Met or matched expectations: what accounts for a successful back pain consultation in primary care?

• Published in: Health expectations : an international journal of public participation in health care and health policy 2013-06, Vol.16 (2), p.143-154
• Main Authors: Georgy, Ehab E., Carr, Eloise C.J., Breen, Alan C.
• Format: Article
• Language: English
• Subjects: Agreements; Archives & records; Attitude of Health Personnel; Back pain; Back Pain - psychology; Back Pain - therapy; Conceptual models; Consultation; Doctors; expectations; Family physicians; Frame analysis; Health care; Health status; Humans; Identification; Internal medicine; Literature reviews; matched; Medical referrals; Medicine; met; Models, Theoretical; Pain; Patient Satisfaction; Patients; Perceptions; Physicians; Primary care; Primary health care; Primary Health Care - methods; Primary Health Care - standards; Qualitative research; Quality of care; Quality of Health Care - standards; Review; Rheumatology; Systematic review; theory development; Treatment Outcome
• ISSN: 1369-6513; 1369-7625
• DOI: 10.1111/j.1369-7625.2011.00706.x

Background  Patients’ as well as doctors’ expectations might be key elements for improving the quality of health care; however, previous conceptual and theoretical frameworks related to expectations often overlook such complex and complementary relationship between patients’ and doctors’ expectations. The concept of ‘matched patient–doctor expectations’ is not properly investigated, and there is lack of literature exploring such aspect of the consultation. Aim  The paper presents a preliminary conceptual model for the relationship between patients’ and doctors’ expectations with specific reference to back pain management in primary care. Methods  The methods employed in this study are integrative literature review, examination of previous theoretical frameworks, identification of conceptual issues in existing literature, and synthesis and development of a preliminary pragmatic conceptual framework. Outcome  A simple preliminary model explaining the formation of expectations in relation to specific antecedents and consequences was developed; the model incorporates several stages and filters (influencing factors, underlying reactions, judgement, formed reactions, outcome and significance) to explain the development and anticipated influence of expectations on the consultation outcome. Conclusion  The newly developed model takes into account several important dynamics that might be key elements for more successful back pain consultation in primary care, mainly the importance of matching patients’ and doctors’ expectations as well as the importance of addressing unmet expectations.