A Comparison of outcomes for walk-in clinic patients who see interns and those who see staff physicians

Purpose. To collect pilot data on the effect of interns' involvement on patient care outcomes. Method. Between January 1995 and August 1998, 750 patients at a walk-in clinic completed pre-visit questionnaires on symptom- related expectations and functional status. Three follow-up surveys (immediately after the visit, at two weeks, and at three months) assessed symptom outcomes, satisfaction, illness worry, and unmet expectations. Physicians were surveyed about their perceptions of the 'difficulty' of each patient encounter. Results. During the study period, 195 patients (26%) were seen by interns and 555 (74%) by staff physicians. The patient groups did not differ in illness worry, unmet expectations, or satisfaction immediately after the visit, at two weeks, or at three months. Patients seen by interns were more satisfied with the time they had spent with their clinicians (p = .007). Interns were more likely to experience their patient encounters as difficult. There was no difference in visit costs, subspecialty referrals, health utilization, or hospitalization rates. Conclusions. Patients who are seen by interns in an ambulatory clinic are similar to those who are seen by staff physicians in terms of post-visit satisfaction, residual expectations, symptom resolution, and functional status improvement.