Patient and Practitioner diagnosis and style

Practitioner Style 

BYRNE AND LONG (1979) found out the features of the doctor-centred style and the patient-centred style and concluded that meaningful dialogue led to more compliance by patients.

Features of doctor-centred style:

• Impersonal atmosphere
• Intent on establishing the link between the symptoms and organic disorder.
• Patient was passive during consultaion.
• No open discussion on diagnosis and alternatives.

 Features of patient-centred style:

• Personal atmosphere
• Less controlling role by the doctors
• Open questions, allowing patients to share information

For more detailed information – Byrne and Long (1979)

SAVAGE AND ARMSTRONG (1990) found out that the doctor-led style had a better effect in terms of patient satisfaction as measured by:

• their perception of the doctor’s understanding of the problem
• the quality of the doctor’s explanation 
• the subjective improvement one week later

For more detailed information – Savage and Armstrong (1990)

Practitioner Diagnosis 

There are occasions where doctors will gather up information wrong and there are two types of errors they can commit:

1. Type I error – occurs when the doctor diagnoses someone to be healthy when in fact the patient is physically and/or psychologically ill. This is also said to be a FALSE POSITIVE.
2. Type II error – occurs when the doctor diagnoses someone to be ill when they are in fact healthy. This is also said to be a FALSE NEGATIVE.

It is quite obvious which error is more significant and may lead to more complications, however both can cause harm and distress to the patient.

Disclosure of Information

For a diagnosis to occur, the patient needs to give information to the doctor. Unfortunately, everyone has their own styles of communication; therefore, it may be difficult to reach a diagnosis that is correct if patients do not contribute effectively.

Sarafino (2006) noted that it becomes difficult to communicate with patients when they:

• Want to criticise the doctor or become angry.
• Ignore what the doctors is asking or saying.
• Insist on taking more tests or on being prescribed medication they do not need.
• Want a certificate for an illness they do not have.
• Make sexual remarks towards the doctor.

ROBINSON AND WEST (1992) found out that patients are less worried about social judgments and disclosing information about symptoms and undesirable behaviour of STDs when they are communicating these to a computer.

• Patients gave more information and admitted to having more sexual partners to the computer than to the doctor they met afterwards.

Strenghts:

+ Useful – it encouraged the development of communication systems in hospital to make                    patients more comfortable and make it easier to reach a correct diagnosis.

+ No demand characteristics – the research was carried out in a real hospital with real                                                             patients, doctors, meaning that the participants would not                                                         change their behaviour to conform with the experiment. 

Weaknesses:

– Ungeneralisable – the research was only carried out at one clinic, making the results                                           less applicable to the entire population and less reliable.

– Patients may have felt it to be useless to mention everything to the doctors since they had just told the computer.