Do we know what patients want? The doctor-patient communication gap in functional gastrointestinal disorders

Clin Gastroenterol Hepatol. 2009 Nov;7(11):1252-4, 1254.e1-2. doi: 10.1016/j.cgh.2009.06.025. Epub 2009 Jul 1.

Abstract

Background & aims: Understanding patients' expectations at initial consultation for functional gastrointestinal disorders (FGIDs) might influence future health care utilization. Ideally, patients and doctors would have a common understanding of the issues involved. We sought to investigate this with matched questionnaires.

Methods: Patients' needs/expectations/understanding were compared with gastroenterologists' and general practitioners' awareness of these. Patients were followed up to investigate satisfaction with and outcomes of specialist consultation.

Results: Specialists underestimated the number and severity of patients' symptoms (in 43% and 41%, respectively), and patients and specialists had quite discordant views on what treatment would best suit their symptoms. Strikingly, only 1 of 13 patients available for follow-up agreed with or accepted the functional diagnosis, despite all being diagnosed by a specialist as having an FGID.

Conclusions: In FGIDs there is a communication gap between patients and gastroenterologists. Importantly, at follow-up, patients do not acknowledge their FGID diagnosis. This communication gap and lack of acceptance of a functional diagnosis are likely to influence future management and health care utilization.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Communication*
  • Female
  • Gastrointestinal Diseases / therapy*
  • Health Services Research*
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data
  • Patient Satisfaction / statistics & numerical data
  • Physician-Patient Relations*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult