The search for reliable and valid measures of patient-centredness

Abstract

While patient-centredness in medical consultations has often been advocated, there are no standard measures for it and relatively little empirical evidence for its beneficial effects. Using the transcripts of 210 general practice consultations we applied two different measures of patient-centredness, and related the results to doctor and patient satisfaction with the consultations and consultation length. One measure was based on combined Verbal Response Modes indicative of Doctor Receptiveness and Patient Involvement, and the other measure was based on global ratings of the extent to which doctors solicited patient views, responded to them, related information to them, involved the patient in decision-making and checked their understanding. There was little relationship between patient satisfaction and patient-centredness of the consultations; more patient-centred consultations tended to last longer and to deal with psychosocial or complex problems, and were related to relative doctor dissatisfaction. It is important that recommendations made to medical practitioners about their professional communication skills should take account of the time and knowledge constraints within medical practice.