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