The evaluation of medical symptoms by patients and doctors

This study investigates discrepancy and congruence between doctors and patients in their beliefs about the need for medical treatment. One hundred seventy-six outpatients and 337 university students rated each of a set of 35 symptoms on the urgency with which they would seek medical advice were they experiencing that symptom. Sixty-six general practitioners rated the urgency with which a person experiencing that symptom should seek medical advice. These symptoms were classified as relatively serious or nonserious on the basis of ratings by a separate set of doctors. General practitioners perceived a greater overall need for treatment than did patients, but this difference was greater for nonserious than for serious symptoms. In fact patients perceived treatment to be more urgent for three serious symptoms, each potentially indicative of cancer. The observed pattern of doctor-patient discrepancies can be explained in terms of the availability heuristic. The role of this heuristic in the cognitive dynamics of doctor-patient relationships merits future attention.