Communicating with the rheumatic patient.

To explore the meanings attached to words by patients and doctors, a multiple-choice questionnaire was given to 214 rheumatic patients, 110 non-rheumatic patients, 227 rheumatologists and 36 general practitioners. Words and phrases dealt with symptoms in descriptive terms, common disorders and parts of the body relevant to rheumatology. Poor agreement was obtained for 'back' among rheumatologists and hospital doctors, and for 'arthritis' among general practitioners. The word 'sciatica' means very different things to different doctors. Among rheumatic sufferers good agreement was only reached for 'rheumatism' and 'hereditary'. Non-rheumatic sufferers obtained better agreement than the rheumatic patients. This may have been due to more in the professional classes among the former group. The poorest agreement among rheumatic patients was for 'numbness', 'sciatica', 'slipped disc', 'vertebra', 'cervical', 'spinal cord', 'arthritis', 'deformity', 'anaemia', 'ligaments', 'osteoarthritis', 'lumbar', 'sacrum' and 'back'. Poor doctor-patient correlation between patients and rheumatologists occurred for 'numbness', 'spinal cord', 'cervical', 'sacrum', 'loin', 'slipped disc', 'arthritis', 'osteoarthritis' and 'steroids'.