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Barbara Starfield, MD, MPH; Donald Steinwachs, PhD; Ira Morris, MD; George Bause; Stephen Siebert; Craig Westin, MD

JAMA. 1979;242(4):344-346.

Abstract
In this study in an urban prepaid group practice, patients and practitioners agreed less than half the time as to what problems required follow-up at a subsequent visit. Problems that were mentioned by both practitioner and patient were much more likely to be followed up subsequently by the practitioner than problems initially mentioned only by the practitioner or only by the patient. Patients reported much more improvement of problems at follow-up when both practitioner and patient mentioned the problem as requiring follow-up than when they had been mentioned only by the patient. The involvement of patients in the process of care may be augmented by a variety of mechanisms. We believe greater patient participation in the processes of care should result in better follow-up of problems and better results, at least as perceived by patients.

(JAMA 242:344-346, 1979)

Author Affiliations
From the Division of Health Care Organization, The Johns Hopkins University School of Hygiene and Public Health (Dr Starfield); Health Services Research and Development Center, The Johns Hopkins Medical Institutions (Dr Steinwachs); East Baltimore Medical Plan (Dr Morris); The Johns Hopkins University School of Medicine (Dr Starfield, Mr Bause, and Mr Siebert); Baltimore; and University of Rochester Medical School, Rochester, NY (Dr Westin).

Footnotes
Reprint requests to 615 N Wolfe St, Baltimore, MD 21205 (Dr Starfield).

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