Doctor-patient communication in a musculoskeletal unit: relationship between an observer-rated structured scoring system and patient opinion.
OBJECTIVE
To investigate the ability of consultant rheumatologists and orthopaedic surgeons to communicate well with patients and to determine the validity of a structured proforma used to assess medical students' communication skills.


METHODS
Seventy new patient appointments with consultant rheumatologists and orthopaedic surgeons were assessed for communication skills exhibited by the consultants and patient satisfaction. Communication skills were assessed using a proforma previously used to examine medical students, and patient ratings were obtained using visual analogue scales.


RESULTS
Median scores attained using the structured proforma for rheumatology, elective orthopaedic and fracture clinic consultations were 17, 15 and 14 out of 20 (P < 0.05). Patient satisfaction scores were high in all three domains measured. Scores were statistically significantly higher for rheumatology appointments than in fracture clinic (median scores 29.5, 29.5 and 28 out of 30). Consultation durations varied, with a median of 23 min for rheumatology and 10.5 and 4 min for orthopaedic surgeons in clinic and fracture clinic, respectively.


CONCLUSIONS
Consultant rheumatologists and orthopaedic surgeons demonstrate good communication skills, according to a tool used to assess medical students. These scores correlate with patient views, suggesting that teaching and assessment of communication skills at medical schools may address concerns of patients. Scores and satisfaction correlate with the duration of the consultation.
O'Neill
J
J
University of Newcastle upon Tyne, UK.
Williams
J R
JR
Kay
L J
LJ
D002983:Clinical Competence; D003142:Communication; D004501:Education, Medical; D004521:Educational Measurement / Q000379:methods; D004739:England; D006757:Hospital Units / Q000592:standards; D006801:Humans; D016014:Linear Models; D009985:Orthopedics / Q000592:standards*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012017:Referral and Consultation / Q000592:standards; D015203:Reproducibility of Results; D012219:Rheumatology / Q000592:standards*; D013997:Time Factors