What is health? Where GPs' and patients' worlds collide

Qualitative studies have highlighted the complexity of patient models of health. The present quantitative study aimed to compare general practitioners' (GPs) and patients' models of health. A questionnaire consisting of 27 'markers of health' was completed by 472 patients (response rate 78.8%) and 64 GPs (response rate 71%). The results showed that GPs and patients were comparable in their ratings of those markers relating to arousal, such as sleep, sex drive and energy and infections, such as neck glands and having lots of colds. However, in the main GPs and patients were consistently different. In particular, the patients showed a higher rating for those markers relating to digestion (e.g. appetite, bloatedness), bodily fluids (e.g. the colour and smell of urine, regularity of bowels), the condition of the tongue, hair and complexion and for more traditional medical markers (e.g. heart beat, body weight). In contrast, GPs reported higher ratings for mood and emotions. To conclude, patients appeared to hold much more diverse models of health than GPs and reported greater endorsement for markers consistent with both a humoral and medical approach to health. These results suggest that GPs and patients do not have a shared understanding of health, which has implications for the effectiveness of primary care consultations.