What's in a name? An experimental study of patients' views of the impact and function of a diagnosis.
OBJECTIVE
The aim of the present study was to examine patients' views about the relative impact and function of lay and medical diagnoses for stomach and throat problems.


METHODS
A questionnaire survey was carried out among 900 consecutive patients attending nine general practices across England. A total of 740 questionnaires were completed (response rate: 82.2%). Each participant rated a series of statements describing the impact upon the patient and the function for the doctor following both a stomach and a throat problem case scenario involving either a lay (stomach upset/sore throat) or medical (gastroenteritis/tonsillitis) label.


RESULTS
The results showed consistent differences between the lay and medical labels for both stomach and throat problems in terms of their impact upon the patient and their function for the doctor. In particular, the medical labels were rated as beneficial for the patient in terms of validating the sick role and improving their confidence in the doctor. In contrast, the lay labels resulted in a greater sense of ownership of the problem which could be associated with unwanted responsibility and blame. In addition, the medical labels were seen to provide the doctor with a greater sense of professionalism, as giving them a clearer role in the consultation and to imply less blame on the part of the patient. 'Stomach upset' was also seen as a more pragmatic label than 'gastroenteritis'.


CONCLUSIONS
Although much current prescriptive literature in general practice advocates the use of lay language in the consultation as a means to promote better doctor-patient partnerships, the issue of diagnosis is more complex than this. Patients attribute greater benefits to the use of medical labels for themselves and state that such medical labels are of greater benefit to the doctor.
Department of General Practice, Guys Kings and St Thomas's School of Medicine, Kings College London, London, UK. Jane.Ogden@kcl.ac.uk
Jane
J
Ogden
Ruben
R
Branson
Annie
A
Bryett
Amaryllis
A
Campbell
Alberto
A
Febles
Ian
I
Ferguson
Hilary
H
Lavender
Jacques
J
Mizan
Robin
R
Simpson
Michael
M
Tayler
D001291:Attitude of Health Personnel; D004739:England; D005194:Family Practice / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007802:Language; D008297:Male; D010608:Pharyngeal Diseases / Q000175:diagnosis*; D010817:Physician-Patient Relations; D011897:Random Allocation; D012803:Sick Role; D013272:Stomach Diseases / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D009626:Terminology as Topic