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Communication about work between general practitioners and patients consulting for musculoskeletal disorders
Harm-Jan A Weevers1, Allard J van der Beek, Atie van den Brink-Muinen
1VU University Medical Center, EMGO Institute for Health and Care Research, Department of Public and Occupational Health, The Netherlands.
Background:
Work-related musculoskeletal disorders (MSDs) are common in general practice. The communication between a general practitioner (GP) and patient is a key element of adequate general practice. No study has investigated the characteristics of communication about work-related matters during consultation of the GP by working patients with MSDs.
Objectives:
The aim of this study was to describe the communication about work-related matters between the GP and his patients with paid work who are consulting for MSDs.
Method:
Descriptive analysis of 680 systematic observations of GP consultations of patients in paid work who were consulting for MSDs.
Results:
Work was discussed in 227 of 680 consultations in general practice. In 69% of these consultations the patient started communication concerning work-related matters, with an average number of 38.5 (standard deviation 45.7) verbal utterances, equalling, on average, 15% of the total consultation time. In 36% of consultations the patient's working conditions were discussed and in 12% the GP advised on whether to stay at home or return to work. There was a statistically significant positive correlation between the extent to which GPs rated the patient's MSDs to be work related and the number of utterances the GP and patient made about work-related matters during the consultation.
Conclusions:
Work is not a standard topic of conversation during the GP consultation. GPs could more often start communication about patients' work. A challenge for future GP practice and education is to include discussion of patients' work to optimise patient-centred care.
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