Patient agendas in primary care

BMJ 2006; 332 doi: http://dx.doi.org/10.1136/bmj.332.7552.1225 (Published 25 May 2006)
Cite this as: BMJ 2006;332:1225

Get access to this article and all of bmj.com for the next 14 days

Sign up for a 14 day free trial today

Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

  1. William Hamilton, senior research fellow (w.t.hamilton@btopenworld.com),
  2. Nicky Britten, professor
  1. Department of Community Based Medicine, University of Bristol, Bristol BS8 1AU
  2. Institute of Health and Social Care Research, Peninsula Medical School, Exeter EX1 2LU

    Perhaps the main benefit is to encourage patients to voice embarrassing problems

    People often have difficulty in fully expressing their concerns in consultations with doctors1 and this may adversely affect outcomes. Some issues go unvoiced or are introduced in a “by the way” presentation at the end of the consultation. The temporal order by which patients present their agendas may not reflect their perceived importance or match the doctor's prioritisation. The first item raised may be the most socially acceptable, and the last (or unvoiced) item—such as breast lumps or rectal bleeding—may be the vaguest or most embarrassing.

    If they have time doctors may try to counter this by an open question, asking if there are any other problems.2 But doctors have to work within time constraints, and a few actively discourage the presentation of more than one problem per consultation. Examining the issue of patients' agendas—their ideas, concerns and expectations—brings out the tension between a patient-centred model of the consultation …

    Get access to this article and all of bmj.com for the next 14 days

    Sign up for a 14 day free trial today

    Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

    Article access

    Article access for 1 day

    Purchase this article for £20 $30 €32*

    The PDF version can be downloaded as your personal record

    * Prices do not include VAT

    THIS WEEK'S POLL