title: Is perceived social distance between the patient and the general practitioner related to their disagreement on patient's health status?
abstract: OBJECTIVE
  To ascertain whether disagreement between patients and general practitioners (GP) on the patient's health status varies according to their respective perceived social distance (PSD).
  
  
  METHODS
  The analysis used the Intermede project's quantitative data collected from 585 patients and 27 doctors via mirrored questionnaires. GPs and patients ranked their own perceived social position (PSP) in society, and their patients' and their GP respectively. PSD was calculated as the PSP's subtraction from the patients' and GPs' assessments.
  
  
  RESULTS
  Disagreement between GPs and patients regarding the patient's health status was associated with PSD by the GP whereas it was not associated with PSD by the patient. In the multilevel analysis, disagreement whereby GPs overestimate patient's health status increased within PSD by the GP: OR:2.9 (95%CI = 1.0-8.6, p = 0.055) for low PSD, OR:3.4 (95%CI = 1.1-10.2, p < 0.05) for moderate PSD and OR:3.8 (95%CI = 1.1-13.1, p < 0.05) for high PSD (reference: no distance).
  
  
  CONCLUSIONS
  Patients perceived with a lower social position by their GP and who consider themselves to have poor health are less likely to be identified in the primary care system.
  
  
  CONCLUSIONS
  Physicians need to be conscious that their own perception influences the quality of the interaction with their patients, potentially resulting in unequal health care trajectories.
authors.affiliation: INSERM UMR 1027, Toulouse, F-31300, France. annececile.schieber@gmail.com
authors.forename: Anne-Cécile
authors.initials: AC
authors.lastname: Schieber
authors.forename: Michelle
authors.initials: M
authors.lastname: Kelly-Irving
authors.forename: Cyrille
authors.initials: C
authors.lastname: Delpierre
authors.forename: Benoît
authors.initials: B
authors.lastname: Lepage
authors.forename: Amel
authors.initials: A
authors.lastname: Bensafi
authors.forename: Anissa
authors.initials: A
authors.lastname: Afrite
authors.forename: Jean
authors.initials: J
authors.lastname: Pascal
authors.forename: Chantal
authors.initials: C
authors.lastname: Cases
authors.forename: Pierre
authors.initials: P
authors.lastname: Lombrail
authors.forename: Thierry
authors.initials: T
authors.lastname: Lang
mesh_terms: D002755:Choice Behavior; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires; D014956:Writing