A comparison of patient-reported reasons for encounter and provider-reported diagnoses

People attending the general practices and hospital OPDs in two rural Queensland towns were asked, before receiving care, to indicate why they were seeking care. The consulting providers reported the outcome of the encounter. Using ICPC Components and Chapters patient and provider reports were compared to assess the level of agreement between same, in order to determine the nexus between patient perceptions and provider diagnoses. Patients tended to report signs and symptoms in preference to specific diagnoses, for both first and follow-up visits. Good concurrence between patient and provider reports were recorded in those Chapters in which conditions commonly had obvious signs and symptoms and relatively high follow-up rates. 'Psychological' conditions were an exception in this regard, suggesting that patient reports are unreliable for such conditions. Patient and provider reports should be seen as different aspects of health care, and therefore should not be used as corollaries of each other. Researchers need to be clear about which perspective is required--that of the patient or the provider--in exploring the content of clinical encounters. Provider reports do not reflect the triggers (perceptions) which persuade patients to seek care.