title: Consulting room computers and their effect on general practitioner-patient communication.
abstract: BACKGROUND
  in the western medical world, computers form part of the standard equipment in the consulting rooms of most GPs. As the use of a computer requires time and attention from GPs, this may well interfere with the communication process. Yet, the information accessed on the computer may also enhance communication.
  
  
  OBJECTIVE
  the present study affords insight into the relationship between computer use and GP-patient communication recorded by the same GPs over two periods.
  
  
  METHODS
  videotaped GP consultations collected in 2001 and 2008 were used to observe computer use and GP-patient communication. In addition, patients questionnaires about their experiences with communication by the GP were analysed using multilevel models with patients (Level 1) nested within GPs (Level 2).
  
  
  RESULTS
  both in 2008 and in 2001, GPs used their computer in almost every consultation. Still, our study showed a change in computer use by the GPs over time. In addition, the results indicate that computer use is negatively related to some communication aspects: the patient-directed gaze of the GP and the amount of information given by GPs. There is also a negative association between computer use and the body posture of the GP. Computer use by GPs is not associated with other (analysed) non-verbal and verbal behaviour of GPs and patients. Moreover, computer use is scarcely related to patients' experiences with the communication behaviour of the GP.
  
  
  CONCLUSIONS
  GPs show greater reluctance to use computers in 2008 compared to 2001. Computer use can indeed affect the communication between GPs and patients. Therefore, GPs ought to remain aware of their computer use during consultations and at the same time keep the interaction with the patient alive.
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), PO Box 1568, 3500 BN Utrecht, The Netherlands. j.noordman@nivel.nl
authors.forename: Janneke
authors.initials: J
authors.lastname: Noordman
authors.forename: Peter
authors.initials: P
authors.lastname: Verhaak
authors.forename: Ilse
authors.initials: I
authors.lastname: van Beljouw
authors.forename: Sandra
authors.initials: S
authors.lastname: van Dulmen
mesh_terms: D003142:Communication; D003201:Computers; D058005:General Practitioners / Q000523:psychology*; D006801:Humans; D009633:Nonverbal Communication; D009819:Office Visits; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000379:methods*; D014705:Verbal Behavior