International Conference on Communication in Healthcare location:Oslo date:2-5 september 2008
In Flanders, Belgium, insurance doctors play a major role in the decision whether a sick patient cannot or should go back at work. Besides clinical and technical investigation, doctor-patient communication is the most important tool in the decision making process. In order to design a communication course for this specific group of insurance doctors, we wanted to know how patients experience and evaluate their contacts with these doctors.
We chose for focus groups with patients as the appropriate method for this explorative study. Four hundred insured patients received a letter to invite them to participate in a study for a university operating independent from their insurance company. Two trained researchers were recruted to facilitate the focus groups. Key issues were selected from literature and transformed into open questions. All groups were audio-taped and transcripts were analysed with Atlas-Ti 5.0 using grounded theory as the research framework. Two researchers (SN and HR) coded all the fragments and did six intercoder reliability controls (with JG and PD) to ascertain that identical codes were developed.
Sixty-two patients participated in seven groups. Every group had a good representation in terms of sex, age, education, profession and sickness duration. All themes mentioned by the participants clustered around five topics: (1) the invitational letter for the consultation, (2) the waiting room and time, (3) the contact with the insurance doctor, (4) the communication of the decision and (5) suggestions on how to ameliorate the communicative aspects of the process.
Notwithstanding the difficult position of the insurance doctor, a number of aspects of the communication process can be ameliorated. Some of these can take place during a communication course where special attention has to go to handling emotions and giving information. Research into insurance doctors communication is a promising field with relevant implications for health care.