Presence of observers at patient-practitioner interactions: impact on coordination of care and methodologic implications

Am J Public Health. 1979 Oct;69(10):1021-5. doi: 10.2105/ajph.69.10.1021.


In this study in an urban practice, the presence of a neutral observer at follow-up visits enhanced the extent to which practitioners recognized problems which patients had in a previous visit. This improvement was limited to those problems which initially had been mentioned by patients as requiring follow-up. Follow-up of problems initially mentioned by practitioners as needing follow-up was not improved by the observer unless the problem was also mentioned by the patient. Investigators whose information about practitioner-patient interaction depends upon the presence of an observer should be aware of this and possibly other effects. Although routine involvement of a neutral observer in patient-practitioner interactions is probably undesirable, selected deployment of observers or similar alternatives may be useful in situations where practitioner-patient communication is inadequate.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Child
  • Continuity of Patient Care
  • Group Practice, Prepaid
  • Humans
  • Maryland
  • Medical Records*
  • Patient Compliance
  • Personal Health Services
  • Physician-Patient Relations*
  • Primary Health Care