[Needs and wishes of healthy patients - how should physicians deal with them?].
BACKGROUND
It is hardly known how physicians feel and act if patients complain about social damage, familial tragedies or problems at work instead of illnesses or diseases.


METHODS
Seven general practitioners discussed this subject in a focus-group setting. Within two hours, the three female and four male practitioners described some typical needs and wishes of their healthy patients. They were also encouraged to relate their feelings, reactions and behaviour as doctors. We interpreted the transcript of the recorded discussion according to the rules of a content-analysis.


RESULTS
Certificates, (non-medical) advice and information, general care and reducing expenses are the main reasons for healthy patients to see them, the doctors quoted. The doctor's feelings depend on the personality of the patient and the reported problems. As a result, the physician's acceptance of needs and wishes of healthy patients varies over a broad spectrum and the decisions differ and seem arbitrary, although reporting on similar situations. Her/his personal attributes and mood mainly determine their decision about the patient's wishes.


CONCLUSIONS
The question of whether to refuse or to respect healthy patients' wishes was arbitrary in this focus-group setting. Because no specific medical curriculum exists, rules for doctors' reactions and decisions on social, familial or working problems of their patients could be helpful. In particular, specific problems should be dealt with by social workers and related professions.
Jobst
D
D
Abteilung Allgemeinmedizin, Heinrich-Heine-Universität Düsseldorf. detmarj@uni-bonn.de
Fuchs
A
A
Joest
A
A
Nagel
N
N
D001291:Attitude of Health Personnel; D003376:Counseling; D004185:Disability Evaluation; D017144:Focus Groups; D005858:Germany; D006301:Health Services Needs and Demand; D006801:Humans; D008016:Life Change Events; D008306:Malingering / Q000175:diagnosis / Q000523:psychology; D020380:Needs Assessment; D010817:Physician-Patient Relations; D018582:Sick Leave; D012803:Sick Role; D012917:Social Adjustment; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology; D019564:Unnecessary Procedures