What do General Practitioners Discuss with their Patients?

Abstract

Thirty audiotaped and transcribed general practice consultations were used to develop a classification scheme to code the content of doctor–patient communication in primary care. Open coding was used to identify subject matter discussed by general practitioners in consultations featuring commonly presented problems such as respiratory, psychological and musculoskeletal complaints. The classification scheme was found to have an adequate inter-rater reliability (0.72) and was used in a pilot study to code a further 75 consultations featuring psychological problems as the main presenting complaints. Multivariate analysis of variance showed significant relationships between what was discussed by general practitioners and the type of treatment decisions made ( F(16, 51) 2.12, p .01). Consultations in which general practitioners talked to their patients about mental coping strategies, social support and treatment options were less likely to end with decisions to prescribe drugs than consultations in which general practitioners did not discuss these subjects.