title: Familiarity between patient and general practitioner does not influence the content of the consultation.
abstract: BACKGROUND
  Personal continuity in general practice is considered to be a prerequisite of high quality patient care based on shared knowledge and mutual understanding. Not much is known about how personal continuity is reflected in the content of GP - patient communication. We explored whether personal continuity of care influences the content of communication during the consultation.
  
  
  METHODS
  Personal continuity was defined as the degree of familiarity between GP and patient, rated by both the GP and the patient. 394 videotaped consultations between GPs and patients aged 18 years and older were analyzed. GP - patient communication was evaluated with an observation checklist, which rated the following topics of conversation: (1) medical issues, (2) psychological themes, and (3) the social environment of the patient. For each of these topics we coded whether or not it received attention, and was built upon prior knowledge. Data were analyzed using multilevel logistic regression analyses.
  
  
  RESULTS
  No relationship was found between GP - patient familiarity and the discussion of medical issues, psychological themes, or the social environment of the patient. But if the patient and the GP knew each other very well, the GP more often displayed prior knowledge with the topic in question. Few patient and GP characteristics were associated with differences in content of communication.
  
  
  CONCLUSIONS
  Given the relatively small sample size, we carefully conclude that familiarity between a GP and a patient does not influence the content of the communication (medical issues, psychological themes nor topics relating to the social environment). This is remarkable because we expected that familiarity would 'open up the communication' for more psychological and social themes. GPs seem to have the communication skills to put both familiar and non-familiar patients at ease enabling them to freely raise any issue they think necessary.
authors.affiliation: NIVEL-Netherlands Institute for Health Services Research, Utrecht, the Netherlands. l.jabaaij@nivel.nl
authors.forename: Lea
authors.initials: L
authors.lastname: Jabaaij
authors.forename: Thijs
authors.initials: T
authors.lastname: Fassaert
authors.forename: Sandra
authors.initials: S
authors.lastname: van Dulmen
authors.forename: Arno
authors.initials: A
authors.lastname: Timmermans
authors.forename: Gerrit A
authors.initials: GA
authors.lastname: van Essen
authors.forename: François
authors.initials: F
authors.lastname: Schellevis
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003142:Communication; D003266:Continuity of Patient Care; D005194:Family Practice / Q000592:standards*; D005260:Female; D019538:Health Care Surveys; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011365:Professional Practice Location / Q000706:statistics & numerical data; D012931:Social Environment; D011795:Surveys and Questionnaires