Choosing to attend an asthma doctor: a qualitative study in adults attending emergency departments

2004; 21: 166–172.Background. Asthma treatment guidelines currently recommend a ‘therapeutic partnership’to achieve best care. It is frequently assumed that individuals presenting to emergency depart-ments with asthma do not have a good doctor–patient relationship. We asked what is the natureof patients’ relationships with their doctors in those presenting to hospital emergencydepartments for asthma care.Methods. A qualitative study of all consenting individuals aged 18–70 years who presented toa hospital emergency department over 2 months was carried out. Sixty-two participants (19male) engaged in in-depth interviews which were taped, transcribed and underwent thematicanalysis. Questionnaire data were also collected and asthma severity determined.Results. Nearly all patients (61/62) had a doctor whom they saw for their asthma. Patientsmade thoughtful choices on where they sought care according to their needs. Our findingsidentified that perceptions of doctors’ competence, listening to patients and time constraintswere important influences on doctor–patient relationships. Participants had strong expectationsthat their personal disease experience would be acknowledged by their doctors.Conclusion. This group of patients had doctors who cared for their asthma. The acceptabilityof medical care was determined as much by patient choice as by the quality of thedoctor–patient relationship.Keywords. Adherence, asthma, bodily experience, chronic illness, discourse, doctor–patientrelationships.