title: The workload of general practitioners does not affect their awareness of patients' psychological problems.
abstract: OBJECTIVE
  To investigate if general practitioners (GPs) with a higher workload are less inclined to encourage their patients to disclose psychological problems, and are less aware of their patients' psychological problems.
  
  
  METHODS
  Data from 2095 videotaped consultations from a representative selection of 142 Dutch GPs were used. Multilevel regression analyses were performed with the GPs' awareness of the patient's psychological problems and their communication as outcome measures, the GPs' workload as a predictor, and GP and patient characteristics as confounders.
  
  
  RESULTS
  GPs' workload is not related to their awareness of psychological problems and hardly related to their communication, except for the finding that a GP with a subjective experience of a lack of time is less patient-centred. Showing eye contact or empathy and asking questions about psychological or social topics are associated with more awareness of patients' psychological problems.
  
  
  CONCLUSIONS
  Patients' feelings of distress are more important for GPs' communication and their awareness of patients' psychological problems than a long patient list or busy moment of the day. GPs who encourage the patient to disclose their psychological problems are more aware of psychological problems.
  
  
  CONCLUSIONS
  We recommend that attention is given to all the communication skills required to discuss psychological problems, both in the consulting room and in GPs' training. Additionally, attention for gender differences and stress management is recommended in GPs' training.
authors: NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands. e.zantinge@nivel.nl
authors: Else M
authors: EM
authors: Zantinge
authors: Peter F M
authors: PF
authors: Verhaak
authors: Dinny H
authors: DH
authors: de Bakker
authors: Jan J
authors: JJ
authors: Kerssens
authors: Klaas
authors: K
authors: van der Meer
authors: Jozien M
authors: JM
authors: Bensing
mesh_terms: D000328:Adult; D003142:Communication; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D012044:Regression Analysis; D012944:Social Support; D016526:Workload