Concordant and discrepant views of patients' physical functioning

Objective. Although considerable research has been done on patient-physician interaction, few studies have examined discrepancies between patients and physicians in their assessments of the patient's physical functioning. One recent study reports such discrepancies between rheumatologists and 41% of their rheumatoid arthritis patients, This article reports data replicating that study and examining the relationships between such discrepancies and a number of other variables. Methods. This is a longitudinal study of 158 patients with rheumatoid arthritis who were interviewed 4 times over a 2-year period and who reported their levels of physical functioning on the Arthritis Impact Measurement Scales. At the time of the fourth interview, the rheumatologists rated each patient's physical functioning an the revised criteria published by the American College of Rheumatology. Results. Rheumatologists' assessments of their patients' physical functioning were discrepant with the patient's assessment for 35% of these patients. Twenty-seven patients were rated as worse than they rated themselves and 28 were rated as better. There were no differences between the concordant and the two discrepant groups in demographic of health status characteristics. Conclusions. Taken together, these data imply that it is important for physicians to verify their perceptions with the patient and that it is important for patients to verify that the physician understands them correctly.