Exploring patient ideas, concerns, and expectations in surgeon-patient consultations

• Published in: Patient education and counseling 2024-08, Vol.125, p.108289-108289, Article 108289
• Main Authors: White, Sarah J., Kim, Ji Woo, Rakhra, Harkirti, Ranatunga, Devindee, Parker, Rhiannon B., Roger, Peter, Cartmill, John A.
• Format: Article
• Language: English
• Subjects: Calgary-Cambridge Guide; Patient agency; Patient perspectives; Patient-centred approach; Surgeon-patient communication
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2024.108289

This study explores patient perspectives (ideas, concerns, and expectations) in surgeon-patient consultations. We examined 54 video-recorded consultations using applied conversation analysis. Consultations took place from 2012 to 2017 in an Australian metropolitan hospital clinic centre and involved seven surgeons across six specialties. Patient perspectives emerged in less than one third of consultations. We describe the initiation of and response to potential perspectives sequences, demonstrating how patients and surgeons co-construct these sequences when they do occur. Findings suggest a need for greater attention to supporting patient agency through explicit pursuit of patient perspectives. The implications extend to the Calgary-Cambridge Guide, suggesting that it may benefit from a focus on active pursuit and appropriate responsiveness to patient perspectives. This study highlights the need for surgeons to actively engage with the patient perspective offered in consultations, emphasising the importance of respect for the patient’s knowledge and expectations to improve patient satisfaction and healthcare outcomes. •Applying patient-centred care skills in surgical consultations can be challenging.•This may be due to the complex, high stakes, and infrequent nature of encounters.•We describe how discussions about patient ideas, concerns, and expectations unfold.•There is potential gap between patient-centred models and actual practice.