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General Practice

Patients' unvoiced agendas in general practice consultations: qualitative study

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7244.1246 (Published 06 May 2000) Cite this as: BMJ 2000;320:1246

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Unvoiced Agendas

Dear Editor - May I draw your attention to the conclusion of a recent
B.M.J. article which possibly escaped your attention at the time it was
accepted for publication:
Conclusion. Patients have many needs and when they are not voiced they can
not be addressed.² - Barry, Bradley, Britten, Stevenson, Barber (B.M.J.
2000, 320:1246-50).

To have five people combine in spending their time to tell us this
appears symptomatic of the ridiculous proliferation of academic study on
general practice. The general aim appears to be to replace the
relationship between doctor and patient with a compendium of hints and a
burdensome chain of economic consequences. In my stint of forty years, it
was obvious patients wouldn¹t tell you the full story unless you took time
to fork it out and at the same time watched keenly for changes in
comportment and appearance as clues to unrevealed pathology. Do we have
to remind the academically-minded that every therapeutic situation is
individual and unique ? What on earth is going on ?

J. Russell Grant,

Retired G.P. Principal,
London
N2 9BP.

Competing interests: No competing interests

19 May 2000
J Russell Grant

Patients' unvoiced agendas

Dear Sir - Christine A Barry et al (1) describe what those of us who
have listened on helplines to hundreds of callers’ accounts of their
encounters with doctors know only too well. Three measures could help
narrow this all too frequent
communication gap and thus improve mutual satisfaction and benefit.
GPs could draw on this kind of research to offer training programmes to
their patients, and even school children, on how to get the best out of a
consultation with a doctor. Medical schools could incorporate the
Samaritans’ course (2) on active listening, second to none in my
experience,
into their student curricula. The government could increase the number of
places available for training doctors. A seven minute consultation can
hardly do justice to many patients’ complex agendas.

Roger M. Goss
Director – Patient Concern

(1) Christine A. Barry, Colin P. Bradley, Nicky Britten, Fiona A.
Stevenson, Nick Barber. Patients’ unvoiced agendas in general practice
consultations: qualitative study. BMJ 2000: 320: 1246-50. (6 May)

(2) Though not a Samaritan, the writer has attended this programme.

Competing interests: No competing interests

12 May 2000
Roger M Goss
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