Physician-patient communication:: A study on the observed behaviours of specialty physicians and the ways their patients perceive them

Objective: To explore the communicative behaviours as used by specialty physicians, and their patients' perception of the communicative act as well as their satisfaction with the encounter. Methods: Cross-sectional study involving 27 specialty physicians and 257 outpatients. Encounters were video-recorded and analysed through the GATHA-ESP scale. Patients rated the quality of the interaction and their satisfaction with it in a questionnaire. Results: Most specialist doctors use a managerial style where there is no exploration of their patients' emotions (22%), expectations (28%) or psychosocial aspects (10-20%). Less than one doctor out of every four ever gave the patient an opportunity to participate in any type of decision making at the surgery. Patients were more satisfied with those encounters they felt more patient-centred (F: 11.37;p < 0.001); higher scores on the GATHA-ESP characterised these visits. Conclusions: Specialty physicians show a limited range of communicative skills as they use a doctor-centred style that allows for little patient participation. Patients' perceptions of patient-centeredness are linked to satisfaction more than the analysis of doctors' behaviour at the consultation does. Practice implications: It seems important to foster training in communication skills in the different specialist vocational training programs. Studies on physician-patient communication should deal with the perceived and observed perspectives on this domain. (c) 2006 Elsevier Ireland Ltd. All rights reserved.