Strategies Primary Care Physicians Use to Deny Patient Requests

Physicians need strategies for addressing patient requests for medically inappropriate tests and treatments. We examined communication processes that physicians use to deal with patient requests of questionable appropriateness. Conclusion: Strategies for saying no may be used to communicate appropriate care plans, to reduce provision of medically inappropriate services, and to preserve the physician- patient relationship. These findings should be considered in the context of physician education and training in light of increasing health care costs.

Debora A. Paterniti, PhD; Tonya L. Fancher, MD, MPH; Camille S. Cipri, BS; Stefan Timmermans, PhD; John Heritage, PhD; Richard L. Kravitz, MD, MSPH