General practitioners show less empathy

Although what patients want most is a doctor who listens, provides support, and shows respect, general practitioners (GPs) mainly give medical information and advice. This has emerged from research conducted by Ligaya Butalid at the Netherlands Institute for Health Services Research (NIVEL) for her doctoral thesis. She received her PhD on January 16. 

GPs and patients feel that the quality of communication in the doctor’s office has improved following the introduction of evidence-based clinical guidelines. Over the years, GPs have also become more aware of the psychosocial aspects that can play a role in physical problems. Yet over time they have also become less empathic, and patients don’t always mention their concerns.
 
The medical consultation – during which GP and patient discuss health problems, possible diagnoses, and treatments – plays a major role in health care. The way in which GPs and patients communicate with each other is influenced by the context in which the consultation takes place – and this context is always changing. For example, there are now more clinical guidelines and more doctors who work part-time than there were thirty years ago. In the research she conducted for her doctoral thesis, Ligaya Butalid studied how this changing context affects doctor-patient communication during GP consultations.
 
She used 824 videos of actual GP consultations – for hypertension, psychosocial problems, or low back pain – to study how communication between GPs and patients has changed over the years. The video material was collected between 1977 and 2008 by NIVEL for previous studies on doctor-patient communication, and shows how this has developed over the course of thirty years.
 
Her study shows that GPs are still trying to find the right balance between evidence-based medicine and patient-centred care. She also found that patients are less assertive than is often assumed. Ligaya Butalid: “By definition, patients remain dependent on their doctor. Because of this, they have to be given enough space to express their doubts and fears during consultations. GPs have to devote attention not only to the disease, but also to the person who has it.”