Expectation of the Ideal General Practitioner VS Reality: the female view in Portugal (Preprint)

Abstract

Background: The effectiveness and success of health care delivery depends, in part, on the doctor-patient relationship that is established. General Practitioners (GPs) work towards developing an effective relationship by preparing the context and environment surrounding the appointment. For patients, both human aspects and the environment surrounding the appointment are considered in their perception of satisfaction, but the real weight of each variable in this encounter is unknown.

Objective: to determine which variables of the doctor and the GP consultation have the greatest impact on patients’ satisfaction and ascertain which variables are most frequently fulfilled at the consultation. Methods: observational, cross-sectional and analytical study, applied to adult women aged 18 years or more residing in Portugal, who answered an online survey from 18th january to 31st march 2022. Following a descriptive analysis of the population included, a logistic regression was built to find the sociodemographic and GP or appointment characteristics with the greatest impact on the female patient's overall satisfaction. Furthermore, we tried to establish a relationship between the expectations regarding the ideal doctor and the consultation method, and what they observe in reality.

Methods: observational, cross-sectional and analytical study, applied to adult women aged 18 years or more residing in Portugal, who answered an online survey from 18th january to 31st march 2022. Following a descriptive analysis of the population included, a logistic regression was built to find the sociodemographic and GP or appointment characteristics with the greatest impact on the female patient's overall satisfaction. Furthermore, we tried to establish a relationship between the expectations regarding the ideal doctor and the consultation method, and what they observe in reality.

Results: We obtained a total of 1204 responses. Prior to the consultation, the variables "satisfaction with the age of the GP" (p=.028, Exp (B)=2.807, CI=1.117 - 7.050) and "time passed since the last appointment" (p=.000, Exp (B)=.387, CI=.247 - 0.607) significantly affect overall satisfaction, decreasing with increasing time interval between appointments. During the appointment, satisfaction with the way they are greeted by their GP (p=.002, Exp (B)=2.737, CI=1.438 - 5.208), feeling that problems are important to him (p=.001, Exp (B)=3.536, CI=1.712 - 7.303) and use of technical medical terms (p=.006, Exp (B)=.394, CI=.202-.770), also significantly impact overall satisfaction. As expected, the use of medical terms negatively affects satisfaction with the physician. At the end of the consultation, asking about existing doubts increases the satisfaction of female users towards the GP (p=.002, Exp (B)= 2.755, CI=1.437-5.283). The expectation that the physician wears a white coat was correlated with their effective use both in the group of women satisfied with their physician (p= .000, V= .319) and in the group of women not satisfied (p= .000, V= .296).

Discussion: This study allowed us to verify which characteristics of the GP and his consultation are more relevant in patients overall satisfaction. Shortening the waiting time for an appointment and investing in medical training, particularly in the clinical interview method, are measures that will increase patient satisfaction. Some previously standardised behaviours, such as wearing a medical white coat, can be discussed with patients, making this a shared doctor-patient decision.

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