The nature of patients' requests for physicians' help

This report describes patients' requests for help in two outpatient settings--one, a general medicine practice (GMP); the other, a medical walk-in unit (WIU). Interview data were collected in 1981 from 200 patients prior to their visits with the doctor. Patients were asked, "How do you hope the doctor (or clinic) can be of help to you today?" Their responses were written down verbatim. A coding system was devised that described the specificity, focus, and form of each request in order to provide the clinician with a classification for recognizing these request elements and responding to them. Specificity (precision) was identified from the response to "What do you hope the doctor will do for you?" The focus (objective) was described by four categories: problem, treatment, relationship, and administration; the form (intervention), by five categories: somatic, cognitive, affective, advice, and instrumental. Patterns of requests differed in the two settings. In the WIU, the pattern of requests had a problem focus with a form split between the cognitive (wanting an explanation) and the somatic (wanting a medical procedure); in the GMP, treatment was the focus, with a somatic form. The overall results indicate the varied requests of medical outpatients that express their perspectives about their illnesses. This classification of requests should be useful to physicians in eliciting and responding to their patients' requests.