Questioning behaviour in general practice: a pragmatic study.

OBJECTIVE

To study the extent to which general practitioners' questioning behaviour in routine practice is likely to encourage the adoption of evidence based medicine.

DESIGN

Self recording of questions by doctors during consultations immediately followed by semistructured interview.

SETTING

Urban Australian general practice.

SUBJECTS

Random sample of 27 general practitioners followed over a half day of consultations.

MAIN OUTCOME MEASURES

Rate of recording of clinical questions about patients' care which doctors would like answered; frequency with which doctors found answers to their questions.

RESULTS

Doctors asked a total of 85 clinical questions, at a rate of 2.4 for every 10 patients seen. They found satisfactory answers to 67 (79%) of these questions. Doctors who worked in small practices (of one or two doctors) had a significantly lower rate of questioning than did those in larger practices (1.6 questions per 10 patients v 3.0 patients, P = 0.049). No other factors were significantly related to rate of questioning.

CONCLUSIONS

These results do not support the view that doctors routinely generate a large number of unanswered clinical questions. It may be necessary to promote questioning behaviour in routine practice if evidence based medicine and other forms of self directed learning are to be successfully introduced.