Association between doctor-patient familiarity and patient-centred care during general practitioner's consultations: a direct observational study in Chinese primary care practice

Chenwen Zhong,Zhuojun Luo,Mengping Zhou,Lina Li,Cuiying Liang,Li Kuang

doi:10.1186/s12875-021-01446-4

Chenwen Zhong, Zhuojun Luo + Show 4 more

Open Access

https://doi.org/10.1186/s12875-021-01446-4

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Abstract

BackgroundPatient-centred care is a core attribute of primary care. Not much is known about the relationship between patient-centred care and doctor-patient familiarity. This study aimed to explore the association between general practitioner (GP) perceived doctor-patient familiarity and the provision of patient-centred care during GP consultations.MethodsThis is a direct observational study conducted in eight community health centres in China. Level of familiarity was rated by GPs using a dichotomized variable (Yes/No). The provision of patient-centred care during GP consultations was measured by coding audiotapes using a modified Davis Observation Code (DOC) interactional instrument. Eight individual codes in the modified DOC were selected for measuring the provision of patient-centred care, including ‘family information’, ‘treatment effects’, ‘nutrition guidance’, ‘exercise guidance’, ‘health knowledge’, ‘patient question’, ‘chatting’, and ‘counseling’. Multivariate analyses of covariance were adopted to evaluate the association between GP perceived doctor-patient familiarity and patient-centred care.ResultsA total of 445 audiotaped consultations were collected, with 243 in the familiar group and 202 in the unfamiliar group. No significant difference was detected in overall patient-centred care between the two groups. For components of patient-centred care, the number of intervals (1.36 vs 0.88, p = 0.026) and time length (7.26 vs. 4.40 s, p = 0.030) that GPs spent in ‘health knowledge’, as well as time length (13.0 vs. 8.34 s, p = 0.019) spent in ‘patient question’ were significantly higher in unfamiliar group. The percentage of ‘chatting’ (11.9% vs. 7.34%, p = 0.012) was significantly higher in the familiar group.ConclusionsThis study suggested that GP perceived doctor-patient familiarity may not be associated with GPs’ provision of patient-centred care during consultations in the context of China. Not unexpectedly, patients would show more health knowledge and ask more questions when GPs were not familiar with them. Further research is needed to confirm and expand on these findings.

Highlights

Patient-centred care is a core attribute of primary care
The main purpose of this study is to investigate the relationship between general practitioner (GP) perceived doctor-patient familiarity and the provision of patientcentred care in the consultations
Study design This study was part of a direct observational study of primary care that provided a profile of GP consultations in community health centres (CHCs) in China [15]

Summary

Introduction

Patient-centred care is a core attribute of primary care. Not much is known about the relationship between patient-centred care and doctor-patient familiarity. Patient-centred care is a core value of general practice and is often connected to high quality of patient care, with a definition of providing care responsive to patient preferences, needs, and values and ensuring that patient values guide all clinical decisions [1, 2] It indicates that patients’ values and preferences are becoming the guidance of all aspects of health care for supporting their realistic health and life goals [3]. Patient-centred care may increase patient satisfaction and empowerment, as well as reduce symptom severity, rate of referral, and health costs [5, 6] Another important concept for general practice is doctor-patient familiarity [7].

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