Most doctors aren't terribly patient-centred in the way they run the consultation

Dr Paul Little

A similar number wanted to be involved in a "partnership" with the GP, so that they could feel they had a say on what they thought was wrong, and how it should be treated.

But only around 25% wanted a prescription when they left the surgery, and only 60% wanted an examination.

Surprise results

Dr Paul Little, a GP from Romsey, Hampshire, and a senior lecturer and researcher at Southampton University who led the research, said it had been a surprise patients wanted to be so involved.

He told BBC News Online the idea of "patient-centred care" had been around for some time, but that no one had asked the patients.

"The current advice is for something called patient-centred care approach.

"But we know that most doctors aren't terribly patient-centred in the way they run the consultation."

Dr Little said if patients did not feel involved, they may misunderstand the treatment plan drawn up for them, or fail to comply with it.

"Patients want their ideas, about their problems, about their ideas about their treatment explored and discussed."

Patients also want their quality of life and emotional problems considered by the doctor.

Prescribing 'pressure'

Dr Little said doctors did often feel under pressure to prescribe.

He said: "I think we were a little bit surprised how strong the desire for patient-centred care was, and the low figure about having a prescription.

"The trouble for doctors is that most have 10 minutes so the question is about whether you're going to be doing a lot of delving. You need to know what are the really important things you need to involve the patient in."

He said GPs should ask patients if they had any particular concerns about what might be wrong with them, or if they had read anything about a certain treatment, to involve them more in the consultation.

The research, published in the British Medical Journal, showed some patients expressed a particular need for good communication skills from their doctor.

Those who were unwell and worried, those who attend regularly (who often have anxiety or depression), and those who had no paid work were the groups who expressed a strongest wish for good listening and communication skills from their doctor.

Middle-aged patients tended to express a strong desire for communication skills, older patients less so.

But older patients were more likely to want a prescription, as were unmarried patients, those with no paid work and no education post-GCSE.

Those who wanted an examination were more likely to have finished education at 16 and to feel worried about their health.

The patient-centred approach covers six areas; talking about the disease, how it affects the person, finding common ground, health promotion and enhancing the doctor-patient relationship.

Dr George Rae, a member of the British Medical Association's GPs' committee said the overwhelming majority of doctors would like to listen to their patients concerns more, but do not have the time.

"Fifteen minutes is what we should be aiming at. One of the reasons that's very difficult to give is the lack of GPs, pro rata, compared to other parts of Europe."