General practitioners empathy and health outcomes: a prospective observational study of consultations in areas of high and low deprivation

Mercer, S. W., Higgins, M., Bikker, A. M., Fitzpatrick, B., McConnachie, A., Lloyd, S. M., Little, P. and Watt, G. C. M. (2016) General practitioners empathy and health outcomes: a prospective observational study of consultations in areas of high and low deprivation. Annals of Family Medicine, 14(2), pp. 117-124. (doi:10.1370/afm.1910) (PMID:26951586) (PMCID:PMC4781514)

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Abstract

PURPOSE We set out to compare patients’ expectations, consultation characteristics, and outcomes in areas of high and low socioeconomic deprivation, and to examine whether the same factors predict better outcomes in both settings. METHODS Six hundred fifty-nine patients attending 47 general practitioners in high- and low-deprivation areas of Scotland participated. We assessed patients’ expectations of involvement in decision making immediately before the consultation and patients’ perceptions of their general practitioners’ empathy immediately after. Consultations were video recorded and analyzed for verbal and non-verbal physician behaviors. Symptom severity and related well-being were measured at baseline and 1 month post-consultation. Consultation factors predicting better outcomes at 1 month were identified using backward selection methods. RESULTS Patients in deprived areas had less desire for shared decision-making (P <.001). They had more problems to discuss (P = .01) within the same consultation time. Patients in deprived areas perceived their general practitioners (GPs) as less empathic (P = .02), and the physicians displayed verbal and nonverbal behaviors that were less patient centered. Outcomes were worse at 1 month in deprived than in affluent groups (70% response rate; P <.001). Perceived physician empathy predicted better outcomes in both groups. CONCLUSIONS Patients’ expectations, GPs’ behaviors within the consultation, and health outcomes differ substantially between high- and low-deprivation areas. In both settings, patients’ perceptions of the physicians’ empathy predict health outcomes. These findings are discussed in the context of inequalities and the “inverse care law.”

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McConnachie, Dr Alex and Watt, Professor Graham and Fitzpatrick, Dr Bridie and Higgins, Ms Maria and Mercer, Professor Stewart and Bikker, Ms Annemieke and Lloyd, Miss Suzanne
Authors: Mercer, S. W., Higgins, M., Bikker, A. M., Fitzpatrick, B., McConnachie, A., Lloyd, S. M., Little, P., and Watt, G. C. M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Annals of Family Medicine
Publisher:Annals of Family Medicine, Inc
ISSN:1544-1709
ISSN (Online):1544-1717

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
388141Verbal and non-verbal communication in the consultation, patients' ratings of quality, and subsequent outcomes in general practice in areasStewart MercerScottish Executive Health Department (SEHHD-CSO)CZH/4/267IHW - GENERAL PRACTICE & PRIMARY CARE