[The evaluation of the approach to the patient in primary care medical consultations].

OBJECTIVE

To study the clinical interview to find the orientation (to the patient or the illness) adopted by Primary Care doctors.

DESIGN

Crossover study.

SETTING

Primary Care.

PATIENTS AND OTHER PARTICIPANTS

74 clinical interviews, covering 11 Primary Care doctors and five third-year family medicine interns, were recorded on video.

INTERVENTIONS

Evaluation of the interviews using a validated evaluation model, which analyses the objectives set and the information received and given.

MEASUREMENTS AND MAIN RESULTS

A climate of confidence was created in 96% of the interviews. The nature of the problem was identified and associated factors were investigated in 67% of the consultations. In the problem-solving part of the interview, the course of action proposed was discussed in detail in 96% of cases, whereas in less than 10% of the consultations were patients' preferences or opinions about the diagnosis and treatment explored, or any interest shown in opinions on the same.

CONCLUSION

In both the investigative and the problem-solving phases, aims to do with the biological side of the illness were mostly achieved, but there was little orientation shown towards involving the patient.