Hypertension in the inner city. I. Analysis of clinic dropouts.

Sixty dropouts from hypertensive clinics were interviewed in depth to determine reasons for noncompliance. Waiting time and a poor doctor-patient relationship were the major reasons given. The average waiting time prior to examination by the doctor was 2.5 hours, and the average waiting time at the pharmacy was 1.8 hours. In contrast the average time spent with the doctor was 7.5 min. The poor doctor-patient relationship deteriorated further since patients were examined by a different physician on each visit. A physician was not essential for compliance, however, since 54% of the patients readily accepted a health aide. In order to enhance compliance our group reorganized its hypertensive clinic using the patients' complaints as guidelines. Operating the clinic with emphasis on a personalized doctor-patient relationship and utilizing a meaningful appointment system has reduced the number of dropouts from 42% in 1966-69 to 8% in 1970-71.