Patient assertiveness and visit outcome in primary care: An observational study

In recent years, there has been growing attention to patient assertiveness in interactions with healthcare providers. This observational study examines patient assertiveness and visit outcomes during routine general practitioner (GP) visits in the Netherlands.

Video-recorded visits (n = 189) were analysed using a systematic coding protocol.

Patients expressed a median of 2 assertive behaviours per visit (IQR, 1-3), with the majority being self-initiated. Around one in eight patients did not express any assertive behaviour during the visit. Assertiveness was most commonly demonstrated through introducing new topics, with disagreements and direct requests being less frequent. Patients whose visit outcome involved treatment or a referral had behaved assertively more often than those receiving advice or reassurance.

This study could serve as a starting point for assessing patient assertiveness in primary care.

These findings suggest that patient assertiveness influences the visit outcome, highlighting the need for future research to assess whether this leads to variations in care and care outcomes.