HOW DO PATIENTS EXPERIENCE CONSULTATIONS AT AN ORTHOPEDIC OUTPATIENT-CLINIC - 18 PATIENTS COMMENT ON VIDEO-TAPED CONSULTATIONS - A QUALITATIVE STUDY

The purpose of this study is to describe experiences of communication in medical consultations, obtained after patients have observed and co mmented on their own video recorded consultations. Eighteen patients i n an orthopaedic out-patient clinic were randomly selected and, of the se, 10 were men and 8 were women. Nine of the visits were first-time c onsultations and an equal number were follow ups. We explained that we wanted to understand what takes place between a doctor and patient, b oth when the experience is satisfactory and when it is not. Approximat ely 1 week after the consultation, the patient was allowed to watch th e video recording. Prior to viewing this, the patient was instructed t hat we were particularly interested in his/her viewpoints and spontane ous reactions. Every time a patient wished to say something, the video tape was stopped and the comments recorded. These comments were later transcribed. The patients' negative comments (60%) described four kind s of experiences indicating aspects of poor communication: i) the pati ent had difficulty understanding what the physician asked, said or did , ii) the physician was insufficiently prepared for the consultation, iii) the physician questioned the findings of other doctors and iv) th e physician showed a lack of understanding.