BMJ  2008;336:790 (12 April), doi:10.1136/bmj.39542.465451.3A

Letters

Multiple health problems

Presentation is important too

The first 100% of the full text of this article appears below.

Anwar et al point out that weaknesses in the healthcare system can disadvantage the patient with multiple health problems.¹ However, there is evidence that the way in which a patient presents might influence whether a particular problem is seen as a priority, a secondary issue, or overlooked altogether. In a study of a videotaped general practice consultation of a male patient with physical, emotional, and social problems, 27 general practitioners were asked to give a diagnosis in their own words.² The patient’s medical records showed deteriorating cardiac and pulmonary disease over the previous eight years. However, the patient presented in an angry and distressed manner. As a consequence, most of the GPs picked up on the psychological issues, but many failed to note the patient’s heart problems.

¹ King’s College London, Division of Health and Social Care Research, London SE1 3QD

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Competing interests: None declared.

1. Anwar R, Gogi N, Anjum SN. Do we neglect patients with multiple health problems? BMJ 2008;336:670. (22 March.)[Free Full Text]
2. Jenkins R, Smeeton N, Marinker M, Shepherd M. A study of the classification of mental ill-health in general practice. Psychol Med 1985;15:403-9.[ISI][Medline]

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Do we neglect patients with multiple health problems?

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