title: Depth of the patient-doctor relationship and content of general practice consultations: cross-sectional study.
abstract: BACKGROUND
  Patient-doctor continuity is valued by both parties, yet the effect of the depth of the patient-doctor relationship on the content of consultations in general practice is unknown.
  
  
  OBJECTIVE
  To assess whether differences in the depth of relationship between a patient and their GP affects the length of consultations, and the number and type of problems and issues raised during a consultation.
  
  
  METHODS
  Cross-sectional study in 22 GP practices in the UK.
  
  
  METHODS
  GP consultations (n = 229) were videotaped and the number of problems and aspects of those problems and issues identified. Patients completed the Patient-Doctor Depth of Relationship (PDDR) and General Practice Assessment Questionnaire-communication (GPAQc) scales. Associations were explored using multivariable linear and logistic regression.
  
  
  RESULTS
  Complete data were available on 190 participants consulting 30 GPs. In unadjusted analysis, patients with a deep relationship with their GP discussed more problems (mean 2.8) and issues (mean 4.7) compared with those with a moderate (2.4 problems; 4.0 issues) or shallow (2.3 problems; 3.8 issues) relationship. Patients with deep relationships had consultations that were on average 118 seconds (95% CI = 1 to 236) longer than those with shallow relationships. Adjustment for participant and GP factors attenuated these relationships, although the main trends persisted.
  
  
  CONCLUSIONS
  A greater number of problems and issues may be raised in a consultation when patients have a deeper relationship with their GP. Over several clinical encounters each year, this may be associated with significant benefits to patients and efficiencies in GP consultations and warrants further investigation.
authors.affiliation: University of Bristol, Bristol.
authors.forename: Samuel William David
authors.initials: SW
authors.lastname: Merriel
authors.affiliation: University of Bristol, Bristol.
authors.forename: Christopher
authors.initials: C
authors.lastname: Salisbury
authors.affiliation: University of Bristol, Bristol.
authors.forename: Chris
authors.initials: C
authors.lastname: Metcalfe
authors.affiliation: University of Bristol, Bristol.
authors.forename: Matthew
authors.initials: M
authors.lastname: Ridd
mesh_terms: D000328:Adult; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D012017:Referral and Consultation / Q000592:standards*; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D014741:Video Recording
keywords: consultation; continuity of care; doctor-patient relations; general practice