An Evaluation of the Public's Expectations and Experiences with Medical Personnel

Atef Eid Madkour Elsayed; Muhannad Khaled Badghaish; Ahmad Mahmood Shamsuddin; Fatema Hasan Mohamed Alajmi; Saleh Mohammed Alamdhi; Sultan Hassan Qurban; Khozama Abdullah Alduhaiman; Bushra Sayed Alawi Taj Hashem Kadhem; Ahmed Al Sahwan; Nouf Alshareef; Shaheen Shaher Almusthi

doi:10.63278/10.63278/mme.v31.1

Authors

Atef Eid Madkour Elsayed Consultant cardiology, King abdelaziz hospital sakaka Saudi Arabia
Muhannad Khaled Badghaish Medical intern, KSAU_HS Jeddah
Ahmad Mahmood Shamsuddin Medical Intern, King Saud bin Abdulaziz university for health sciences
Fatema Hasan Mohamed Alajmi General medicine, Professional Medical center
Saleh Mohammed Alamdhi General Practitioner, tabuk health cluster
Sultan Hassan Qurban ER Physician, Albayt medical center
Khozama Abdullah Alduhaiman Dentist, Athb Dental Clinic
Bushra Sayed Alawi Taj Hashem Kadhem Alkindi Hospital- Bahrain, Obstetrics and gynecology
Ahmed Al Sahwan PharmD
Nouf Alshareef Bachelor of Medical and surgery
Shaheen Shaher Almusthi Intern Physician, Vision college

DOI:

https://doi.org/10.63278/10.63278/mme.v31.1

Keywords:

Doctor-Patient Relationship, Patient Satisfaction, Healthcare Communication.

Abstract

Background: The relationship between healthcare providers and patients is crucial to achieving optimal clinical outcomes. While physicians’ clinical competence is universally recognized, patients in low- and middle-income countries (LMICs) increasingly prioritize communication, empathy, and technical expertise. However, a gap exists between patient expectations and their actual healthcare experiences, often leading to dissatisfaction and negative consequences, such as physician-targeted violence. Understanding and addressing this disparity is essential for improving healthcare delivery.

Methods: This cross-sectional study assessed the public’s expectations and experiences with medical personnel. A total of 500 participants were surveyed using a composite questionnaire derived from the Patient Picker Experience-15 (PPE-15) and the Exceptionally Good Doctor Survey. The questionnaire evaluated sociodemographic factors, patient expectations, and their most recent healthcare experiences. Data were analyzed using descriptive statistics and logistic regression to identify factors associated with high expectations and negative experiences.

Results: The study found that 65% of participants had high expectations of their healthcare providers, particularly in communication, professionalism, and technical expertise. However, 55% of participants reported at least one negative experience, with poor communication being the most frequent issue (45%). Participants with high expectations, especially regarding communication and professionalism, were more likely to report dissatisfaction when these expectations were unmet. Significant issues included insufficient time for consultation, dismissal of concerns, and inadequate information.

Conclusion: The findings highlight the need for healthcare providers to align their practices with patient expectations, particularly in communication, empathy, and technical expertise. By addressing these key areas, healthcare systems can improve patient satisfaction, reduce negative experiences, and foster stronger, more trusting doctor-patient relationships, particularly in LMICs where resources and infrastructure may be limited.

References

Sabaté E. Adherence to long-term therapies: evidence for action. World Health Organization; 2003.

Setlhare V, Madiba S. Doctor attributes that patients Desire during Consultation: the perspectives of doctors and patients in Primary Health Care in Botswana. Healthc (Basel Switzerland). 2023;11(6).

Hall JA, Roter DL, Katz NR. Meta-analysis of correlates of provider behavior in medical encounters. Med Care. 1988;26(7):657–75. doi: 10.1097/00005650-198807000-00002.

Zafar W, Khan UR, Siddiqui SA, Jamali S, Razzak JA. Workplace Violence and self-reported Psychological Health: coping with post-traumatic stress, Mental Distress, and Burnout among Physicians Working in the Emergency Departments compared to other specialties in Pakistan. J Emerg Med. 2016;50(1):167–77e1. doi: 10.1016/j.jemermed.2015.02.049.

Baig LA, Shaikh S, Polkowski M, Ali SK, Jamali S, Mazharullah L, et al. Violence against Health Care Providers: a mixed-methods study from Karachi, Pakistan. J Emerg Med. 2018;54(4):558–566e2. doi: 10.1016/j.jemermed.2017.12.047.

Bright T, Felix L, Kuper H, Polack S. A systematic review of strategies to increase access to health services among children in low and middle income countries. BMC Health Serv Res [Internet]. 2017;17(1):252. 10.1186/s12913-017-2180-9.

Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. High-quality health systems in the Sustainable Development goals era: time for a revolution. Lancet Glob Heal. 2018;6(11):e1196–252. doi: 10.1016/S2214-109X(18)30386-3.

Krztoń-Królewiecka A, Oleszczyk M, Windak A. Do Polish primary care physicians meet the expectations of their patients? An analysis of Polish QUALICOPC data. BMC Fam Pract [Internet]. 2020;21(1):118. 10.1186/s12875-020-01190-1.

Attree M. Patients’ and relatives’ experiences and perspectives of good and not so good quality care. J Adv Nurs. 2001;33(4):456–66. doi: 10.1046/j.1365-2648.2001.01689.x.

Razzaq N, Huda Z. Violence against doctors at government tertiary care hospitals in Pakistan: someone’s life over your own? Ann Med Surg. 2022;79:104012. doi: 10.1016/j.amsu.2022.104012.

Leonardsen A-CL, Grøndahl VA, Ghanima W, Storeheier E, Schönbeck A, Løken T-A et al. Evaluating patient experiences in decentralised acute care using the Picker Patient Experience Questionnaire; methodological and clinical findings. BMC Health Serv Res [Internet]. 2017;17(1):685. 10.1186/s12913-017-2614-4.

Schnelle C, Jones MA. Characteristics of exceptionally good Doctors-A survey of public adults. Heliyon. 2023;9(2):e13115. doi: 10.1016/j.heliyon.2023.e13115.

Dean AG, SK SM. OpenEpi;Open Source Epidemiologic Statistics for Public Health, Version. 2013 [Internet]. 2013. Available from: http://www.openepi.com/Menu/OE_Menu.htm.

Hasan A. The Urban Resource Centre, Karachi. Environ Urban [Internet]. 2007;19(1):275–92. 10.1177/0956247807076921.

Fernandes K. Katchi abadis: living on the edge. Environ Urban [Internet]. 1994;6(1):50–8. 10.1177/095624789400600105.

Abbas S, Ansari MRK. Pattern of Karachi katchi-abadies. J Basic Appl Sci. 2010;6(2).

Pakistan G, Majority. (80%) Pakistanis trust medical advice of doctors. Least trust regarding health advice is found to be in media (52%): Gallup & Gilani Pakistan [Internet]. Available from: https://gallup.com.pk/post/31480.

Maresova P, Javanmardi E, Barakovic S, Barakovic Husic J, Tomsone S, Krejcar O, et al. Consequences of chronic Diseases and other limitations associated with old age–a scoping review. BMC Public Health. 2019;19:1–17. doi: 10.1186/s12889-019-7762-5.

Saleem T, Khalid U, Qidwai W. Geriatric patients’ expectations of their physicians: findings from a tertiary care hospital in Pakistan. BMC Health Serv Res [Internet]. 2009;9(1):205. 10.1186/1472-6963-9-205.

Ghimire K, Dahal R. Geriatric Care Special Needs Assessment. 2021.

Pakistan Gof. Health and Nutrition. In. Available from: https://www.finance.gov.pk/survey/chapter_22/PES11-HEALTH.pdf.

Sagheer U, Kielmann AA, Mumtaz Z, Shahab S. Cost of establishing and maintaining a bed in a tertiary care hospital in Pakistan. Leadersh Heal Serv [Internet]. 2000;13(2):1–6. 10.1108/13660750010326848.

Kemp KA, Fairie P, Steele BJ, Santana MJ. How to analyze and link patient experience surveys with administrative data to drive health service improvement - examples from Alberta, Canada. Int J Popul data Sci. 2022;7(4):1763. doi: 10.23889/ijpds.v7i4.1763.

Mushtaque I, Dasti MR, Mushtaq M, Ali A. Attitude towards Covid-19 vaccine: a cross-sectional Urban and Rural Community Survey in Punjab, Pakistan. Hosp Top. 2021;1–8.

Aleemi AR, Khaliqui H, Faisal A. Challenges and Patterns of Seeking Primary Health Care in Slums of Karachi. Asia Pacific J Public Heal [Internet]. 2018;30(5):479–90. Available from: https://www.jstor.org/stable/27009127.

Qidwai W, Ali SS, Baqi M, Ayub S. Patient expectations from an emergency medical service. J Ayub Med Coll. 2005;17(3):3.

Qidwai W. Paternalistic model of medical practice. J Coll Physicians Surg Pakistan. 2003;13(5):296.

Khan NU, Khan UR, Ahmed N, Ali A, Raheem A, Soomar SM, et al. Improvement in the diagnosis and practices of emergency healthcare providers for heat emergencies after HEAT (heat emergency awareness & treatment) an educational intervention: a multicenter quasi-experimental study. BMC Emerg Med. 2023;23(1):12. doi: 10.1186/s12873-022-00768-5.

Imam SZ, Syed KS, Ali SA, Ali SU, Fatima K, Gill M et al. Patients’ satisfaction and opinions of their experiences during admission in a tertiary care hospital in Pakistan– a cross sectional study. BMC Health Serv Res [Internet]. 2007;7(1):161. 10.1186/1472-6963-7-161.

Saleem SG, Haider KF, Salman S, Samad L, Yasin Z, Rybarczyk M. Bridging the Gap in Emergency Medicine in Pakistan. Vol. 21, The western journal of emergency medicine. United States; 2020. p. 233–4.

Ether S, Saif-Ur-Rahman KM. A systematic rapid review on quality of care among non-communicable diseases (NCDs) service delivery in South Asia. Public Heal Pract [Internet]. 2021;2:100180. Available from: https://www.sciencedirect.com/science/article/pii/S2666535221001051.

Wasay M, Zaidi S, Khan M, Jooma R. Non communicable diseases in Pakistan: burden, challenges and way forward for health care authorities. 2014.

Ghazanfar A, Idress IN, Zia Z, Munir N, Maryam S. Comparison of patients satisfaction levels in public and private tertiary care centres. J Pak Med Assoc. 2017;67(8):1305–8.

Gala P, Sriram V, Kotian C, Ballala K, Vedanthan R, Perish E et al. Perceptions of the Doctor-Patient Relationship Among Patients in a Private, Secondary-Level Hospital in Southern India [Internet]. Vol. 9, Frontiers in Public Health. 2022. Available from: https://www.frontiersin.org/articles/10.3389/fpubh.2021.768705.

Dzau VJ, Mate K, O’Kane M. Equity and Quality—Improving Health Care Delivery Requires Both. JAMA [Internet]. 2022;327(6):519–20. 10.1001/jama.2022.0283.

Primary care doctor And nurse consultations among people who live in slums: a retrospective, cross-sectional survey in four countries. BMJ Open. 2022;12(1):e054142. doi: 10.1136/bmjopen-2021-054142.

Epstein RM, Street RLJ. The values and value of patient-centered care. Vol. 9, Annals of family medicine. United States; 2011. p. 100–3.

Kravitz RL. Patients’ expectations for medical care: an expanded formulation based on review of the literature. Med Care Res Rev. 1996;53(1):3–27. doi: 10.1177/107755879605300101.

Beckman HB, Frankel RM. The effect of physician behavior on the collection of data. Ann Intern Med. 1984;101(5):692–6. doi: 10.7326/0003-4819-101-5-692.

Lipkin M, Putnam SM, Lazare A, Carroll JG, Frankel RM. The medical interview: clinical care, education, and research. Volume 22. Springer; 1995.

Holsinger JW Jr, Beaton B. Physician professionalism for a new century. Clin Anat [Internet]. 2006;19(5):473–9. 10.1002/ca.20274.