Can asking for patients’ opinions about diagnoses help physicians?
Type de matériel :
29
Introduction: Diagnostic uncertainty is a frequent problem in primary care. It is often perceived as an issue. At the same time, there are few references on the merit of taking the patient’s opinion into account in situations of diagnostic uncertainty. Measuring the extent to which patients give their opinion to their physician, and whether or not this opinion is deemed helpful for the practitioner, appeared to be interesting avenues for research. Method: The study was conducted in two stages starting with a prospective descriptive study, conducted among eighteen primary care practitioners in the Vienne and Charente departments in France. The analysis was based on a sample of 457 consultations involving situations of diagnostic uncertainty. The patient variables included gender, age, socio-professional status, and how spontaneously the opinion was offered. The physicians used a five-point Likert scale to measure the extent to which the patient’s opinion was a hindrance or help. They also took note of the “diagnoses.” The second stage involved presenting the results to investigators via a videoconference with a focus group to fuel discussion on the findings. Results: More than eight out of ten patients had an opinion about their condition. This advice was given spontaneously in 67 percent of cases. It was considered by the practitioner as helpful in 56 percent of cases. Conversely, the patient’s opinion was considered as a hindrance in one out of four cases. This inconvenience was deemed significant in 5 percent of cases. The clinicians gave less credence to the opinion of patients aged under 35. Moreover, they expressed being hindered more by the opinion of patients aged over 65. Patient opinion is perceived as a significant help in infectious pathologies, ENT pathologies, cystitis, vulvitis, low back pain, sciatica, and hernias. The physician is hindered by the patient’s opinion in cases involving psychological disorders and in emergency situations. Discussion: This study shows that patients are willing to express spontaneous opinions regarding their conditions. In more than 50 percent of cases, the physician considers the patient’s opinion helpful. To conclude, taking patients’ opinions into consideration could be an inexpensive and sometimes valuable aid in situations of diagnostic uncertainty.
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