Why patients consult and what happens when they do
Open accessAbstract
OBJECTIVE: To study patients' perceptions of why they consulted the doctor, how ill they thought they were, and what happened in the consultation. To compare patients' perceptions before and after the consultation and to compare these perceptions with those of the doctor. DESIGN: Patients filled in a questionnaire before and after the consultation. The doctor filled a questionnaire in after the consultation. SETTING: Three general practices in Bedfordshire and one in Hertfordshire. PATIENTS: 500 consecutive patients consulting in each practice. MAIN OUTCOME MEASURES: Changes in patients' perceptions and differences between the perceptions of patients and doctors. RESULTS: Doctors perceived patients to be less ill than the patients themselves did. Patients from social classes IV and V and children perceived themselves to be more ill than the average. Patients perceived themselves to be less ill after the consultation. A third of patients attended because doctors had told them to, and a quarter of patients had already tried to treat their problem themselves when they attended the consultation. Doctors' perceptions of the consultation emphasised listening, supporting, and giving advice. Patients' perceptions emphasised prescribing, reassuring, and referring to a consultant. Doctors perceived that they listened, examined, and gave advice less to social classes IV and V than to social classes I, II, and III and gave explanations more often to men than to women. Patients perceived external factors rather than lifestyle factors as being more important in causing their problems. CONCLUSION: Doctors' perceptions of patients' problems differed from those of patients expressed both before and after their consultation. Doctors' and patients' perceptions also differed about the consultation itself. The consultation reassured some patients.
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Healthcare professionals tend to involve low SES patients less in their consultations by giving them less information, spending less time building rapport with them and listening less attentively.
“Furthermore healthcare professionals tend to involve low SES patients less in their consultations by giving them less information, spending less time building rapport with them and listening less attentively (9,11,12).”
From High levels of socioeconomic deprivation do not inhibit patients’ communication of concerns in head and neck cancer review clinics (2018) · cites this paper as [12]
The 'What the doctor did in consultation' section and Table VII report that doctors perceived themselves as explaining, listening, and giving advice less often to patients in social classes IV and V. The paper does not establish that they spent less time building rapport or listened less attentively; it also cautions that patient perceptions differed less by social class than doctors’ perceptions did. (LLM, conf=0.88)
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Research works printed but not linked: 10
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Socio-economic status of the patient and doctor–patient communication: does it make a difference?
Willems, S., De Maesschalck, S., Deveugele, M., Derese, A., & De Maeseneer, J. (2005) · Patient Education and Counseling · doi:10.1016/j.pec.2004.02.011 · Cited by 582 · see citing works
The social gradient in doctor-patient communication
Verlinde, E., De Laender, N., De Maesschalck, S., Deveugele, M., & Willems, S. (2012) · International Journal for Equity in Health · doi:10.1186/1475-9276-11-12 · Cited by 307 · see citing works
Allen, S., Harris, R., Brown, S. L., Humphris, G., Zhou, Y., & Rogers, S. N. (2018) · British Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.bjoms.2018.05.015 · Cited by 9 · see citing works
- Authors
- Martin, E., Russell, D., Goodwin, S., Chapman, R., North, M., & Sheridan, P.
- Affiliations
- University of Aberdeen (GB)
- ORCID
- Martin, E
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1991-08-03
- Volume
- 303
- Issue
- 6797
- Pages
- 289-292
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- OpenAlex
- W1963810805
- Cited by
- 59
- References
- 0
- Citations by year
- 2025: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 2 · 2017: 1 · 2015: 1 · 2013: 1 · 2012: 2
- FWCI
- 7.71
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Keywords
- patient perspectives, doctor-patient consultation, perceived illness, patient self-assessment, social class, gender differences, self-medication, drug prescribing, referral, reassurance, general practice
- MeSH terms
- Attitude to Health, Communication, Female, United Kingdom, Humans, Male, Office Visits, Patient Acceptance of Health Care, Perception, Physician-Patient Relations, Physicians, Family, Social Class
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