alexa Patients Perceptions and Expectations of the General Practice Consultation and of the Doctors Prioritisation Skills of Multi-Morbidity | Open Access Journals
ISSN: 2329-9126
Journal of General Practice
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Patients Perceptions and Expectations of the General Practice Consultation and of the Doctors Prioritisation Skills of Multi-Morbidity

Carter Singh1-3*

1GP Partner Willowbrook Medical Practice, UK

2NHS Mansfield & Ashfield CCG Governing Body GP Board Member, UK

3NHS Mansfield & Ashfield CCG Audit & Clinical Governance GP Clinical Lead, UK

*Corresponding Author:
Carter Singh
GP Partner Willowbrook Medical Practice, UK
Tel: 07814737426
E-mail: [email protected]

Received date: January 25, 2017; Accepted date: April 17, 2017; Published date: April 21, 2017

Citation: Singh C (20127) Patients’ Perceptions and Expectations of the General Practice Consultation and of the Doctor’s Prioritisation Skills of Multi-Morbidity. J Gen Pract (Los Angel) 5:302. doi:10.4172/2329-9126.1000302

Copyright: © 2017 Singh C. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Journal of General Practice

Abstract

Purpose: Patients presenting with multiple problems during a single general practice consultation have been anecdotally referred to as ‘shopping list patients’. The aims of this study were to explore the factors that could help general practitioners develop effective strategies to manage these patients.

Methods: This is a questionnaire based study with a total sample size of (n=66). The study timeframe was July 2012 to Jan 2013 and the response rate was 82.5%.

Results: Irrespective of age or gender, most patients admitted to presenting to the GP with multiple problems approximately 30% of the time. Lack of timely access to GP appointments was the main reason cited by the majority of patients for presenting with multiple problems.

Conclusions: Improving access to GP appointments would reduce patients presenting with multiple problems during a single consultation. The reasons and explanations should be patient centered.

The findings from the research above may facilitate GP’s to increase levels of patient/GP satisfaction and safety, optimize rapport, reduce complaints, help to manage time more effectively (reduce late running of appointments) and increase practice productivity.

Keywords

General practitioners; Single consultation; Patient knowledge

Introduction

Patients presenting with multiple problems during a single general practice consultation have been anecdotally referred to as ‘shopping list patients’.

The potential complexity in effectively managing these patients has been the topic of both viva exam cases and tea-break discussions amongst general practitioners (GP’s) [1,2].

There is no identifiable research analyzing the determinants and circumstances surrounding the reasons why patients present with multiple problems during a single consultation.

Exploring the agendas, ideas, concerns and expectations of ‘shopping list patients’, could assist general practitioners increase levels of patient/GP satisfaction and safety, optimize rapport, reduce complaints, help to manage time more effectively (reduce late running of appointments) and increase practice productivity [3].

Aims

The aims of this study were to explore the factors that could help GP’s developed effective strategies to manage ‘shopping list patients’ [1].

The principal areas that were investigated were

(i) Trying to identify if there were any demographic trends amongst ‘shopping list patients’ i.e. gender, age or presence chronic disease,

(ii) Frequency with which ‘shopping list patients’ presented with multiple problems,

(iii) Determinants of their presentation with multiple problems,

(iv) The reactions of ‘shopping list patients’ to being told by their GP that their problems were beyond the scope of one consultation,

(v) Their perceptions of the reasons why some GPs do not deal with every problem they may have during a standard 10 minute consultation,

(vi) The patient’s knowledge of the practice policy of booking extended GP appointments [4-7].

Methods

This is a questionnaire based study in which the determinants and circumstances surrounding the reasons why patients present with multiple problems during a single consultation were explored.

The total sample (n=66) were recruited by one GP distributing the questionnaires to patients after the consultation during which they had presented with three or more problems which were deemed by the GP to be beyond the scope of that consultation [6].

A single GP was used to eliminate intra-observer error. The study timeframe was July 2012 to Jan 2013 and the response rate was 82.5%. The study was conducted at a single six-partner GP training practice in Nottinghamshire with a list size of approximately 13000 patients (Figures 1-5).

general-practice-rheumatic-age-frequency

Figure 1: Relationship between age and frequency of presenting with multiple problems.

general-practice-rheumatic-gender-frequency

Figure 2: Relationship between gender and frequency of presenting with multiple problems.

general-practice-rheumatic-GP-multiple-problems

Figure 3: Reason patient to the GP with multiple problems.

general-practice-rheumatic-10-minutes-appointment

Figure 4: Patients reaction to Gp’s explanation for dealing with one problem per 10 minutes appointment.

general-practice-rheumatic-Patients-perception

Figure 5: Patients perception of why some GP’s don’t deal with multiple problems during a single appointment.

Key

a) It took you that long to get an appointment for the original problem that another one developed whilst you were waiting.

b) You feel that unless you present with more than one problem it is not worthwhile ‘troubling’ the doctor.

c) Your life is that busy that you wait until you have more than one problem until you visit your doctor so that you do not have to attend on multiple occasions.

d) It was by chance that you had more than one problem and you believe that it is your GP’s duty to deal with all of your problems within the allotted 10 minute time slot.

Key

a) You would feel angry that all of your problems have not been dealt with.

b) You would understand that the GP has prioritized the most important problem via a discussion with yourself and has explained the reasons behind why he/she cannot effectively deal with all of your problems in a 10 minute appointment.

c) You would feel disappointed that not all of your problems have been dealt with and you would be less likely to see that GP again.

d) You would be dissatisfied with the fact that you would need to return for another appointment and as a result this would cause you significant disruption.

e) You feel that you would rather the GP spend more time addressing all of your problems in one go even if that meant other patients would have to wait significantly longer for their appointments as a result of the delay.

Key

a) The GP wants to deal with each of your problems safely and effectively and therefore this requires the appropriate amount of time. Occasionally 10 minutes is not enough.

b) You feel that the GP is lazy.

c) All patients are equal and therefore spending significantly more time with one patient than another is not fair.

d) You think that GPs are only paid for the allotted 10 minutes and anything beyond this is ‘out of the GP’s own pocket’.

e) The GP is not skilled in time management and therefore cannot deal with all of your problems in 10 minutes.

Discussion

Irrespective of age or gender, most patients admitted to presenting to the GP with multiple problems approximately 30% of the time. Lack of timely access to GP appointments was the main reason cited by the majority of patients for presenting with multiple problems [8,9].

The explanation that a significant majority of patients want to hear is that the GP wants to deal with each of your problems safely and effectively and therefore this requires the appropriate amount of time.

The themes arising from this research suggest that improving access to GP appointments would reduce patients presenting with multiple problems during a single consultation. Most patients do not mind if all of their problems are not dealt with during a single consultation provided effective communication skills are used by the GP to help make the patients fully aware of the reasons. The reasons and explanations should be patient, rather than GP centered [10].

For example, a GP-centered reason would be:

Surgery is running late and unfortunately, I only have 10 minutes to deal with all of your problems today. Please could you re-book?”

A patient-centered reason would be:

“I want to ensure that all of your problems are dealt with appropriately and I want to provide you with the best standard of safe clinical service. To ensure I can devote the time that you deserve and to avoid either of us feeling rushed, could you book perhaps a double appointment so that we can discuss all of your problems further?”

A shared decision needs to be made regarding which problem is prioritized taking into account the patients’ ideas, concerns and expectations coupled with the GP’s clinical prioritization skills [7].

Conclusion

The findings from the research above may facilitate GP’s to increase levels of patient/GP satisfaction and safety, optimize rapport, reduce complaints, help to manage time more effectively (reduce late running of appointments) and increase practice productivity.

References

Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Relevant Topics

Article Usage

  • Total views: 336
  • [From(publication date):
    April-2017 - Oct 18, 2017]
  • Breakdown by view type
  • HTML page views : 298
  • PDF downloads :38
 

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords