BMJ  2004;328 (21 February), doi:10.1136/bmj.328.7437.0-e

...but perceived pressure from patients affects doctors' behaviour

Doctors' behaviour in primary care consultations is strongly associated with perceived medical needs, but it is affected also by perceived patient pressure. Little and colleagues (p 444) invited 847 patients attending five general practices to fill in a questionnaire before consultation and asked doctors about their perception of patients' needs and perceived pressure. They provide data showing that a minority of examinations, prescriptions, and referrals, and almost half of investigations, are only slightly needed or not needed at all, and that perceived pressure from patients predicts whether doctors examine, prescribe, refer, or investigate.

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Relevant Article

Importance of patient pressure and perceived pressure and perceived medical need for investigations, referral, and prescribing in primary care: nested observational study

Paul Little, Martina Dorward, Greg Warner, Katharine Stephens, Jane Senior, and Michael Moore
BMJ 2004 328: 444. [Abstract] [Full Text] [PDF]