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Logo of brjgenpracThe British Journal of General Practice
Br J Gen Pract. 2000 October; 50(459): 809–810.
PMCID: PMC1313822

Doctor-patient concordance and patient initiative during episodes of low back pain.

D Hermoni, J M Borkan, S Pasternak, A Lahad, R Van-Ralte, A Biderman, S Reis, and Low Back Pain Working Group; RAMBAM Israeli Family Practice Research Network


Doctor-patient concordance and patient initiative were examined in a prospective network interview study, with telephone follow-up, of a cohort of 100 patients presenting with low back pain to their family physician. The average overall rate of concordance was 60% (95% CI = 53 to 66), with the highest rates for radiographic imaging studies and sick leave. No correlation was found between concordance and patient parameters. Subjects initiated an average of two (95% CI = 1.7 to 2.3) diagnostic or therapeutic procedures, the most common of which were for medications (40%), followed by bed rest (26%) and back school (22%). One out of every six subjects initiated a referral to a complementary therapist. Positive correlation was found between patient initiatives and pain severity (P = 0.022) and disability (P = 0.02). There was a negative correlation between the subjects' initiatives and their belief that the physician understood the cause of their pain and its influence on their life (P = 0.02). Overall, those patients who described more pain or disability sought more types of diagnostic and therapeutic measures, while those who felt they had been understood sought less.

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners