Choice of Providers

Anchoring Vignettes for Choice of Providers

Questions:

Now, overall, how would you rate [your/name of person's] experience of being able to choose to see the health care provider [you/he] went to?

Response categories:

1. Very good
2. Good
3. Moderate
4. Very bad
5. Bad

Vignettes:

1. [Simon] has joint pains and breathlessness. He sees two specialists for these problems once every 2 months. Recently as his breathlessness was worsening, he asked to see a heart specialist. On his request, he was referred to a heart specialist who adjusted his medicines.

2. [Zubin] lives in a large city with more than 5000 doctors. Zubin belongs to a medical insurance that allows him to go to any of these doctors. After using a few different doctors, Zubin decides that he prefers using one particular doctor, Dr Chowdary. He told the last doctor he saw before Dr. Chowdary and this doctor transferred his medical records to Dr. Chowdary who was able to see [Zubin] as his regular doctor.

3. [Nathan] went to a clinic because of headaches. The doctor there gave him medicine but that did not help. [Nathan] asked twice to be referred to a specialist. The second time, the doctor agreed to refer him to a specialist, Dr Ready. Dr Ready examined him and detected cancer. He recommended surgery. [Nathan] knew of a surgeon he liked and asked whether this surgeon could operate on him. Dr Ready phoned this surgeon and was able to arrange for that surgeon to operate on [Nathan].

4. [Ibrahim] had stomach problems for several years. He has visited his doctor many times. His requests for a referral to a particularly well-known stomach specialist have been turned down because his doctor was sure that he was capable of treating the illness and assured [Ibrahim] of this.

5. [Waheed] was feeling pains in his chest and was worried that he was having a heart attack. He went to a city clinic he usually used but they turned him away because they were full. He explained to the nurse that he wanted to use that clinic because he knew the place and the staff there and didn't want to change environments when he is feeling sick. They agreed to take him in.

6. [Alfredo] has a doctor, whom he consults regularly. Recently, friends advised him to consult a herbalist [substitute appropriate name for a type of alternative medicine provider ] for a skin problem. When he asked for a referral, his doctor said that he would prefer to send him to a skin specialist he knew.

7. [Andhaka] went to a hospital in the city. The hospital was large with different sections for different diseases. After he told the nurse he had an ear infection, he was sent to a particular department dealing with ear infections. When he went to the department, he saw the doctor on duty. On returning for a follow-up visit, he asked to see the same doctor but he was told that he could not see him because he was not available.

8. [Sophia] has a lump in her chest, and is referred to a hospital for surgery. She wants her doctor to operate on her but the hospital says its not possible because only government employees can operate at that facility. She would like to go to another hospital but the only other one near her is too expensive. She resigned to having the operation done by some other doctor she does not know.

9. [Mamadou] goes to the community health centre for his epilepsy. When the health centre is not very busy, he can choose which doctor he wants to see. But when it is busy, he cannot decide which specific doctor he will see, because at those times he gets sent to whoever is free.

10. [Pascal] had his blood pressure taken several times at a certain hospital . Each time that he went, he was seen by a different doctor. When he asked to see the same doctor, he was told that it is not possible as the way the doctors worked was to see whoever was waiting when they were free. The problem [Pascal] experienced was that each time he visited the doctor would ask him the same questions as though he were going there for the first time.