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Can asking the patient’s opinion about the diagnosis of his disorder help the doctor? Volume 18, issue 9, November 2022

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Authors
1 Interne de médecine générale, Poitiers
2 Université de Poitiers, Faculté de Médecine et Pharmacie, 6 rue de la militerez, TSA 51115, 86073 Poitiers Cedex 9 ; Membre titulaire de la Société Française de Médecine Générale
Correspondance : J. Moreau

Introduction

Diagnostic uncertainty is a frequent problem in general practice. It is often perceived as an issue. But there are not many references on the interest of taking the patient’s opinion into account in situations of diagnostic uncertainty. It seemed interesting to measure in what proportion patients give their opinion to their doctor, and if this opinion is a help for him or not.

Method

The study was realized in two steps. A prospective descriptive study, conducted with 18 general practitioners in the Vienne and Charente French departments. The analysis was based on a sample of 457 consultations in a situation of diagnostic uncertainty. The information collected concerned the patient (gender, age, socio-professional category), the spontaneity of their opinion on their disorder, if it was helping or not according to a Likert evaluation scale, and the consultation result. In a second step, the results were presented to the investigators with the aim of received their perceptions during a focus group by videoconference.

Results

More than 8 out of 10 patients had an opinion about their conditions. This advice was given spontaneously in 67% of cases. It was considered by the practitioner as a help in 56% of cases. Conversely, the patient’s opinion was considered a hindrance one time out of four. This inconvenience was significant in 5% of cases. The clinician gave less importance to the opinion of patients under 35. Moreover, he was more annoyed by the opinion of patients over 65. The patient’s point of view is perceived as a significant help in infectious pathologies, ENT pathologies, cystitis, vulvitis, low back pain, sciatica and hernias. The doctor is embarrassed by the patient’s opinion when he presents psychological disorder and in emergency situations.

Discussion

This study confirms the patient has a spontaneous opinion on his disorder. More than one out of two times, the physician considers that he is helped by the patient’s point of view. To conclude, the only consideration of the patient’s opinion would be an inexpensive and sometimes valuable aid in frequent situations of diagnostic uncertainty.