Saying ‘no’ to patient requests lowers physician ratings, study finds

Doctor examining patient
Researchers suggest doctors may benefit from communication training to help them when denying a patient request for tests or treatment. (Getty/kazoka30)

When doctors deny special requests from patients they often see their satisfaction levels drop, according to a new study.

Patients who ask for referrals to specialists, laboratory tests or certain medications and have their request denied tend to be less satisfied with their physicians, according to a study published in JAMA Internal Medicine.

The researchers from UC Davis Health suggested that communications training could help doctors effectively respond to patient requests for unnecessary tests or treatments.

“Physicians rarely receive training on how to deal with those situations, which is crucial given the importance placed on patient satisfaction survey results in improving healthcare and, in some cases, to determine physician compensation,” lead author Anthony Jerant, M.D., chair of the department of family and community medicine at UC Davis Health, said in an announcement about the study findings.

The study included more than 1,100 patients in the family and community medicine clinic at UC Davis Health. These patients made 1,700 specific requests of their doctors, When the physicians fulfilled patient requests, which was about 85% of the time, their satisfaction ratings were generally high, the study found. But when they denied requests for referrals, pain medications, other medications and tests, satisfaction ratings dropped significantly, by 10 to 20 percentage points.

Physicians may be able to use a strategy known as watchful waiting, where they don’t give a patient a flat denial but don’t give an immediate "yes" to a request, to keep patients more satisfied, Jerant suggested.

Previous research has shown that effective, empathetic communication with patients makes them much more satisfied with their care experience. Doctors can take specific steps, such as those found on a checklist, to improve the patient experience during office visits, Hawaii Pacific Health, a nonprofit healthcare network discovered.