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|Title:||The patient's agenda : written lists of patients' concerns in primary care consultations|
|Authors:||Middleton, John F.|
|Abstract:||It is argued that the consultation is central to general practice and that the patient's agenda is of prime importance within it. A written list of patient's concerns is proposed as an aid to communication. However, some doctors have prejudices about patients and their lists.;Pilot work:.;1. This involved the development of a form to be completed by patients prior to consultations (the 'list form').;2. A new form (the PtAF) was designed in order to help patients to express more of their ideas.;3. An educational workshop, using a simulated patient, was designed. The aim was to increase the doctor's efficiency in using the PtAF.;RESULTS: After the workshop there was an increase in one item of the doctor's satisfaction scale - perceived understanding (100% of 89.2%; P = 0.034). There were strong trends towards reduced time per problem, more problems identified and less time perceived by patients, but no other significant differences.;Subsequently, the workshop was amplified from two to six hours and GPs recruited from practices in Nottinghamshire and Leicestershire for a larger study, the power calculation having been based on the reduction in time per problem.;There appears to be little basis for the prejudices which some doctors have about patients and written lists. Use of the PtAF and attendance at an educational workshop are each associated with the identification of more problems and a tendency for longer consultations. The reasons for the lack of change in patient's and doctor's satisfaction, and BTWS are not clear. The patient's problems may be associated with complex agendas which include ideas and reasoning. It is suggested that medical education should focus on the patient's agenda and that consultation time should be sufficient to address this agenda.|
|Rights:||Copyright © the author. All rights reserved.|
|Appears in Collections:||Theses, College of Medicine, Biological Sciences and Psychology|
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