Primary Care     1. Paul Little, professor of primary care
research (psl3{at},   2. Martina Dorward, research nurse1,   3.
Greg Warner, general practitioner2,   4. Katharine Stephens,
medical student1,   5. Jane Senior, medical student1,   6.
Michael Moore, general practitioner3   1. 1Primary Medical Care,
Community Clinical Sciences Division, Southampton University,
Aldermoor Health Centre, Southampton SO16 5ST   2. 2Nightingale
Surgery, Romsey SO51 7QN   3. 3Three Swans Surgery, Salisbury
SP1 1DX   1. Correspondence to: P Little   • Accepted 10
December 2003    Design Observational study nested within a
randomised controlled trial.  Setting Five general practices in
three settings in the United Kingdom.  Participants 847
consecutive patients, aged 16-80 years.  Main outcomes measures
Patient preferences and doctors' perception of patient pressure
and medical need.  Results Perceived medical need was the
strongest independent predictor of all behaviours and confounded
all other predictors. The doctors though