Skip to main content
Top
Published in: BMC Health Services Research 1/2009

Open Access 01-12-2009 | Study protocol

Patient-physician interaction in general practice and health inequalities in a multidisciplinary study: design, methods and feasibility in the French INTERMEDE study

Authors: Michelle Kelly-Irving, Christine Rolland, Anissa Afrite, Chantal Cases, Paul Dourgnon, Pierre Lombrail, Jean Pascal, Thierry Lang

Published in: BMC Health Services Research | Issue 1/2009

Login to get access

Abstract

Background

The way in which patients and their doctors interact is a potentially important factor in optimal communication during consultations as well as treatment, compliance and follow-up care. The aim of this multidisciplinary study is to use both qualitative and quantitative methods to explore the 'black box' that is the interaction between the two parties during a general practice consultation, and to identify factors therein that may contribute to producing health inequalities. This paper outlines the original multidisciplinary methodology used, and the feasibility of this type of study.

Methods and design

The study design combines methodologies on two separate samples in two phases. Firstly, a qualitative phase collected ethnographical and sociological data during consultation, followed by in-depth interviews with both patients and doctors independently. Secondly, a quantitative phase on a different sample of patients and physicians collected data via several questionnaires given to patients and doctors consisting of specific 'mirrored' questions asked post-consultation, as well as collecting information on patient and physician characteristics.

Discussion

The design and methodology used in this study were both successfully implemented, and readily accepted by doctors and patients alike. This type of multidisciplinary study shows great potential in providing further knowledge into the role of patient/physician interaction and its influence on maintaining or producing health inequalities. The next challenge in this study will be implementing the multidisciplinary approach during the data analysis.
Appendix
Available only for authorised users
Literature
1.
go back to reference Arber S, McKinlay J, Adams A, Marceau L, Link C, O'Donnell A: Patient characteristics and inequalities in doctors' diagnostic and management strategies relating to CHD: A video-simulation experiment. Social Science & Medicine. 2006, 62 (1): 103-115. 10.1016/j.socscimed.2005.05.028.CrossRef Arber S, McKinlay J, Adams A, Marceau L, Link C, O'Donnell A: Patient characteristics and inequalities in doctors' diagnostic and management strategies relating to CHD: A video-simulation experiment. Social Science & Medicine. 2006, 62 (1): 103-115. 10.1016/j.socscimed.2005.05.028.CrossRef
2.
go back to reference Adams A, Buckingham CD, Lindenmeyer A, McKinlay JB, Link C, Marceau L, Arber S: The influence of patient and doctor gender on diagnosing coronary heart disease. Sociology of Health & Illness. 2008, 30: 1-18. 10.1111/j.1467-9566.2007.01025.x.CrossRef Adams A, Buckingham CD, Lindenmeyer A, McKinlay JB, Link C, Marceau L, Arber S: The influence of patient and doctor gender on diagnosing coronary heart disease. Sociology of Health & Illness. 2008, 30: 1-18. 10.1111/j.1467-9566.2007.01025.x.CrossRef
3.
go back to reference Arber S, McKinlay J, Adams A, Marceau L, Link C, O'Donnell A: Influence of patient characteristics on doctors' questioning and lifestyle advice for coronary heart disease: a UK/US video experiment. Br J Gen Pract. 2004, 54 (506): 673-678.PubMedPubMedCentral Arber S, McKinlay J, Adams A, Marceau L, Link C, O'Donnell A: Influence of patient characteristics on doctors' questioning and lifestyle advice for coronary heart disease: a UK/US video experiment. Br J Gen Pract. 2004, 54 (506): 673-678.PubMedPubMedCentral
4.
go back to reference Street RL, Gordon H, Haidet P: Physicians' communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?. Social Science & Medicine. 2007, 65 (3): 586-598. 10.1016/j.socscimed.2007.03.036.CrossRef Street RL, Gordon H, Haidet P: Physicians' communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?. Social Science & Medicine. 2007, 65 (3): 586-598. 10.1016/j.socscimed.2007.03.036.CrossRef
5.
go back to reference Willems S, De Maesschalck S, Deveugele M, Derese A, De Maeseneer J: Socio-economic status of the patient and doctor-patient communication: does it make a difference?. Patient Educ Couns. 2005, 56 (2): 139-146. 10.1016/j.pec.2004.02.011.CrossRefPubMed Willems S, De Maesschalck S, Deveugele M, Derese A, De Maeseneer J: Socio-economic status of the patient and doctor-patient communication: does it make a difference?. Patient Educ Couns. 2005, 56 (2): 139-146. 10.1016/j.pec.2004.02.011.CrossRefPubMed
6.
go back to reference Heritage J, Maynard DW: Problems and Prospects in the Study of Physician-Patient Interaction: 30 Years of Research. Annual Review of Sociology. 2006, 32 (1): 351-374. 10.1146/annurev.soc.32.082905.093959.CrossRef Heritage J, Maynard DW: Problems and Prospects in the Study of Physician-Patient Interaction: 30 Years of Research. Annual Review of Sociology. 2006, 32 (1): 351-374. 10.1146/annurev.soc.32.082905.093959.CrossRef
7.
go back to reference Kinnersley P, Stott N, Peters TJ, Harvey I: The patient-centredness of consultations and outcome in primary care. Br J Gen Pract. 1999, 49 (446): 711-716.PubMedPubMedCentral Kinnersley P, Stott N, Peters TJ, Harvey I: The patient-centredness of consultations and outcome in primary care. Br J Gen Pract. 1999, 49 (446): 711-716.PubMedPubMedCentral
8.
go back to reference Krupat E, Bell RA, Kravitz RL, Thom D, Azari R: When physicians and patients think alike: Patient-centered beliefs and their impact on satisfaction and trust. J Fam Pract. 2001, 50 (12): 1057-1062.PubMed Krupat E, Bell RA, Kravitz RL, Thom D, Azari R: When physicians and patients think alike: Patient-centered beliefs and their impact on satisfaction and trust. J Fam Pract. 2001, 50 (12): 1057-1062.PubMed
9.
go back to reference Bensing JM, Tromp F, van Dulmen S, Brink-Muinen van den A, Verheul W, Schellevis FG: Shifts in doctor-patient communication between 1986 and 2002: a study of videotaped general practice consultations with hypertension patients. BMC Fam Pract. 2006, 7: 62-10.1186/1471-2296-7-62.CrossRefPubMedPubMedCentral Bensing JM, Tromp F, van Dulmen S, Brink-Muinen van den A, Verheul W, Schellevis FG: Shifts in doctor-patient communication between 1986 and 2002: a study of videotaped general practice consultations with hypertension patients. BMC Fam Pract. 2006, 7: 62-10.1186/1471-2296-7-62.CrossRefPubMedPubMedCentral
10.
go back to reference Street RL, O'Malley KJ, Cooper LA, Haidet P: Understanding concordance in patient-physician relationships: Personal and ethnic dimensions of shared identity. Ann Fam Med. 2008, 6 (3): 198-205. 10.1370/afm.821.CrossRefPubMedPubMedCentral Street RL, O'Malley KJ, Cooper LA, Haidet P: Understanding concordance in patient-physician relationships: Personal and ethnic dimensions of shared identity. Ann Fam Med. 2008, 6 (3): 198-205. 10.1370/afm.821.CrossRefPubMedPubMedCentral
11.
go back to reference Bao Y, Fox SA, Escarce JJ: Socioeconomic and Racial/Ethnic Differences in the Discussion of Cancer Screening: "Between-" versus "Within-" Physician Differences. Health Serv Res. 2007, 42 (3p1): 950-970. 10.1111/j.1475-6773.2006.00638.x.CrossRefPubMedPubMedCentral Bao Y, Fox SA, Escarce JJ: Socioeconomic and Racial/Ethnic Differences in the Discussion of Cancer Screening: "Between-" versus "Within-" Physician Differences. Health Serv Res. 2007, 42 (3p1): 950-970. 10.1111/j.1475-6773.2006.00638.x.CrossRefPubMedPubMedCentral
12.
go back to reference Gordon HS, Street JRL, Adam Kelly P, Souchek J, Wray NP: Physician-patient communication following invasive procedures: an analysis of post-angiogram consultations. Social Science & Medicine. 2005, 61 (5): 1015-1025. 10.1016/j.socscimed.2004.12.021.CrossRef Gordon HS, Street JRL, Adam Kelly P, Souchek J, Wray NP: Physician-patient communication following invasive procedures: an analysis of post-angiogram consultations. Social Science & Medicine. 2005, 61 (5): 1015-1025. 10.1016/j.socscimed.2004.12.021.CrossRef
13.
go back to reference Cooper LA, Roter DL, Johnson RL, Ford DE, Steinwachs DM, Powe NR: Patient-Centered Communication, Ratings of Care, and Concordance of Patient and Physician Race. Ann Intern Med. 2003, 139 (11): 907-915.CrossRefPubMed Cooper LA, Roter DL, Johnson RL, Ford DE, Steinwachs DM, Powe NR: Patient-Centered Communication, Ratings of Care, and Concordance of Patient and Physician Race. Ann Intern Med. 2003, 139 (11): 907-915.CrossRefPubMed
14.
go back to reference Gordon HS, Street RL, Sharf BF, Souchek J: Racial differences in doctors' information-giving and patients' participation. Cancer. 2006, 107 (6): 1313-1320. 10.1002/cncr.22122.CrossRefPubMed Gordon HS, Street RL, Sharf BF, Souchek J: Racial differences in doctors' information-giving and patients' participation. Cancer. 2006, 107 (6): 1313-1320. 10.1002/cncr.22122.CrossRefPubMed
15.
go back to reference Charles M-A, Eschwege E, Basdevant A: Monitoring the Obesity Epidemic in France: The Obepi Surveys 1997–2006. Obesity. 2008, 16 (9): 2182-2186. 10.1038/oby.2008.285.CrossRefPubMedPubMedCentral Charles M-A, Eschwege E, Basdevant A: Monitoring the Obesity Epidemic in France: The Obepi Surveys 1997–2006. Obesity. 2008, 16 (9): 2182-2186. 10.1038/oby.2008.285.CrossRefPubMedPubMedCentral
16.
go back to reference Molarius A, Seidell JC, Sans S, Tuomilehto J, Kuulasmaa K: Educational level, relative body weight, and changes in their association over 10 years: An international perspective from the WHO MONICA Project. Am J Public Health. 2000, 90 (8): 1260-1268. 10.2105/AJPH.90.8.1260.CrossRefPubMedPubMedCentral Molarius A, Seidell JC, Sans S, Tuomilehto J, Kuulasmaa K: Educational level, relative body weight, and changes in their association over 10 years: An international perspective from the WHO MONICA Project. Am J Public Health. 2000, 90 (8): 1260-1268. 10.2105/AJPH.90.8.1260.CrossRefPubMedPubMedCentral
17.
go back to reference CNIL: La mise en œuvre, à titre expérimental, d'une étude ayant pour objet la relation patient-malade et son incidence sur la construction des inégalités sociales de santé. Volume n° 1228223. Paris; 11 September 2007 (ethical approval document). 1228223, . Paris; 11 September 2007 (ethical approval document) CNIL: La mise en œuvre, à titre expérimental, d'une étude ayant pour objet la relation patient-malade et son incidence sur la construction des inégalités sociales de santé. Volume n° 1228223. Paris; 11 September 2007 (ethical approval document). 1228223, . Paris; 11 September 2007 (ethical approval document)
18.
go back to reference Last JM: A dictionary of epidemiology. 2001, Oxford: Oxford University Press, fourth Last JM: A dictionary of epidemiology. 2001, Oxford: Oxford University Press, fourth
19.
go back to reference Glaser BG, Strauss AL: The discovery of grounded theory: strategies for qualitative research. 1967, Chicago: Aldine publishing co. Glaser BG, Strauss AL: The discovery of grounded theory: strategies for qualitative research. 1967, Chicago: Aldine publishing co.
Metadata
Title
Patient-physician interaction in general practice and health inequalities in a multidisciplinary study: design, methods and feasibility in the French INTERMEDE study
Authors
Michelle Kelly-Irving
Christine Rolland
Anissa Afrite
Chantal Cases
Paul Dourgnon
Pierre Lombrail
Jean Pascal
Thierry Lang
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2009
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-9-66

Other articles of this Issue 1/2009

BMC Health Services Research 1/2009 Go to the issue