Communication in general practice: differences between European countries

Area of Science:

• General Practice
• Health Services Research
• Cross-cultural Communication

Background:

• Healthcare system variations, including the gatekeeping role of General Practitioners (GPs), may influence doctor-patient communication across European countries.
• Diverging characteristics of GPs and patients at the microlevel also contribute to communication differences.

Purpose of the Study:

• To compare doctor-patient communication in general practice across different European countries.
• To investigate the impact of gatekeeping systems and GP/patient characteristics on doctor-patient communication.

Main Methods:

• A study involving 190 GPs and 2825 patients from six European countries (gatekeeping: Netherlands, Spain, UK; non-gatekeeping: Belgium, Germany, Switzerland).
• Data collection via patient and GP questionnaires and observation of videotaped consultations.
• Analysis using one-way and multilevel, multivariate statistical methods.

Main Results:

• Significant cross-country differences were observed in affective/instrumental behavior, biomedical/psychosocial talk, GP gaze, and consultation length.
• The gatekeeping role of GPs was found to be less influential on communication than anticipated.
• Patient factors (gender, age, psychosocial issues, familiarity) and GP characteristics were key predictors of communication variations.

Conclusions:

• The gatekeeping function of GPs has minimal impact on doctor-patient communication, contrary to expectations.
• Doctor-patient communication dynamics are more complex, with patient and GP characteristics playing a more significant role.
• Future research should incorporate cultural factors to further elucidate communication patterns.