TY - JOUR T1 - Why the ‘reason for encounter’ should be incorporated in the analysis of outcome of care JF - British Journal of General Practice JO - Br J Gen Pract SP - e839 LP - e841 DO - 10.3399/bjgp11X613269 VL - 61 IS - 593 AU - Tim C olde Hartman AU - Hiske van Ravesteijn AU - Peter Lucassen AU - Kees van Boven AU - Evelyn van Weel-Baumgarten AU - Chris van Weel Y1 - 2011/12/01 UR - http://bjgp.org/content/61/593/e839.abstract N2 - In the traditional medical model, the diagnosis takes a central stage in the delineation of treatment and care. The diagnosis as the determinant of the response to patients1 has been the general line of medical education,2 is at the core of most evidence-based guidelines and protocols,3 and shapes the payment of physicians’ performance.4Since its renaissance in the 1960s, general practice has questioned the narrow focus on the diagnosis as the single determinant of professional performance and pursued a person-centred, holistic approach of health care;5,6 diseases do not come in isolation but occur in the context of an individual with the disease, and it is to this broader context that health care has to respond.Yet, despite the growing international support of people at the centre of health care, professional performance is mainly regulated and awarded in relation to the diagnosis, disregarding the broader individual and social context of diseases, even in countries with a long and strong primary care tradition.3,7 Person-centredness should be part of every consultation. Clarifying the patient perspective parallel to the health problem can be a practical way of achieving this.In this article we call on the discipline of general practice to clarify patients’ perspectives in a systematic way, in patient care and research. We argue that patients’ reasons to seek medical care reflect their personal needs and expectations, and we illustrate how the use of the International Classification of Primary Care (ICPC)8 can help better understand the process and outcome of care. ICPC was a major step in the development of health informatics for primary care, by incorporating different aspects alongside the classification of health problems.9 For this … ER -