Doctor-patient concordance and patient initiative during episodes of low back pain

D. Hermoni*, J. M. Borkan, S. Pasternak, A. Lahad, R. Van-Ralte, A. Biderman, S. Reis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Doctor-patient concordance and patient initiative were examined in a prospective network interview study, with telephone follow-up, of a cohort of 100 patients presenting with low back pain to their family physician. The average overall rate of concordance was 60% (95% Cl = 53 to 66), with the highest rates for radiographic imaging studies and sick leave. No correlation was found between concordance and patient parameters. Subjects initiated an average of two (95% Cl = 1.7 to 2.3) diagnostic or therapeutic procedures, the most common of which were for medications (40%), followed by bed rest (26%) and back school (22%). One out of every six subjects initiated a referral to a complementary therapist. Positive correlation was found between patient initiatives and pain severity (P = 0.022) and disability (P = 0.02). There was a negative correlation between the subjects' initiatives and their belief that the physician understood the cause of their pain and its influence on their life (P = 0.02). Overall, those patients who described more pain or disability sought more types of diagnostic and therapeutic measures, while those who felt they had been understood sought less.

Original languageAmerican English
Pages (from-to)809-810
Number of pages2
JournalBritish Journal of General Practice
Issue number459
StatePublished - 2000
Externally publishedYes


  • Concordance
  • Low back pain
  • Patient initiative


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