Hidden agenda meaning6/1/2023 These aspects may be systematically ignored or overlooked in check-up consultations while the physicians tend to focus on delivering of screening recommendations. Yet, often there may be hidden motives- to use the doctor as a counsellor to discuss problems, to seek reassurance regarding undeclared symptoms or to find security. Health maintenance is the declared objective of a check-up examination. Patients may openly mention their reasons to the physician ("open agenda"), or they might not ("hidden agenda"). The actual reasons behind most check-up examinations requested by patients are generally unknown and qualitative data about the percentage of patients who request check-ups for reasons other than routine screening is lacking. However, patients who request a check-up examination may expect more than just routine screening in accordance with current medical guidelines. When patients request check-ups, physicians may assume it is for detection of asymptomatic disease. For European countries, epidemiological data on the use of check-up examinations have not yet been reported. From 2002 to 2004, approximately 44 millions US adults per year received a periodic health examination. Furthermore, physicians must be alert for possible hidden agendas, as one in three patients have one or more hidden reasons for requesting a check-up.Ĭheck-up examinations, referred to as periodic health examination (PHE), or an annual physical examination, are among the most common reasons adults see a physician. The majority of patients requesting a general check-up tend to be motivated by specific symptoms and health concerns and are not "asymptomatic" patients who primarily come for preventive issues. The primary categories for hidden agendas were health concerns, psychosocial concerns and the patient's concept of disease. In 23 patients a total of 31 hidden agendas were revealed. The remaining 59 patients spontaneously mentioned a mean of 4.2 ± 3.3 symptoms during their first consultation. ResultsĪll patients initially declared to be asymptomatic but this was ultimately the case in only 7 out of 66 patients. All consultations were videotaped and analysed for information about spontaneously mentioned symptoms and reasons for the clinic consultation ("open agendas") and for cues to hidden patient agendas using the Roter interaction analysis system (RIAS). All patients actively denied upon prompting having any symptoms or specific health concerns at the time they made their appointment. Methodsįor a year, we prospectively enrolled 66 patients who explicitly requested a "check-up" at our medical outpatient division. However, quantitative and qualitative data about the discrepancy between patient- and provider expectations for this type of clinic consultation is lacking. Patients' perceptions and expectations regarding a check-up exam may differ from these principles. Current guidelines for a check-up recommend routine screening not triggered by specific symptoms for some known risk factors and diseases in the general population.
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