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.

Nigel C Smeeton, lecturer in medical statistics

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

nigel.smeeton@kcl.ac.uk

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.[Web of Science][Medline]

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Relevant Article

Do we neglect patients with multiple health problems?
Rahij Anwar, Nitish Gogi, and Syed Neshat Anjum
BMJ 2008 336: 670. [Extract] [Full Text] [PDF]

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