Physician-patient communication: a study on the observed behaviours of specialty physicians and the ways their patients perceive them.
OBJECTIVE
To explore the communicative behaviours as used by specialty physicians, and their patients' perception of the communicative act as well as their satisfaction with the encounter.


METHODS
Cross-sectional study involving 27 specialty physicians and 257 outpatients. Encounters were video-recorded and analysed through the GATHA-ESP scale. Patients rated the quality of the interaction and their satisfaction with it in a questionnaire.


RESULTS
Most specialist doctors use a "managerial" style where there is no exploration of their patients' emotions (22%), expectations (28%) or psychosocial aspects (10-20%). Less than one doctor out of every four ever gave the patient an opportunity to participate in any type of decision making at the surgery. Patients were more satisfied with those encounters they felt more patient-centred (F: 11.37; p<0.001); higher scores on the GATHA-ESP characterised these visits.


CONCLUSIONS
Specialty physicians show a limited range of communicative skills as they use a doctor-centred style that allows for little patient participation. Patients' perceptions of patient-centeredness are linked to satisfaction more than the analysis of doctors' behaviour at the consultation does.


CONCLUSIONS
It seems important to foster training in communication skills in the different specialist vocational training programs. Studies on physician-patient communication should deal with the perceived and observed perspectives on this domain.
Ruiz-Moral
Roger
R
Family Medicine Teaching Unit, Cordoba School of Medicine, COGRAMA Group, Spanish Primary Care Research Network (redIAPP), Spain. roger.ruiz.sspa@juntadeandalucia.es
Pérez Rodríguez
Esperanza
E
Pérula de Torres
Luis Angel
LA
de la Torre
Javier
J
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001318:Authoritarianism; D002983:Clinical Competence; D003142:Communication; D003430:Cross-Sectional Studies; D003657:Decision Making; D004501:Education, Medical; D005260:Female; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006780:Hospitals, Rural; D006786:Hospitals, Urban; D006801:Humans; D016015:Logistic Models; D008297:Male; D008511:Medicine / Q000458:organization & administration; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology*; D010358:Patient Participation / Q000523:psychology; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations; D013030:Spain; D013038:Specialization; D011795:Surveys and Questionnaires