Objective: To find what patients request from their general practitioner after they have seen a doctor privately and the type of negotiation which follows.
Design: A descriptive observation study of a crossover type.
Setting: Palma-Palmilla Health Centre (Málaga); within the primary care ambit.
Patients and other participants: Everyone at the on-demand clinics of five general medical practices, who requested something concrete from their general practitioner after they had seen a doctor privately, in the period from june to october 1993.
Measurements and main results: There were 83 patients who attended a clinic after seeing a doctor privately, which was 0.63% of the total consultations during this period. 69 of these patients asked their general practitioner to give them the same prescriptions that they had been prescribed privately. In 77% of the cases there was negotiation with the patient, a mutual promise being the most common result. There was no negotiation with 19 patients (23%). In 74% of the cases the medication prescribed privately was considered necessary. The wishes of the patients were fulfilled in practice in 65% of cases.
Conclusions: In most cases there was negotiation with patients. doctors agreed to a high degree with patients' requests, which doctors considered sufficient and necessary for the diagnosis and/or treatment of their condition.