Non-obtrusive sources and secondary actors

Abstract

In general practice we often use many peripheral little bits of information to help us make our diagnoses and to organise our management plans. Like the title of this column they are the peripheralia and marginalia that we glean, almost subconsciously, from items or artifacts that are apart from the patient’s grand narrative. It might be a photograph, a throw away comment by a staff member or a relative, a letter written to us by the patient or a paragraph in a local newspaper or some form of self-observation or reaction that one has to a patient. These sources of information from our peripheral vision and practice background are called nonobtrusive sources and the persons who interact with the index patient and ourselves are called secondary actors.