Comparing clinical and lay accounts of the diagnosis and treatment of back pain.

This paper builds on the body of knowledge concerning clinician-patient relationships, patient-centred care and concordance. It extends the analysis to directly comparing patient and professional accounts of diagnosis, treatment and outcomes over time. Comparisons will be made between lay and clinical perspectives, but also between different professional approaches and patients' assessment of those differences. The paper is based upon an in-depth qualitative analysis of two case studies: first, one patient who established concordant relationships with the health professionals who treated her back pain; second, one patient who had both concordant and discordant relationships with health professionals. The issues explored centre on the determinants of concordant/discordant therapeutic relationships and whether greater attention given to the meaning of illness leads to improved care.