General practitioners' comments on video recorded consultations as an aid to understanding the doctor-patient...

The aim of this study was to describe, understand and interpret physicians' experiences of consultations. Forty-six consultations were videotaped in four primary health care centres. Twelve general practitioners and 46 patients participated. Afterwards the patients and the physicians (on different occasions) commented on the recorded consultations. The comments were analysed from an inductive as well as a hypothetical-deductive model. The analyses agreed well with each other. The result demonstrated that the physicians often had difficulties understanding the patient, that they did not really know how to handle the conversation and felt that they did not really understand the context. The perceived relation to the patient was mainly related to the patients' ability to give adequate information. It is concluded that a key factor in communication is the difficulty which the physician has in understanding what the patient in fact wants-the failure to be on the same wavelength so that the message from the patient can be received.