Negotiating medical care in the doctor's office: How patients respond and how GPs answer
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2023-06-26
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en
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General practitioners (GPs) regularly deal with patient requests yet research on implicit patient requests is poorly operationalised. A codebook was developed to quantitatively analyse sixty-six consultations covering common diagnoses (e.g. constipation, moles). Coders categorised three items (n=277): patient requests based on content (request type) and form (speaker, directness), adjacent GP responses based on action (e.g. asking a question, explaining), and request resolution (i.e. rejection or acceptance). Results showed that when requesting verbal care, patients were more direct and GPs most common response was explaining. Requests for medical care were more often non-directly formulated and GPs either granted the requests or asked a question. Request resolution could only be predicted by request type: GPs were more likely to reject requests for medical than verbal care. As such, golden standards for handling requests could not be formulated, thereby highlighting the complexity of medical care consultations that GPs deal with.
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