Why patients consult and what happens when they do

Area of Science:

• General Practice
• Patient Experience
• Doctor-Patient Communication

Background:

• Patient perceptions of illness severity and reasons for consultation significantly influence healthcare interactions.
• Understanding discrepancies between patient and doctor viewpoints is crucial for effective medical communication.

Purpose of the Study:

• To investigate patients' perceptions of their illness and consultation reasons.
• To compare patient perceptions before and after consultations with doctor perceptions.
• To identify differences in how patients and doctors view the consultation process and outcomes.

Main Methods:

• A questionnaire-based study involving 500 consecutive patients per general practice across four UK sites.
• Patients completed questionnaires pre- and post-consultation; doctors completed questionnaires post-consultation.
• Analysis focused on changes in patient perceptions and discrepancies between patient and doctor viewpoints.

Main Results:

• Patients perceived themselves as more ill than doctors did, particularly those from lower social classes and children.
• Patients reported feeling less ill post-consultation; some attended due to prior doctor advice or self-treatment.
• Discrepancies were noted in consultation priorities: doctors emphasized listening and advice, while patients focused on prescriptions and referrals.
• Doctors' communication patterns varied by social class and gender, with less engagement observed in lower social classes and more explanations to men.

Conclusions:

• Significant differences exist between patient and doctor perceptions of patient problems and the consultation itself.
• These differing perspectives can impact the effectiveness of medical consultations.
• Consultations can provide reassurance to patients, though underlying perceptual gaps remain.