Patient certification through mutual problem lists.

Objective: To determine whether retired military personnel and spouses are cognizant of the patient's complete list of medical problems.

Methods: Receiving help from their spouses or other personal care givers, 12 patients listed their health problems from memory plus from a page-by-page review of their permanent medical records. The personal physician produced his own lists and combined them with the patient-generated lists. After mutual review, these combined lists were accepted as the mutual problem lists. Other professionals in the clinic also audited the same patients' charts.

Results: Twelve patients identified an average of 4.58 problems, the physician identified an average of 7.75 problems, and the other professionals identified an average of 6.54 problems.

Conclusion: This lack of agreement has implications for patient education and certification as full collaborators in primary care.