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Multicenter Study
. 2015 Aug;65(637):e545-51.
doi: 10.3399/bjgp15X686125.

Depth of the patient-doctor relationship and content of general practice consultations: cross-sectional study

Samuel William David Merriel  1 , Christopher Salisbury  1 , Chris Metcalfe  1 , Matthew Ridd  1
Affiliations
Multicenter Study

Depth of the patient-doctor relationship and content of general practice consultations: cross-sectional study

Samuel William David Merriel et al. Br J Gen Pract. 2015 Aug.

Abstract

Background: Patient-doctor continuity is valued by both parties, yet the effect of the depth of the patient-doctor relationship on the content of consultations in general practice is unknown.

Aim: To assess whether differences in the depth of relationship between a patient and their GP affects the length of consultations, and the number and type of problems and issues raised during a consultation.

Design and setting: Cross-sectional study in 22 GP practices in the UK.

Method: GP consultations (n = 229) were videotaped and the number of problems and aspects of those problems and issues identified. Patients completed the Patient-Doctor Depth of Relationship (PDDR) and General Practice Assessment Questionnaire-communication (GPAQc) scales. Associations were explored using multivariable linear and logistic regression.

Results: Complete data were available on 190 participants consulting 30 GPs. In unadjusted analysis, patients with a deep relationship with their GP discussed more problems (mean 2.8) and issues (mean 4.7) compared with those with a moderate (2.4 problems; 4.0 issues) or shallow (2.3 problems; 3.8 issues) relationship. Patients with deep relationships had consultations that were on average 118 seconds (95% CI = 1 to 236) longer than those with shallow relationships. Adjustment for participant and GP factors attenuated these relationships, although the main trends persisted.

Conclusion: A greater number of problems and issues may be raised in a consultation when patients have a deeper relationship with their GP. Over several clinical encounters each year, this may be associated with significant benefits to patients and efficiencies in GP consultations and warrants further investigation.

Keywords: consultation; continuity of care; doctor-patient relations; general practice.

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Figures

Figure 1.
Figure 1.
Patient selection flow diagram.
Figure 2.
Figure 2.
Distribution of Patient–Doctor Depth of Relationship scale (PDDR).
See this image and copyright information in PMC

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