title: Computer use in primary care and patient-physician communication.
abstract: OBJECTIVE
  This study evaluated how physicians and patients perceive the impact of computer use on clinical communication, and how a patient-centered orientation can influence this impact.
  
  
  METHODS
  The study followed a descriptive cross-sectional design and included 106 family physicians and 392 patients. An original questionnaire assessed computer use, participants' perspective of its impact, and patient centered strategies.
  
  
  RESULTS
  Physicians reported spending 42% of consultation time in contact with the computer. A negative impact of computer in patient-physician communication regarding the consultation length, confidentiality, maintaining eye contact, active listening to the patient, and ability to understand the patient was reported by physicians, while patients reported a positive effect for all the items. Physicians considered that the usual computer placement in their consultation room was significantly unfavorable to patient-physician communication.
  
  
  CONCLUSIONS
  Physicians perceive the impact of computer use on patient-physician communication as negative, while patients have a positive perception of computer use on patient-physician communication.
  
  
  CONCLUSIONS
  Consultation support can represent a challenge to physicians who recognize its negative impact in patient centered orientation. Medical education programs aiming to enhance specific communication skills and to better integrate computer use in primary care settings are needed.
authors.affiliation: Family Health Unit of Ramalde, Health Centres Grouping of Porto Ocidental, Porto, Portugal; Department of Clinical Neurosciences and Mental Health, Medical Psychology Unit, Faculty of Medicine, University of Porto, Porto, Portugal. Electronic address: djsobral@med.up.pt.
authors.forename: Dilermando
authors.initials: D
authors.lastname: Sobral
authors.affiliation: Department of Family Medicine, University of Iowa Carver College of Medicine, Iowa City, USA.
authors.forename: Marcy
authors.initials: M
authors.lastname: Rosenbaum
authors.affiliation: Department of Clinical Neurosciences and Mental Health, Medical Psychology Unit, Faculty of Medicine, University of Porto, Porto, Portugal.
authors.forename: Margarida
authors.initials: M
authors.lastname: Figueiredo-Braga