Methods: Thirty-nine doctors - 23 specialist general practitioners (GPs) and 16 other specialists (e.g. physicians, surgeons) - were purposively selected as leaders in their fields. Participants were interviewed individually (n=17) or participated in focus groups of 3-9 participants. Interview guides included questions exploring doctors perceptions of patient question-asking, PQPLs and a sample PQPL created using an Australian government-funded online tool, Question Builder. Recordings were transcribed verbatim and data analysed thematically using the method by Braun and Clarke.
Results: Analysis showed that patient question-asking is viewed as a normal part of [the] consultation process as are PQPLs. Although doctors acknowledged that questions are a good thing they wanted to see whats on the list and had to decide how (they) are going to approach it all particularly when the patient agenda is perceived to exceed the constraints of the consultation. Time, patient factors and medical complexity affected strategies employed by doctors to manage PQPLs: You have to get a feel for what information they want... so it's very individual each consultation. Regarding the sample PQPL, available consultation time and specialty influenced responses: Id just feel overwhelmed...itll just take up so much time (GP) compared with I have the luxury of having plenty of time in my consultations. So I can give them time to think (specialist).
Conclusion: Doctors strive to manage patient expectations and maintain the benefits of PQPLs in practice. Clarifying doctor and patient expectations and agendas may lead to more effective use of PQPLs.
Implications for practice: All stakeholders need to be involved in PQPL development to ensure their effectiveness in practice.