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Patients with worry: presentation of concerns and expectations for response
Michael R Floyd1, Forrest Lang, Ronald S McCord
1Department of Family Medicine, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614-0621, USA. floyd@mail.etsu.edu
Abstract:
Patients with the same underlying concern express this with different styles that predict preference for physician responses. One hundred primary care patients imagined having chest pain and selected from a videotape, the most likely response which they would tell their physician: (1) symptoms only--no disclosure of underlying concern; (2) symptoms and a "Clue" to an underlying concern; or (3) symptom with an explicit concern. Depending on their preferred expression, they were presented videotaped doctors responses to that disclosure and ranked their response preferences. Patients stating they would present with symptoms only (17%) preferred a biomedical question response; patients selecting a symptom and a clue (43%) were equally comfortable with a biomedical question, facilitation or, an exploration of the clue. Of patients presenting with an explicit concern (40%), most wanted the physician to acknowledge and explore the origins of that concern.
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