Zambia’s only outpatient neurology clinic operates two mornings weekly with approximately 50 patients seen each day on a first come-first served basis.  In 2018, neurology residents were incorporated as providers within the clinic.  Formal feedback has not been previously solicited from patients.

 We distributed surveys in English, Nyanja and Bemba to patients in the neurology clinic over four weeks. No identifying information was collected, and participant responses were entered into a Qualtrics database. 

191 patients participated. Since attending the clinic, 46% reported understanding of their diagnoses improved, 20% reported medication modifications, 18% motor improvement or re-gained ambulation, and 14% better seizure control.

The majority were at least “somewhat satisfied” with competence (89%) and communication skills (86%) of clinic doctors, time spent with the physician (90%), and with their follow-up plan (82%). When asked to compare the neurology clinic to other clinics they attended, patients reported superior diagnostics and treatment options, better physician bedside manner, and more time spent with patients.

Half of participants were at least “somewhat unsatisfied” with wait times to be seen after arriving at the clinic. Still, most (56%) preferred to see the same neurologist each visit, while 17% preferred to see the first available provider and the rest were undecided/ambivalent.

The Zambian neurology clinic provides diagnostic clarity for patients and better satisfaction with treatment plans and patient/doctor relationships than other clinics. Despite prolonged wait times, most patients preferred provider continuity over expedited care. Thus, hospitals in resource-limited settings should consider introducing specialist public sector clinics whenever possible and replacing “first available provider” models with “provider continuity” models to improve clinical care and patient satisfaction. Providing formal appointment times in lieu of a first come-first served appointment model may also improve patient satisfaction.