Qualität in der Primärversorgung Offener Zugang

Abstrakt

Communication about work between general practitioners and patients consulting for musculoskeletal disorders

Harm Jan A Weevers, Allard J van der Beek, Atie van den Brink-Muinen, Jozien Bensing, Cecile RL Boot, Willem van Mechelen

Background Work-related musculoskeletal disorders (MSDs) are common in general practice. The communication between a general practitioner (GP) and patient is a key element of adequate general practice. No study has investigated the characteristics of communication about work-related matters during consultation of the GP by working patients with MSDs. Objectives The aim of this study was to describe the communication about work-related matters between the GP and his patients with paid work who are consulting for MSDs. Method Descriptive analysis of 680 systematic observations of GP consultations of patients in paid work who were consulting for MSDs. Results Work was discussed in 227 of 680 consultations in general practice. In 69% of these consultations the patient started communication concerning work-related matters, with an average number of 38.5 (standard deviation 45.7) verbal utterances, equalling, on average, 15% of the total consultation time. In 36% of consultations the patient’s working conditions were discussed and in 12% the GP advised on whether to stay at home or return to work. There was a statistically significant positive correlation between the extent to which GPs rated the patient’s MSDs to be work related and the number of utterances the GP and patient made about work-related matters during the consultation.Conclusions Work is not a standard topic of conversation during the GP consultation. GPs could more often start communication about patients’ work. A challenge for future GP practice and education is to include discussion of patients’ work to optimise patient-centred care.