Developing a new line of patter: can doctors change their consultations for sore throat?

Doctors report pressure from peers to reduce prescribing of antibiotics for minor respiratory illnesses, and from patients to do the opposite. It has been suggested that doctors adopt a more patient-centred consulting style in order to encourage patient satisfaction and shared decision-making. No evidence exists that such changes are achievable. We developed a new, on-site method for training postgraduates and used this for teaching patient-centred intervention. Here, we examine whether this training method is associated with changes in consulting patterns in consultations for sore throat with children, among doctors from a single group practice.

Audiotaped consultations (simulated and real) conducted before and after training were analysed and interviews were carried out with participants about the impact of training.

A general practice in South Wales.

Four general practitioners who consulted with 25 real and simulated patients participated in the study.

Four patient-centred skills used by doctors and 2 patient behaviours measured before and after training were identified.

Three out of 4 practitioners produced clear evidence of changes in patient-centred consulting skills. These changes were evident in simulated and real consultations 2 and 4 weeks later, respectively. Prior to training the doctors produced only five examples of patient-centred skills in 10 consultations. After training they produced 39 examples in 15 consultations.

Evidence from both consultations and interviews indicated that the intervention and training were well received and had been put into practice.