• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
Br J Gen Pract. Sep 1999; 49(446): 711–716.
PMCID: PMC1313498

The patient-centredness of consultations and outcome in primary care.

Abstract

BACKGROUND: There is general support for general practitioners (GPs) using patient-centred styles. However, there is limited British evidence of beneficial outcomes for patients from such styles. AIM: To explore whether, for patients presenting for new episodes of care, the GP's consulting style, specifically the patient-centredness of the consultation, is related to five generic outcomes. METHOD: General practitioners in South Wales were recruited, and one surgery consulting session was audiotape recorded for each participating clinician. Questionnaires were given to consenting patients before their consultations, immediately afterwards, and, by post, at two weeks to measure the following outcomes: doctor-patient agreement (on the nature of the problem and management), patient satisfaction, resolution of symptoms, resolution of concerns, and functional health status. From the patients consulting for a new episode of care and completing all three questionnaires, one patient was selected at random for each GP and the audiotape of their consultation rated for patient-centredness. Statistical analysis employed correlation coefficients and t-tests, followed by multiple regression and logistic regression to control for potential confounders. RESULTS: In total, 143 patients consulting 143 GPs were studied. The patient-centred score was positively and statistically significantly associated with patient satisfaction (Pearson correlation = 0.28; P = 0.002). No other associations were found with the other outcomes measured. CONCLUSION: The study presents evidence that patient-centred styles of consulting produce benefits in terms of increased patient satisfaction for patients consulting for new episodes of care in Britain.

Full Text

The Full Text of this article is available as a PDF (68K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Hampton JR, Harrison MJ, Mitchell JR, Prichard JS, Seymour C. Relative contributions of history-taking, physical examination, and laboratory investigation to diagnosis and management of medical outpatients. Br Med J. 1975 May 31;2(5969):486–489. [PMC free article] [PubMed]
  • Hall JA, Roter DL, Katz NR. Meta-analysis of correlates of provider behavior in medical encounters. Med Care. 1988 Jul;26(7):657–675. [PubMed]
  • Simpson M, Buckman R, Stewart M, Maguire P, Lipkin M, Novack D, Till J. Doctor-patient communication: the Toronto consensus statement. BMJ. 1991 Nov 30;303(6814):1385–1387. [PMC free article] [PubMed]
  • Orth JE, Stiles WB, Scherwitz L, Hennrikus D, Vallbona C. Patient exposition and provider explanation in routine interviews and hypertensive patients' blood pressure control. Health Psychol. 1987;6(1):29–42. [PubMed]
  • Greenfield S, Kaplan SH, Ware JE, Jr, Yano EM, Frank HJ. Patients' participation in medical care: effects on blood sugar control and quality of life in diabetes. J Gen Intern Med. 1988 Sep-Oct;3(5):448–457. [PubMed]
  • Kaplan SH, Greenfield S, Ware JE., Jr Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Med Care. 1989 Mar;27(3 Suppl):S110–S127. [PubMed]
  • Horder J, Moore GT. The consultation and health outcomes. Br J Gen Pract. 1990 Nov;40(340):442–443. [PMC free article] [PubMed]
  • Thomas KB. General practice consultations: is there any point in being positive? Br Med J (Clin Res Ed) 1987 May 9;294(6581):1200–1202. [PMC free article] [PubMed]
  • Savage R, Armstrong D. Effect of a general practitioner's consulting style on patients' satisfaction: a controlled study. BMJ. 1990 Oct 27;301(6758):968–970. [PMC free article] [PubMed]
  • Levenstein JH, McCracken EC, McWhinney IR, Stewart MA, Brown JB. The patient-centred clinical method. 1. A model for the doctor-patient interaction in family medicine. Fam Pract. 1986 Mar;3(1):24–30. [PubMed]
  • Stewart MA. What is a successful doctor-patient interview? A study of interactions and outcomes. Soc Sci Med. 1984;19(2):167–175. [PubMed]
  • Brown J, Stewart M, McCracken E, McWhinney IR, Levenstein J. The patient-centred clinical method. 2. Definition and application. Fam Pract. 1986 Jun;3(2):75–79. [PubMed]
  • Henbest RJ, Stewart MA. Patient-centredness in the consultation. 1: A method for measurement. Fam Pract. 1989 Dec;6(4):249–253. [PubMed]
  • Henbest RJ, Stewart M. Patient-centredness in the consultation. 2: Does it really make a difference? Fam Pract. 1990 Mar;7(1):28–33. [PubMed]
  • Kinnersley P, Peters T, Stott N. Measuring functional health status in primary care using the COOP-WONCA charts: acceptability, range of scores, construct validity, reliability and sensitivity to change. Br J Gen Pract. 1994 Dec;44(389):545–549. [PMC free article] [PubMed]
  • Wolf MH, Putnam SM, James SA, Stiles WB. The Medical Interview Satisfaction Scale: development of a scale to measure patient perceptions of physician behavior. J Behav Med. 1978 Dec;1(4):391–401. [PubMed]
  • Kinnersley P, Stott N, Peters T, Harvey I, Hackett P. A comparison of methods for measuring patient satisfaction with consultations in primary care. Fam Pract. 1996 Feb;13(1):41–51. [PubMed]
  • Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307–310. [PubMed]
  • Maggs-Rapport F, Kinnersley P, Owen P. In-house referral: changing general practitioners' roles in the referral of patients to secondary care. Soc Sci Med. 1998 Jan;46(1):131–136. [PubMed]
  • Fitzpatrick RM, Hopkins AP, Harvard-Watts O. Social dimensions of healing: a longitudinal study of outcomes of medical management of headaches. Soc Sci Med. 1983;17(8):501–510. [PubMed]
  • Howie JG, Porter AM, Heaney DJ, Hopton JL. Long to short consultation ratio: a proxy measure of quality of care for general practice. Br J Gen Pract. 1991 Feb;41(343):48–54. [PMC free article] [PubMed]
  • Davis MS. Variations in patients' compliance with doctors' advice: an empirical analysis of patterns o communication. Am J Public Health Nations Health. 1968 Feb;58(2):274–288. [PMC free article] [PubMed]
  • Little P, Williamson I, Warner G, Gould C, Gantley M, Kinmonth AL. Open randomised trial of prescribing strategies in managing sore throat. BMJ. 1997 Mar 8;314(7082):722–727. [PMC free article] [PubMed]
  • Butler CC, Rollnick S, Kinnersley P, Jones A, Stott N. Reducing antibiotics for respiratory tract symptoms in primary care: consolidating 'why' and considering 'how'. Br J Gen Pract. 1998 Dec;48(437):1865–1870. [PMC free article] [PubMed]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...