What do patients bring up in consultations? An observational study in general practice

Prior research has shown that consultations in general practice often involve multiple patient concerns, but the exact number and nature of these issues remain unclear. It was already known that general practitioners (GPs) manage a wide range of health problems, yet the extent to which patients raise multiple issues in a single visit has not been fully quantified. This gap motivated a closer examination of consultation dynamics. No prior work had resolved how patient demographics influence the number of problems presented. Observational studies have typically focused on specific conditions rather than overall consultation patterns. The role of patient expectations in shaping these interactions is also underexplored. Understanding the full scope of patient concerns is essential for improving consultation efficiency. This paper contributes by analyzing a broad sample of consultations and patient perspectives.

The study aimed to determine how many and what types of problems patients present during consultations with their GPs. Researchers wanted to explore the relationship between patient characteristics and the number of problems raised. A secondary objective was to assess patients' expectations regarding the consultation process. The paper addresses the need for data on consultation content in primary care settings. It focuses on unselected consultations to avoid bias in problem identification. The goal was to capture a realistic picture of patient-GP interactions. Researchers also sought to understand how GPs handle multiple issues in a single visit. This approach allows for insights into the practical challenges of general practice.

Researchers conducted an observational study in four general practices in Oslo, Norway. They used a cross-sectional design to capture a snapshot of patient-GP interactions. A pre-designed scheme was used to record consultation details. Patients also completed a brief questionnaire after waiting to see their GP. The study included 201 patients in consultations and 177 waiting patients. Data collection focused on the number and type of problems raised. Researchers analyzed whether GPs addressed these issues during the visit. The study combined direct observation with patient self-reporting to ensure comprehensive data.

The average number of problems raised per consultation was 2.6, with a range of 1 to 16. When excluding acute appointments, the mean increased to 3.3. Somatic problems made up about half of all reported issues. Mental health concerns were present in over 25% of consultations. Female patients and older individuals tended to raise more problems. In one-quarter of encounters, four or more problems were discussed. GPs addressed most of the problems during the consultation itself. Patients rated the ability to discuss all their issues as highly important.

The study shows that patients often present multiple unrelated problems during a single consultation. GPs handle these diverse issues within the same visit, which patients value highly. Female sex and increasing age correlate with a higher number of problems raised. Mental health concerns are frequently discussed alongside somatic issues. The findings suggest that managing multiple problems is a core aspect of general practice. Training and working conditions must support this complex task. The authors propose that this approach is central to maintaining the value of primary care. These results highlight the need for efficient consultation practices.