Do our talks with patients meet their expectations?
Yes, for the most part they do. Results of this study, however, reveal specific areas that require greater attention.
Physician gender often makes a difference. Our findings suggest that female doctors are more affective and task-oriented when talking with their patients than are male doctors, especially with female patients. In view of the steady increase of female doctors in general practice, this combined communication style may become more common in the future.
Psychosocial complaints prompt affective communication. Patients with a psychosocial problem are more likely to encounter an affective doctor than those with a biomedical problem. The growing number of psychosocial problems in the population may lead to a more affective communication.
Eventually the demand and the supply of affective communication may coincide. However, it is a challenge for every doctor to keep his or her mind open to both biomedical (task-oriented) and psychosocial (affective-oriented) information.31
Study caveats. Because we used scale scores for affect- and task-oriented preferences instead of the separate item scores for patient preferences, the reflection of preferences for GP communicative behavior might be somewhat overestimated. Likewise, we used total observation scores for affect- and task-oriented talk instead of the separate RIAS categories. More detailed measures of such communication aspects as empathy might give better insight into patient preferences.
Final thoughts on personal application. Primary care physicians would do well to take notice of patients’ preferences for communication. GPs in our study were often able to grasp what patients considered important to talk about, and there seemed to be only modest mismatches between patient expectations and physician behavior. To increase the quality of health care, consider asking patients at the end of a visit whether their preferences were met.
Acknowledgments
We acknowledge the participating general practitioners and patients, the observers of the videotaped consultations, and the Ministry of Health, Welfare and Sports for funding (for the greater part) the research project.
Correspondence
A. van den Brink-Muinen, PhD, NIVEL, PO Box 1568, 3500 BN Utrecht, The Netherlands; a.vandenbrink@nivel.nl
