Abstract

Behavioural conditions such as Attention-deficit/hyperactivity disorder (ADHD) are present in up to 5% of children across the world. This is a common reason for referral from primary care to Pediatricians. When a primary care provider refers a patient to a specialist, they often create a set of expectations in the patient. These expectations may have a strong effect on the patient relationship with the specialist. It has been shown that parental expectations can influence prescribing practices in Pediatrics. Low socioeconomic status, a risk factor for behavioural conditions is also a risk factor for poor physician-patient communication. If patient expectations set up in primary care are not reflected in the referral question sent to the Pediatrician, this may hinder Pediatrician-patient communication and impact care. A clinic nurse conducted 440 pre-appointment intake interviews of guardians in children with a referral related to a behavioural concern and asked them their expectations for the consultation. The referral question and parental expectations were categorized by question of behavioural diagnosis, learning difficulties, medical complaint or unknown. There was a high level of discordance between referral question and parent expectations. We could improve our patient-centered approach and satisfaction by being clear in what is being offered by paediatric consultation and the needs of the family.