Effect of a general practitioner's consulting style on patients' satisfaction: a controlled study.

Abstract

OBJECTIVE--To compare the effect of directing and sharing styles of consultation by a general practitioner on patients' satisfaction with the consultation. DESIGN--Patients were randomised to receive a directing or sharing style in the part of the consultation concerned with giving treatment, advice, and prognosis. SETTING--An inner London general practice. PATIENTS--359 Randomly selected patients consulting with one general practitioner. Four patients refused to participate and five were excluded. Thirty failed to complete the initial assessment and 110 failed to complete the assessment a week later, giving response rates of 89% and 58% respectively. MAIN OUTCOME MEASURES--Patients' satisfaction with the general practitioner's perceived understanding of their problem and the explanation they received and whether they felt that they had been helped immediately after the consultation and one week later. RESULTS--Patients who had the directing style of consultation reported significantly higher levels of satisfaction on almost all the outcome measures. This was particularly striking for patients with physical problems (excellent explanation 23/68 (34%) v 10/65 (15%), p less than 0.02; excellent understanding 25/68 (37%) v 9/66 (14%), p = 0.004), and for patients who received a prescription (excellent explanation 20/60 (33%) v 9/59 (15%), p less than 0.04; excellent understanding 27/60 (45%) v 10/59 (17%), p = 0.04). There was no significant difference in the responses to the directing and sharing styles in longer consultations (8/31 (26%) v 8/31 (26%)), in which the main treatment was advice (10/30 (33%) v 7/36 (19%)), and among patients with psychological (6/17 (35%) v 6/27 (22%)) or chronic problems (14/28 (50%) v 8/32 (25%)). CONCLUSIONS--Style of consultation does influence the satisfaction of the patient, but its effect is most noticeable in consultations with patients with physical problems and patients who receive a prescription.