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Table 5 Synthesis of the doctor-patient interaction aspects associated with patient satisfaction/dissatisfaction (n = 186)

From: Patient satisfaction with doctor-patient interactions: a mixed methods study among diabetes mellitus patients in Pakistan

Patient experiences Examples Theoretical concepts
Dominance of doctor Patients think doctor is superior to them on the basis of knowledge. Doctors can snub the patients. Patient should not counter question so the doctor may not get irritated. Patients don’t mind rudeness of doctors. No realization of patient rights.
Lack health education.
Illiteracy.
Communication is affected
External interruption Patients are seen by doctors in presence of others unrelated people. Medical representatives come in the doctor’s room any time even when patient is being checked. Doctors attend phone calls and anyone who interrupts. No realization of Patient right to privacy.
Time constraints Due to dominance of doctors and short time available, the patients are unable to express their symptoms and provide history. They fear reaction of doctors. Short meeting time.
Long waiting time.
Inability of diagnose Patients are not touched for physical examination. Doctors reveal disgust towards poor patients. Doctors write many irrelevant medical tests. When patients take reports to doctor, he says that these are fine now go get other tests done. After many expensive tests doctor remains unable to diagnose what exactly is the problem. In some cases, doctors recommends retests as the reports are inaccurate. Patients feel that the junior doctors are experimenting on poor people. Patients feel deprived of specialist care in public clinics. Inability to see the same doctor again. Patients are in poor hygiene.
Physical examination.
Excessive reliance on tests.
Inexperienced trainee doctors.
Inability to judge on the basis of Clinical symptoms.
Specialist doctors.
Unfamiliar with the type of DM diagnosed Patients are uneducated, they cannot understand medical terminologies, cannot differentiate between specialist or trainee doctor, lack health education. They are not explained by their doctors regarding what type of diabetes they suffer from. Vulnerability
Lack health education
Communication with doctors Patients feel that the doctors don’t explain in detail. They don’t appreciate asking questions. They neither convey necessary risks nor unnecessary risks to the patient. Over/Low/Not at all informing the patient.