Objective To examine the discrepancies between the self-reporting of STI preventive care and the actual care provided by male doctors to male patients in several subdistricts of the state of Karnataka, south India.
Methods Of 3376 allopathic medical practitioners (doctors) enumerated, 2846 were contacted in person. Doctors who saw at least five patients with STI a month were then interviewed (814). Further, 451 of these practitioners were visited by a ‘surrogate patient.’ Comparative analyses were conducted of items from the survey questionnaire and from the surrogate patient answer sheet that unambiguously tapped into the same information.
Results Systematic differences in the self-report by the doctors and the report by the surrogate patients were found. For instance, 99% of practitioners reported examining the patients, whereas only 71% of surrogate patients reported being examined. 96% of practitioners reported advising condom use, whereas only 19% of surrogate patients reported receiving this advice. 97% of practitioners reported advising partner treatment, whereas only 10% of surrogate patients reported receiving this advice. Younger practitioners, doctors in rural centres and doctors with STI in-service training were more likely to be discordant in what they self-reported and what surrogate patients reported.
Conclusions The discrepancies between doctor self-reporting and surrogate patient observations bring into question the reliability of practitioner recall, suggesting that the use of self-reporting surveys should be reassessed.
- STD services
- primary care
- health advice
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Funding Canadian Institutes of Health Research (CIHR); Bill and Melinda Gates Foundation. The views expressed herein are those of the authors and do not necessarily reflect the official policy or position of the Bill & Melinda Gates Foundation. JM was supported by a CIHR postdoctoral fellowship. JFB holds a Canada research chair tier II from CIHR. SM was the recipient of a CIHR investigator award.
Competing interests None.
Ethics approval This study was conducted with the approval of St John's Medical College, Bangalore, India.
Provenance and peer review Not commissioned; externally peer reviewed.
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