Abstract
Communication difficulties persist between patients and physicians. In order to improve care, patients’ experiences of this communication must be understood. The main objective of this study is to synthesize qualitative studies exploring patients’ experiences in communicating with a primary care physician. A secondary objective is to explore specific factors pertaining to ethnic minority or majority patients and their influence on patients’ experiences of communication. Pertinent health and social sciences electronic databases were searched systematically (PubMed, Cinahl, PsychNet, and IBSS). Fifty-seven articles were included in the review on the basis of being qualitative studies targeting patients’ experiences of communication with a primary care physician. The meta-ethnography method for qualitative studies was used to interpret data and the COREQ checklist was used to evaluate the quality of included studies. Three concepts emerged from analyses: negative experiences, positive experiences, and outcomes of communication. Negative experiences related to being treated with disrespect, experiencing pressure due to time constraints, and feeling helpless due to the dominance of biomedical culture in the medical encounter. Positive experiences are attributed to certain relational skills, technical skills, as well as certain approaches to care privileged by the physician. Outcomes of communication depend on patients’ evaluation of the consultation. Four categories of specific factors exerted mainly a negative influence on consultations for ethnic minorities: language barriers, discrimination, differing values, and acculturation. Ethnic majorities also raised specific factors influencing their experience: differing values and discrimination. Findings of this review are limited by the fact that more than half of the studies did not explore cultural aspects relating to this experience. Future research should address these aspects in more detail. In conclusion, all patients seemed to face additional cultural challenges. Findings provide a foundation for the development of tailored interventions to patients’ preferences, thus ensuring more satisfactory experiences. Health care providers should be sensitive to specific factors (cultural and micro-cultural) during all medical encounters.
Highlights
Physician-patient communication is a central element in primary care consultations and has been described as having specific purposes
Articles were first selected by reading the title, by examining the abstract, and last, by reading the full text
Physicians should strive to treat patients with dignity and respect in order to alleviate the harmful effects of negative experiences
Summary
Physician-patient communication is a central element in primary care consultations and has been described as having specific purposes. A favorable communication has been linked to many positive outcomes, such as patient satisfaction with care, higher quality of care and of physician-patient relationship, adherence to treatment, and to better objective physical outcomes [3,4,5,6,7,8]. Benefits associated to favorable physician-patient communication are well documented, communication difficulties in medical encounters persist. Inadequate communication has been linked to patient dissatisfaction with care, incomprehension of treatment plan, non-adherence to treatment, lower quality of care and of physician-patient relationship, overutilization or underutilization of resources, and medical errors [4, 7, 9, 10]
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