Met or Matched Expectations What accounts for a successful back pain consultation in Primary Care?. Ehab Georgy PG Researcher Bournemouth University United Kingdom Prof. Eloise Carr Deputy Dean, School of Health & Social Care Bournemouth University Prof. Alan Breen
What accounts for a successful back pain consultation in Primary Care?
Prof. Eloise Carr
Deputy Dean, School of Health & Social Care Bournemouth University
Prof. Alan Breen
Professor, Musculoskeletal Health Care, Anglo-European College of Chiropractic
A presentation for the 3rd bi-annual conference of the European Forum for Primary Care - Pisa, Italy 2010
(Malmivaara et al., 1995; Skelton et al., 1995; Maniadakis and Gray, 2000; Walker, 2000; Gask and Usherwood, 2002; Breen et al., 2007; Savigny et al., 2009).
Patients and doctors appear to have a specific agenda during the consultation;
These agendas seem to have different content and focus
there seems to be a mismatch between patients and doctors beliefs in regards to different aspects of the consultation
(Ogden et al., 1997; Georgy et al., 2009)
of the problem
(Kravitz et al., 1994; Sanchez-Menegay and Stalder, 1994; Turner et al., 1998; Tomlin et al., 1999; Verbeek et al., 2004; Parsons et al., 2007; Ruiz-Moral et al., 2007).
Patient-doctor agreement is of paramount importance and has the potential to affect the consultation outcome in various ways:
greater adherence to treatment
better general health outcomes
positive perception of improvement
higher satisfactionMatched patient-doctor expectations:why important?
(Starfield et al., 1981; Williams et al., 1995; Cedraschi et al., 1996; Liaw, Young and Farish, 1996; Fagerberg et al., 1999; Maly et al., 2002; Kerse et al., 2004; Krupat et al., 2004; Azoulay et al., 2005; Staiger et al., 2005)
Highly expected the potential to affect the consultation outcome in various ways:
Less expectedFindings- Questionnaire analysis
Findings- the potential to affect the consultation outcome in various ways:Questionnaire analysis
Better communication and interaction:
Mrs A (BP patient): “… obviously, if I feel I have agreed with my doctor about most aspects during the consultation, for example, explanation of the problem, the need for tests or referral and about the treatment plan that can fit my life style, then I feel I have had a positive experience and that I was able to share my doubts and concerns with my doctor much better”.
Dr B (GP): “... if the doctor is hopefully on the same wavelength of anticipation as the patient, the patient feels as if the doctor has been listening and the consultation would be much more valuable”.
Better compliance and adherence to treatment:
Mr C (patient): “Patient-doctor agreement is very important, because if you feel that the doctor has been listening to you and isn’t just treating you as a number and does know your needs, then you are more likely to listen to what the doctor says and take his advice”.
Dr D (GP): “… if the patient’s agenda is not revealed and if the doctor is directing the consultation in a way that patient's expectations are not explored, most probably, this consultation will go wrong and the outcome will be compromised, and this obviously will affect the compliance and adherence to treatment and consequently the satisfaction and possibly the symptom improvement”.
Met or Matched Model. Georgy EE, Carr ECJ and Breen AC (2010). In review; Health Expectations Journal
It is proposed that, for more successful back pain consultation, it is important to:
Have a very enjoyable and fruitful time in Pisa the potential to affect the consultation outcome in various ways:
References: the potential to affect the consultation outcome in various ways: