Authors: Weevers, Harm-Jan A.¹; van der Beek, Allard J.²; van den Brink-Muinen, Atie³; Bensing, Jozien⁴; Boot, Cécile R.L.¹; van Mechelen, Willem⁵

Source: Quality in Primary Care, Volume 17, Number 3, June 2009 , pp. 197-203(7)

Publisher: Radcliffe Publishing Ltd.

Abstract:

Background: Work-related musculoskeletal disorders (MSDs) are common in general practice. The communication between a general practitioner (GP) and patient is a key element of adequate general practice. No study has investigated the characteristics of communication about work-related matters during consultation of the GP by working patients with MSDs.

Objectives: The aim of this study was to describe the communication about work-related matters between the GP and his patients with paid work who are consulting for MSDs.

Method: Descriptive analysis of 680 systematic observations of GP consultations of patients in paid work who were consulting for MSDs.

Results: Work was discussed in 227 of 680 consultations in general practice. In 69% of these consultations the patient started communication concerning work-related matters, with an average number of 38.5 (standard deviation 45.7) verbal utterances, equalling, on average, 15% of the total consultation time. In 36% of consultations the patient's working conditions were discussed and in 12% the GP advised on whether to stay at home or return to work. There was a statistically significant positive correlation between the extent to which GPs rated the patient's MSDs to be work related and the number of utterances the GP and patient made about work-related matters during the consultation.

Conclusions: Work is not a standard topic of conversation during the GP consultation. GPs could more often start communication about patients' work. A challenge for future GP practice and education is to include discussion of patients' work to optimise patient-centred care.

Keywords: COMMUNICATION; FAMILY PRACTICE; MUSCULOSKELETAL DISORDERS; REFERRAL AND CONSULTATION; WORK

Document Type: Regular paper

Affiliations: 1: VU University Medical Center, EMGO Institute for Health and Care Research, Department of Public and Occupational Health, The Netherlands 2: Professor of Occupational Epidemiology and Vice-Head of Department, VU University Medical Center, EMGO Institute for Health and Care Research, Department of Public and Occupational Health, The Netherlands 3: Netherlands Institute for Health Services Research (NIVEL), The Netherlands 4: Professor of Clinical and Health Psychology and Director, Netherlands Institute for Health Services Research (NIVEL), The Netherlands 5: Professor of Occupational and Sports Medicine and Head of Department, VU University Medical Center, EMGO Institute for Health and Care Research, Department of Public and Occupational Health, The Netherlands

Publication date: 2009-06-01

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