Grant: Project Grant

A patient visits their doctor with a set of symptoms hoping for a diagnostic test, a prescription, or a diagnosis. Yet, sometimes doing nothing is better. Unnecessary interventions needlessly expose the patient to harms, lengthen the wait for other patients in need of tests or therapy, and burden the health system with avoidable costs. The challenge is how to have doctor-patient conversations about clinical decisions about tests and procedures in a way that is patient-focused and maintains trust. To change the conversation, we need a better understanding of the doctor-patient interaction. We need to understand how doctors build trust with their patients, and do these strategies change if the doctor feels that the patient before them might face barriers in accessing health services. This is very important when faced with suggestions that "doing more" (tests, procedures) is not necessarily better. We need to understand how different groups of patients perceive their doctor visits, including how these might affect Metis patients compared to other Manitobans. In theory, all Manitobans, including the Metis, have equal access to the health care system, but the reality is quite varied and different. Some, by virtue of education, income, race, gender, language, and other issues might have trouble accessing health services and have poorer health outcomes. It is important to understand if there are aspects of initiatives promoting "more isn't better" that might harm some Manitoba patients, like the Metis, because of their already poorer health status. Equally important, unless the expectations of patients who are able to access the health system are met about what they need to feel assured they are getting the best care, trust in doctor recommendations may be compromised. Using interviews with doctors and focus groups with Metis and other Manitobans in Winnipeg, Brandon and Winkler, we focus on common reasons bringing patients to visit their doctor: pain or infection.