Abstract
BackgroundGeneral practitioners often take their impression of patients' expectations into account in their decision to have blood tests done. It is commonly recommended to involve patients in decision-making during consultations. The study aimed to obtain detailed information on patients' expectations about blood tests.MethodsQualitative study among patients in waiting rooms of general practices. Each patient was presented with a short questionnaire about their preferences in terms of diagnostics. Patients who would like blood tests to be done were interviewed.ResultsFifty-seven (26%) of the 224 respondents wanted blood tests. Twenty-two were interviewed. Patients overestimated the qualities of blood tests. Favourable test results were regarded as proof of good health. Patients regarded blood tests as a useful instrument to screen for serious disorders, and were confirmed in this belief by people in their social environment and by the media. Many patients expected their GP to take an active test ordering approach, though some indicated that they might be convinced if their GP proposed a wait-and-see policy.ConclusionsGPs' perceptions about patient expectations seem justified: patients appear to have high hopes for testing as a diagnostic tool. They expect diagnostic certainty without mistakes and a proof of good health. The question is whether it would be desirable to remove patients' misconceptions, allowing them to participate in policy decisions on the basis of sound information, or whether it would be better to leave the misconceptions uncontested, in order to retain the 'magic' of additional tests and reassure patients. We expect that clarifying the precise nature of patients' expectations by the GP may be helpful in creating a diagnostic strategy that satisfies both patients and GPs. GPs will have to balance the benefits of reassuring their patients by means of blood tests which may be unnecessary against the benefits of avoiding unnecessary tests. Further research is needed into the effects of different types of patient information and the effects of testing on satisfaction and anxiety.
Highlights
General practitioners often take their impression of patients' expectations into account in their decision to have blood tests done
No detailed information is available on patients' motives and their possible misconceptions especially as regards blood tests for diagnostic purposes, the impact of environmental factors on patients' expectations and the role of blood tests in the relation between patients and general practitioners (GPs)
All participating patients were presented with a short questionnaire, which asked for demographics and preferences regarding the use of diagnostics by the GP
Summary
General practitioners often take their impression of patients' expectations into account in their decision to have blood tests done. Various studies have shown that general practitioners (GPs) regularly order blood tests without good medical arguments [1,2]. GPs often have non-medical reasons to order blood tests anyway, such as the desire to end the consultation or to reassure a patient, or the assumption that patients expect blood tests or see testing as an indicator of quality of care [5,6,7]. There appears to be a tension between the frequently limited diagnostic value of blood tests in general practice and the great appreciation for supplementary diagnostics among patients [18]. The purpose of the present study was a detailed assessment of patients' views on the value of blood testing when an actual desire for blood tests exists
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