Physicians' opinions on patients' requests for specific treatments and examinations.

Objective: The number of technologies used in health care is growing, patients' educational level has risen, health and drug information is increasingly available and patients today are actively looking for information from different sources. The aim of the study was to investigate physicians' opinions on patients' requests for specific treatments and examinations.

Design: The data were gathered as part of an annual physician's survey sent to all Finnish physicians (n=16,698) by the Finnish Medical Association in March 2002. The response rate was 85% (n=14,157). Physicians involved in clinical work were selected for this study (n=12,255).

Results: Half (53%, n=6,521) of the clinicians reported either 'very often', or 'often' receiving requests from patients for specific treatments or examinations, and of them, 76% (n=4,972) reported an increase in such requests. The younger clinicians received more often patient requests. Women physicians, those working in health centres, and non-specialized clinicians reported more experience of, and an increase in patients making requests. Of those clinicians who received patient requests 'very often' or 'often', 24% (n=1,595) considered such requests as having a positive, and 43% (n=2,808) a negative, effect on patient care and interaction; clinicians who did not receive many patient requests had similar opinions. Older, men, those working in private practice and specialized clinicians had a more positive attitude towards such requests than other clinicians. The reasons given for the positive and negative opinions were varied.

Conclusions: Active patients (consumer patients) are a reality in the Finnish health care system. Physicians have varying opinions on this phenomenon.