Urgency in seeking medical care for specific symptoms: perceptions of physicians and patients

A patient's appraisal of symptom significance is important to the timeliness with which care is sought. Little is known, however, about the variations in patients' responses to symptoms and the factors determining variations. To assess lay individuals' perception of the importance of symptoms, 75 private and 75 clinic outpatients and 73 inpatients were surveyed on 13 sets of hypothetical symptoms to determine whether they would seek care immediately, call for an appointment, or wait and see. All sets of symptoms were adjudged to be clinically significant by a panel of three physicians. Twenty-one other physicians were surveyed using the same questionnaire. Weighted mean responses of patients and physicians differed on seven symptoms. Physicians recommended more immediate care for symptoms suggestive of impending heart attack and stroke than did patients, and patients indicated that they would seek care earlier than physicians for less serious symptoms. Clinic patients would seek immediate care for symptoms more often than other patient groups. Nonwhites and those with less formal education reported greater urgency in seeking care for six symptoms. The results indicate that patients may not agree with physicians in the way they interpret symptoms of disease and that symptom appraisal may differ depending on patients' sociodemographic characteristics.