Is perceived social distance between the patient and the general practitioner related to their disagreement on patient's health status?

ABSTRACT

OBJECTIVE: To ascertain whether disagreement between patients and general practitioners (GP) on the patient's health status varies according to their respective perceived social distance (PSD). METHODS: The analysis used the Intermede project's quantitative data collected from 585 patients and 27 doctors via mirrored questionnaires. GPs and patients ranked their own perceived social position (PSP) in society, and their patients' and their GP respectively. PSD was calculated as the PSP's subtraction from the patients' and GPs' assessments. RESULTS: Disagreement between GPs and patients regarding the patient's health status was associated with PSD by the GP whereas it was not associated with PSD by the patient. In the multilevel analysis, disagreement whereby GPs overestimate patient's health status increased within PSD by the GP OR2.9 (95%CI = 1.0-8.6, p = 0.055) for low PSD, OR3.4 (95%CI = 1.1-10.2, p < 0.05) for moderate PSD and OR3.8 (95%CI = 1.1-13.1, p < 0.05) for high PSD (reference no distance). CONCLUSIONS: Patients perceived with a lower social position by their GP and who consider themselves to have poor health are less likely to be identified in the primary care system. PRACTICE IMPLICATIONS Physicians need to be conscious that their own perception influences the quality of the interaction with their patients, potentially resulting in unequal health care trajectories.