Abstract
BACKGROUND: Although much has been written about what patients want when they contact their general practitioner (GP), there are no published data from large cohort studies of what patients expect. AIM: To describe the expectations of a large group of patients who consulted with their GPs. METHOD: A GP and a social sciences graduate carried out a content analysis of written agenda forms completed by 819 patients who consulted 46 randomly selected GPs. Inter- and intra-rater reliabilities were confirmed. RESULTS: A total of 756 (92%) agenda forms were returned. Inter-rater reliability was satisfactory (kappa > 0.6 for all but two main themes). Almost all patients had requests they wished to make of their doctor, 60% had their own ideas about what was wrong, and 38% had considered explanations about why they were unwell. Forty-two per cent and 24% of patients had consulted because they had reached the limit of their anxiety or tolerance respectively. Seven per cent, 4%, and 2% had comments, which were usually negative, to make about previous management, communication with doctors, or time in the consultation. CONCLUSION: These data demonstrate that most patients come to the consultation with a particular agenda. Failure to address this agenda is likely to adversely affect the outcome of many consultations.
Full Text
The Full Text of this article is available as a PDF (47.0 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Becker M. H., Drachman R. H., Kirscht J. P. A new approach to explaining sick-role behavior in low-income populations. Am J Public Health. 1974 Mar;64(3):205–216. doi: 10.2105/ajph.64.3.205. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Beckman H. B., Frankel R. M. The effect of physician behavior on the collection of data. Ann Intern Med. 1984 Nov;101(5):692–696. doi: 10.7326/0003-4819-101-5-692. [DOI] [PubMed] [Google Scholar]
- Bertakis K. D., Roter D., Putnam S. M. The relationship of physician medical interview style to patient satisfaction. J Fam Pract. 1991 Feb;32(2):175–181. [PubMed] [Google Scholar]
- Cromarty I. What do patients think about during their consultations? A qualitative study. Br J Gen Pract. 1996 Sep;46(410):525–528. [PMC free article] [PubMed] [Google Scholar]
- Cunningham-Burley S., Allbutt H., Garraway W. M., Lee A. J., Russell E. B. Perceptions of urinary symptoms and health-care-seeking behaviour amongst men aged 40-79 years. Br J Gen Pract. 1996 Jun;46(407):349–352. [PMC free article] [PubMed] [Google Scholar]
- Helman C. G. Disease versus illness in general practice. J R Coll Gen Pract. 1981 Sep;31(230):548–552. [PMC free article] [PubMed] [Google Scholar]
- Kettell J., Jones R., Lydeard S. Reasons for consultation in irritable bowel syndrome: symptoms and patient characteristics. Br J Gen Pract. 1992 Nov;42(364):459–461. [PMC free article] [PubMed] [Google Scholar]
- Like R., Zyzanski S. J. Patient requests in family practice: a focal point for clinical negotiations. Fam Pract. 1986 Dec;3(4):216–228. doi: 10.1093/fampra/3.4.216. [DOI] [PubMed] [Google Scholar]
- Lydeard S., Jones R. Factors affecting the decision to consult with dyspepsia: comparison of consulters and non-consulters. J R Coll Gen Pract. 1989 Dec;39(329):495–498. [PMC free article] [PubMed] [Google Scholar]
- Marteau T. M., Kinmonth A. L., Pyke S., Thompson S. G. Readiness for lifestyle advice: self-assessments of coronary risk prior to screening in the British family heart study. Family Heart Study Group. Br J Gen Pract. 1995 Jan;45(390):5–8. [PMC free article] [PubMed] [Google Scholar]
- Mayer R., Graham H., Schuberth C., Launer J., Tomson D., Czauderna J. Family systems ideas in the 10-minute consultation: using a reflecting partner or observing team in a surgery. Br J Gen Pract. 1996 Apr;46(405):229–230. [PMC free article] [PubMed] [Google Scholar]
- Middleton J. F. Asking patients to write lists: feasibility study. BMJ. 1995 Jul 1;311(6996):34–34. doi: 10.1136/bmj.311.6996.34. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Middleton J. F. The exceptional potential of the consultation revisited. J R Coll Gen Pract. 1989 Sep;39(326):383–386. [PMC free article] [PubMed] [Google Scholar]
- Mushlin A. I., Appel F. A. Testing an outcome-based quality assurance strategy in primary care. Med Care. 1980 May;18(5 Suppl):1–100. [PubMed] [Google Scholar]
- Peppiatt R. Eliciting patients' views of the cause of their problem: a practical strategy for GPs. Fam Pract. 1992 Sep;9(3):295–298. doi: 10.1093/fampra/9.3.295. [DOI] [PubMed] [Google Scholar]
- Stewart M. A., McWhinney I. R., Buck C. W. How illness presents: a study of patient behavior. J Fam Pract. 1975 Dec;2(6):411–414. [PubMed] [Google Scholar]
- Stott N. C., Davis R. H. The exceptional potential in each primary care consultation. J R Coll Gen Pract. 1979 Apr;29(201):201–205. [PMC free article] [PubMed] [Google Scholar]
- Williams S. J., Calnan M. Key determinants of consumer satisfaction with general practice. Fam Pract. 1991 Sep;8(3):237–242. doi: 10.1093/fampra/8.3.237. [DOI] [PubMed] [Google Scholar]
- Wyke S., Hewison J., Russell I. T. Respiratory illness in children: what makes parents decide to consult? Br J Gen Pract. 1990 Jun;40(335):226–229. [PMC free article] [PubMed] [Google Scholar]
- van de Kar A., Knottnerus A., Meertens R., Dubois V., Kok G. Why do patients consult the general practitioner? Determinants of their decision. Br J Gen Pract. 1992 Aug;42(361):313–316. [PMC free article] [PubMed] [Google Scholar]