Redefining Appropriate Treatment Expectations

A number of studies suggest that physicians are not adequately addressing patients' expectations, resulting in widespread dissatisfaction with the quality of care. Patients complain that providers fail to appreciate the impact of symptoms on function and neglect discussion of diagnosis and prognosis. Physician-patient communication appears to be central to patients' perceptions of quality of care. Specifically, addressing patients' expectations may influence satisfaction as much, or more than, the outcome of treatment itself. The gap between patient expectations and physician response is cited commonly in studies conducted in patients with painful conditions. This review describes factors that contribute to the expectation gap, with emphasis on studies conducted in this patient subset.