Exploring negative evaluations of health care by Polish patients: an attempt at cross-cultural comparison

Understanding patient dissatisfaction is essential as it provides information on how to improve the relationship between healthcare users and medical professionals. The aim of this paper is to determine how Polish patients verbally express negative opinions of their healthcare services, and to compare the patterns of opinion-giving behaviour between patients in Poland and Western Europe. A qualitative approach employing in-depth interviews was used. Nine primary healthcare centres were chosen in various regions of Poland, taking into account both type of practice, i.e. small and large, and location of residence, i.e. urban (small and large towns) and rural. In every centre, interviews were performed with four patients coming consecutively to their family physician. Thirty-six patients aged 20-78 years were interviewed. Their views could be categorised into eight reasons for avoiding expressing negative opinions: unpleasant emotions induced by giving a negative evaluation; avoiding offending healthcare providers; fear that their utterances could have a negative effect on their further medical care; fear of giving a hasty evaluation based on their own inexpert medical knowledge; determinants from recent Polish history; prestige of the medical profession; entrusting the most important aspect of life, i.e. health, to a doctor; and lack of faith that their opinions could cause change for the better. The respondents used certain rhetorical tricks to soften their criticisms. Patients face cultural barriers to expressing dissatisfaction about their health care. In the Polish context, these are the high social status of the physician and the low position of the patient. In their spontaneous utterances, the respondents gave detailed suggestions for raising the level of patient satisfaction with health care.