People attending the general practices and hospital OPDs in two rural
Queensland towns were asked, before receiving care, to indicate why th
ey were seeking care. The consulting providers reported the outcome of
the encounter. Using ICPC Components and Chapters patient and provide
r reports were compared to assess the level of agreement between same,
in order to determine the nexus between patient perceptions and provi
der diagnoses. Patients tended to report signs and symptoms in prefere
nce to specific diagnoses, for both first and follow-up visits. Good c
oncurrence between patient and provider reports were recorded in those
Chapters in which conditions commonly had obvious signs and symptoms
and relatively high follow-up rates. 'Psychological' conditions were a
n exception in this regard, suggesting that patient reports are unreli
able for such conditions. Patient and provider reports should be seen
as different aspects of health care, and therefore should not be used
as corollaries of each other. Researchers need to be clear about which
perspective is required-that of the patient or the provider-in explor
ing the content of clinical encounters. Provider reports do not reflec
t the triggers (perceptions) which persuade patients to seek care.